Should vardenafil be used for the treatment of lower urinary tract symptoms associated with BPH?

This Practice Point commentary discusses the study by Stief and colleagues, and the relationship between lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and benign prostatic hyperplasia (BPH). This randomized, placebo-controlled study analyzed the effects of the phosphodiesterase type 5 inhibitor vardenafil (a treatment for ED) on LUTS related to BPH. Significant improvements in LUTS were observed in patients in the vardenafil group compared with those in the placebo group, and improvements in erectile function and quality of life were reported in both groups. The treatment was well tolerated. The design of this study and the characteristics of the selected study populations were not typical for a BPH study. Consequently, while this study demonstrates that vardenafil is a promising treatment for symptoms secondary to BPH, including LUTS and ED, further studies are needed before phosphodiesterase type 5 inhibitors become a treatment for LUTS associated with BPH.