Mechanism of Phosphodiesterase 5 Inhibitor relief of Prostatitis Symptoms

Background: Chronic prostatitis is a common urological complaint without clearly defined causation or definitive treatment. Hypothesis: Phosphodiesterase 5 (PDE5) Inhibitor mediated relaxation of prostatic duct smooth muscle increases washout of prostatic reflux products reducing prostatic inflammation and consequent prostatitis symptoms. Rationale of hypothesis: The presence of both Nitric Oxide Synthase and Phosphodiesterase 5 in human prostatic tissue and the effect of nitric oxide donors and PDE5 inhibitors in vitro indicate PDE5 inhibitors relax prostatic smooth muscle. Significant retrograde urinary flux into prostatic ducts has been described and suggested as the mechanism of chronic prostatitis. We postulate PDE5 inhibitors alter prostatic reflux hence prostatitis symptoms. Conclusion: PDE5 inhibitors may represent a simple, effective treatment for chronic prostatitis. (c) 2006 Elsevier Ltd. All rights reserved.