May 22, 2007 -- Medications commonly used to
treat erection problems in men may also relieve the bothersome urinary symptoms
associated with an enlarged prostate gland, researchers say.
Studies on the topic were presented this week at the annual meeting of the
American Urological Association in Anaheim, Calif.
"Before, we looked at these two conditions as two different diseases," says
Kevin McVary, MD, professor of urology at Northwestern University Feinberg
School of Medicine in Chicago, who moderated a press briefing.
But in the past three or four years, he says, the thinking among urologists
Sexual performance in men seems to decline as their prostate enlargement becomes
more severe, experts have begun to notice. Doctors also notice that men with
milder prostate problems often have less erectile
dysfunction (ED) than do those with moderate or severely enlarged prostates
and urinary symptoms.
"These two diseases -- erectile dysfunction and the lower urinary tract
symptoms associated with benign
prostatic hyperplasia -- are probably linked," McVary says.
Prostate problems and ED problems both tend to increase with age. About 31%
of men aged 50 to 59 have an enlarged prostate (also known as benign prostatic
hyperplasia or BPH); 44% of those 70 and older have an enlarged prostate,
according to the National Institutes of Health. As the gland enlarges, it
constricts the urine-carrying tube called the urethra, making it difficult to
empty the bladder.
Common symptoms of BPH include weak urine stream, leaking or dribbling,
feeling that the bladder hasn't emptied completely after voiding, and more
Medications are prescribed to relieve the symptoms. Some medications work by
relaxing the muscles at the neck of the bladder and prostate; others inhibit a
hormone that contributes to the growth of the gland.
Erectile dysfunction, defined as an inability to get or keep an erection, is
experienced by 20% to 46% of men aged 40 to 69, according to the NIH.
Medications to treat erection problems help increase blood flow to the penis
when a man is sexually stimulated.
A once-a-day dose of Cialis helped men with erectile dysfunction and
moderate to severe urinary tract symptoms due to an enlarged prostate improve
sexual functioning, says Marc Gittelman, MD, a urologist in Aventura, Fla., and
a study researcher.
Of the 281 men who enrolled in the study, "81% were sexually active, and
they were in their low 60s," he says. All had moderate to severely enlarged
prostates and urinary problems; 68% of the sexually active men had a medical
history of erectile dysfunction. Gittelman's team assigned about half to take
placebo and half to take Cialis.
At the end of 12 weeks, men who took Cialis -- first 5 milligrams a day and
then up to 20 milligrams -- had significantly higher scores on a standard index
of erectile function, he says.