Editorial Comment from Dr Amano to Tadalafil is sufficiently effective for severe chronic prostatitis/chronic pelvic pain syndrome in patients with benign prostatic hyperplasia
Abstract
Phosphodiesterase type 5 inhibitors induce relaxation of smooth muscle in blood vessels, the urethra, prostate, bladder neck and so on. Tadalafil, one of the phosphodiesterase type 5 inhibitors, is applied for treatment of erectile dysfunction initially, followed by pulmonary hypertension and benign prostate hyperplasia (BPH). After the launch of tadalafil for BPH, several studies from Japanese institutions reported improvement in endothelial function as an additional effect of tadalafil. Thus, tadalafil might have some potency to improve various symptoms by increasing blood flow with relaxation of smooth muscle. Tadalafil is highly effective for the relief of BPH symptoms. In addition, many urologists expect tadalafil to be effective for chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS), which are causes of several bothersome lower urinary symptoms. However, tadalafil cannot be used to treat these disorders at present. Thus, there are limitations to clarifying the mechanism and efficacy of tadalafil for CP/ CPPS at this time. Under these difficult circumstances, the study by Hiramatsu et al. suggested efficacy of tadalafil for severe CP/CPPS in patients with BPH. In daily practice, we have many younger patients who suffer from CP/CPPS without BPH, accordingly we would like to treat them with tadalafil if it would be sufficiently effective. More evidence, including histological findings and clinical efficacy, is required, so prospective studies should be carried…
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