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Treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: sexual function.
BJU Int. 2005 Jun; 95 Suppl 4:12-8.BI

Abstract

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH), and sexual dysfunction, are common, highly bothersome conditions in older men, and the prevalence of both disorders increases with age. Sexual dysfunction manifests mainly as erectile dysfunction (ED), ejaculatory disorders, or decreased libido/hypoactive sexual desire (HSD). Whereas both reduced rigidity and reduced ejaculate volume are highly prevalent in ageing men, reduced rigidity and pain on ejaculation are considered to be most bothersome. Sexual dysfunction is much more prevalent in patients with LUTS/BPH than in men with no LUTS/BPH, even after controlling for confounding variables such as age or comorbidities. Hence LUTS/BPH is considered an independent risk factor for sexual dysfunction. Whether this is because of a common underlying pathology, or whether the considerable bother associated with LUTS/BPH leads to reduced sexual functioning, remains to be elucidated. Despite a decline in the frequency of sexual intercourse, as well as in overall sexual functioning, most ageing men report regular sexual activity and consider their sex life as an important dimension of their quality of life (QoL). However, most patients with LUTS/BPH experience a negative effect of their LUTS on their sex life. Hence, treatment of LUTS/BPH should aim to at least maintain or, if possible, improve sexual function. Current medical treatment of LUTS/BPH consists of monotherapy with alpha1-adrenoceptor (AR) antagonists, 5alpha-reductase inhibitors (RIs) or a combination of these. Whereas 5alpha-RIs increase the risk of ED, ejaculatory disorders and HSD, alpha1-AR antagonists can induce ejaculatory disorders, but do not provoke HSD or ED. Combined therapy carries the cumulative risk for sexual dysfunction associated with either type of drug. As already indicated, ED is generally perceived as more bothersome than ejaculatory disorders. In addition, alpha1-AR antagonists slightly improve overall sexual function, possibly by increasing blood flow in the penis through alpha1-AR blockade and/or to an increased overall QoL from the relief of LUTS. It can be concluded that alpha1-AR antagonists constitute a first-line therapy for LUTS/BPH because they combine good treatment efficacy with very few adverse effects on sexual function.

Authors+Show Affiliations

Department of Urology, St. Luke's-Roosevelt Hospital Center, New York 10019, USA. fclowemd@aol.com

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15871731

Citation

Lowe, Franklin C.. "Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: Sexual Function." BJU International, vol. 95 Suppl 4, 2005, pp. 12-8.
Lowe FC. Treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: sexual function. BJU Int. 2005;95 Suppl 4:12-8.
Lowe, F. C. (2005). Treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: sexual function. BJU International, 95 Suppl 4, 12-8.
Lowe FC. Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: Sexual Function. BJU Int. 2005;95 Suppl 4:12-8. PubMed PMID: 15871731.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: sexual function. A1 - Lowe,Franklin C, PY - 2005/5/6/pubmed PY - 2005/6/7/medline PY - 2005/5/6/entrez SP - 12 EP - 8 JF - BJU international JO - BJU Int VL - 95 Suppl 4 N2 - Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH), and sexual dysfunction, are common, highly bothersome conditions in older men, and the prevalence of both disorders increases with age. Sexual dysfunction manifests mainly as erectile dysfunction (ED), ejaculatory disorders, or decreased libido/hypoactive sexual desire (HSD). Whereas both reduced rigidity and reduced ejaculate volume are highly prevalent in ageing men, reduced rigidity and pain on ejaculation are considered to be most bothersome. Sexual dysfunction is much more prevalent in patients with LUTS/BPH than in men with no LUTS/BPH, even after controlling for confounding variables such as age or comorbidities. Hence LUTS/BPH is considered an independent risk factor for sexual dysfunction. Whether this is because of a common underlying pathology, or whether the considerable bother associated with LUTS/BPH leads to reduced sexual functioning, remains to be elucidated. Despite a decline in the frequency of sexual intercourse, as well as in overall sexual functioning, most ageing men report regular sexual activity and consider their sex life as an important dimension of their quality of life (QoL). However, most patients with LUTS/BPH experience a negative effect of their LUTS on their sex life. Hence, treatment of LUTS/BPH should aim to at least maintain or, if possible, improve sexual function. Current medical treatment of LUTS/BPH consists of monotherapy with alpha1-adrenoceptor (AR) antagonists, 5alpha-reductase inhibitors (RIs) or a combination of these. Whereas 5alpha-RIs increase the risk of ED, ejaculatory disorders and HSD, alpha1-AR antagonists can induce ejaculatory disorders, but do not provoke HSD or ED. Combined therapy carries the cumulative risk for sexual dysfunction associated with either type of drug. As already indicated, ED is generally perceived as more bothersome than ejaculatory disorders. In addition, alpha1-AR antagonists slightly improve overall sexual function, possibly by increasing blood flow in the penis through alpha1-AR blockade and/or to an increased overall QoL from the relief of LUTS. It can be concluded that alpha1-AR antagonists constitute a first-line therapy for LUTS/BPH because they combine good treatment efficacy with very few adverse effects on sexual function. SN - 1464-4096 UR - https://www.unboundmedicine.com/medline/citation/15871731/Treatment_of_lower_urinary_tract_symptoms_suggestive_of_benign_prostatic_hyperplasia:_sexual_function_ L2 - https://doi.org/10.1111/j.1464-410X.2005.05486.x DB - PRIME DP - Unbound Medicine ER -