Evidence for the Additional Health Benefits Associated with Phosphodiesterase 5 Inhibitors when Used for Treating Erectile Dysfunction, with a Focus on Prostate Cancer Patients and Other Associated Conditions

Abstract

Erectile dysfunction (ED) affects the majority of prostate cancer (PCa) patients. Although phosphodiesterase 5 inhibitors (PDE5i) are the first-line treatment for ED and are strongly supported by evidence as safe and effective, they remain underutilised in PCa patients. Furthermore, there is a large evidence base that supports the association of PDE5i with favourable clinical outcomes in several different health conditions that are also often considered co-morbidities for men with PCa. We present this review to examine the evidence on favourable clinical outcomes associated with PDE5i use in a range of urological, cardiovascular, metabolic, and skeletal conditions. In men who have been treated for PCa, these co-morbidities are common and may even be exacerbated by treatment itself. The evidence base suggests that PDE5i could potentially co-treat several comorbidities in men treated for PCa in addition to ED, provided high-quality randomised controlled trials replicate and confirm the findings of observational studies and animal models. If validated, PDE5i may be prescribed in appropriately selected patients and exert its beneficial effects in these men post PCa treatment, not only improving health outcomes but also quality of life.