It is well accepted that phosphodiesterase type 5 inhibitors work on the lower urinary tract and PDE5 inhibitors are used as first line therapy for erectile dysfunction, but more recently the PDE5 inhibitors, namely sildenafil, vardenafil and tadalafil, were found to be effective for the treatment of benign prostatic syndrome (BPS), symptomatic benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) with the recent approval of tadalafil in these indications [13–16]. This evidence concerns the gene PDE5A and Bartsocas-Papas syndrome 1.