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Erectile Function Declines With LUTS Severity No ED 30 No Mild Incidence, % 20 10 22.3 21.1 18.9 14.9 19.2 18.3 15.8 12.4 15.3 13.2 Moderate Severe 10.3 7.5 0 50-59 Years 60-69 Years 70-79 Years Severe ED n=10,636 sexually active men within the last 4 weeks. McVary KT, et al. BJU Int. 2006;97(suppl 2):23-28. PMID: 16507050.
BPH-LUTS and ED Common Pathophysiologic Mechanisms Reduced NO– cGMP signaling Increased RhoA– ROCK signaling Autonomic hyperactivity Pelvic atherosclerosis FUNCTIONAL CONSEQUENCES AT TISSUE LEVEL (corpora cavernosa, prostate, urethra, and bladder functional alterations) • Reduced function of nerves and endothelium • Altered smooth muscle relaxation or contractility • Arterial insufficiency, reduced blood flow, and hypoxia-related tissue damage BPH-LUTS ED Chronic inflammation Steroid hormone unbalance Comorbidities Hypertension, Metabolic Syndrome, Diabetes, etc. cGMP, cyclic guanosine monophosphate; NO, nitric oxide; ROCK, Rho-associated protein kinase. Gacci M, et al. Eur Urol. 2011;60(4):809-825. PMID: 21726934.
Page 1 and 2: Gaining Ground in Men’s Genitouri
Page 3 and 4: Accreditation This program has been
Page 5 and 6: Learning Objectives ! Explain the s
Page 7 and 8: Matt T. Rosenberg, MD Disclosures S
Page 9 and 10: Disclosures ! Faculty of this CE ac
Page 11 and 12: Get Social with Us CMEOutfitters.co
Page 13 and 14: Georgia Association of Physician As
Page 15 and 16: Matt T. Rosenberg, MD Disclosures S
Page 17 and 18: In what percentage of your patients
Page 19 and 20: Function of the Prostate Normal Fun
Page 21 and 22: Benign Prostatic Hyperplasia ! A co
Page 23 and 24: Predominant Symptoms ! The enlarged
Page 25 and 26: Definition of OAB International Con
Page 27 and 28: How to differentiate the etiology o
Page 29 and 30: Common Comorbidities in BPH-LUTS Co
Page 31: Audience Response Question Fact: ED
Page 35 and 36: What to Keep in Mind in the Evaluat
Page 37 and 38: The Evaluation of LUTS: History, Ph
Page 39 and 40: Medications Can Cause or Exacerbate
Page 41 and 42: Laboratory Tests ! Urinalysis ! Inf
Page 43 and 44: Audience Response Question The most
Page 45 and 46: The Purpose of the Voiding Diary !
Page 47 and 48: Rosenberg MT, et al. Publication Pe
Page 49 and 50: STEP 1: Informed Surveillance If th
Page 51 and 52: Clinical Management Step2a: Alpha B
Page 53 and 54: Clinical Management Step2b: Phospho
Page 57 and 58: Antimuscarinics - Immediate Release
Page 59 and 60: ! Dry Mouth ! Constipation ! Headac
Page 61 and 62: Beta 3 Agonists Drug Mirabegron Dos
Page 63 and 64: Clinical Management Step3b: Adding
Page 65 and 66: 5 Alpha Reductase Inhibitors (5ARI)
Page 69 and 70: Clinical Connections: Summary ! Tre

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