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Updated: May 14, 2026

Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility
Published on: May 30, 2025
[Medicinal therapy of benign prostate syndrome with phosphodiesterase-5 inhibitors]
A Herlemann1, C Gratzke, K-E Andersson
1Urologische Klinik und Poliklinik, Klinikum der Universität München-Großhadern, Marchioninistraße 15, Munich, Germany. annika.herlemann@med.uni-muenchen.de
Abstract:
Phosphodiesterase-5 (PDE5) inhibitors, such as sildenafil, tadalafil and vardenafil are first line treatment for erectile dysfunction (ED). These PDE5 inhibitors are known to increase cyclic guanosine monophosphate (cGMP) concentrations in the smooth muscle cells of the corpora cavernosa penis by inhibiting PDE5, leading to smooth muscle relaxation. This mode of action is also believed to result in prostatic smooth muscle relaxation and to improve lower urinary tract symptoms (LUTS). Randomized controlled trials have shown beneficial effects on LUTS and on objective parameters such as maximum urinary flow rate (tadalafil). Based on these data tadalafil was recently approved for treatment of patients with male LUTS; however, the mechanisms leading to improvement of symptoms are still under debate.
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