Srpski arhiv za celokupno lekarstvo 2014 Volume 142, Issue 9-10, Pages: 572-578
https://doi.org/10.2298/SARH1410572S
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Improvement of sexual function in men with benign prostatic hyperplasia by pharmacologic therapy
Stojanović Nebojša (Military Hospital, Department of Urology, Niš)
Bogdanović Dragan (State University of Novi Pazar, Department of Biochemical and Medical Sciences, Novi Pazar)
Introduction. Benign prostatic hyperplasia (BPH) causes disorders of voiding
and sexual function. Pharmacologic therapy reduces symptoms of voiding thus
impacting sexual function. Objective. To determine sex life status in men
with BPH before and after pharmacologic treatment adapted to achieve
satisfactory sexual function. Methods. We studied 117 sexually active BPH
patients, not previously treated for BPH. After clinical examinations,
symptoms of voiding, sexual and ejaculatory function were measured using
standardized IPSS, IIEF and MSHQ-EjD questionnaires. After obtaining
patients’ personal opinion about the importance of their sex life, therapy
was chosen and possible side effects explained. Three groups of 39 patients
each were formed. The first group was treated with alpha-blocker, tamsulosin,
the second with 5-alpha reductase inhibitor, finasteride, while the third
group was administered a combination therapy. The complete examination
procedure was repeated after 3 and 6 months of therapy. Results. The average
age of patients was 61.34±3.04 years. Eighty-seven percent reported that
their sex life was important to a certain degree. Satisfaction with their sex
life was reported by 47% of patients before treatment and by 67% of
respondents 6 months after treatment. Questionnaire scores indicated general
improvement of sexual function in all groups, which was statistically
significant compared to baseline only in the group on tamsulosin
alpha-blocker (2.95±7.81; p=0.028). The overall satisfaction with sex life as
a component of sexual function, improved significantly in the group on the
combined therapy (0.78±1.81; p=0.012). Conclusion. Before BPH treatment
sexual function should be assessed and therapy customized to the patient’s
expectations. Side effects of drugs should be presented especially to
patients who emphasize the importance of sex life. In the manifested stages
of the disease overall satisfaction with sex life may be improved by combined
therapy comprising 5-alpha reductase inhibitors and third generation alpha
blockers. In earlier stages, BPH alpha blockers monotherapy may improve
overall sexual function.
Keywords: prostate, sex life, tamsulosin, finasteride