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Ejaculatory dysfunction in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
BJU Int. 2009 Oct; 104(7):974-83.BI

Abstract

OBJECTIVE

To assess, using the psychometrically validated Male Sexual Health Questionnaire (MSHQ), the prevalence of ejaculatory dysfunction (EjD) and bother due to EjD in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH), and to assess predictors of EjD in this population.

PATIENTS AND METHODS

In all, 5999 sexually active men with LUTS completed the International Prostate Symptom Score (IPSS) which rates LUTS severity, and the MSHQ long-form, which evaluates seven EjD symptoms and bother due to EjD. Concomitant intake of medical treatments for BPH and previous BPH-related surgery were collected. The impact of treatments on EjD was compared to a control group (i.e. no previous BPH-related surgery and no medical treatment for BPH). The relationship between EjD, bother due to EjD and selected clinical characteristics was analysed using multiple regression analysis.

RESULTS

EjD was highly prevalent and bothersome in men with LUTS, with decreased force of ejaculation (77.9%) and decreased amount of semen (74.4%) being the most commonly reported symptoms. LUTS severity was the strongest predictor of EjD and bother due to EjD. EjD was considered a problem by 35.6%, 51.6% and 64.1% of men with mild, moderate and severe LUTS, respectively (P < 0.001). EjD (except pain/discomfort on ejaculation) and bother due to EjD were also strongly related to age. Men with previous BPH-related surgery and men treated with a 5α-reductase inhibitor plus an α(1)-blocker or tamsulosin alone showed the highest rates of dry ejaculation (67.4%, 57.2% and 52.3%, respectively) compared to controls (31.6%, P < 0.001). Conversely, in men treated with alfuzosin, most EjD symptoms were significantly lower than in controls. Bother due to EjD was also significantly lower with alfuzosin than in controls (34.4% vs 53.1%, P < 0.001) while there was no significant difference for other treatments.

CONCLUSIONS

EjD is highly prevalent and bothersome in sexually active men with LUTS, and is strongly related to LUTS severity and age. Treatment options for BPH do not have the same effect on EjD. EjD should be considered in the initial evaluation and clinical management of men with LUTS.

Authors+Show Affiliations

New England Research Institutes, Watertown, MA 02472, USA. rrosen@neriscience.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19426189

Citation

Rosen, Raymond C., et al. "Ejaculatory Dysfunction in Men With Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia." BJU International, vol. 104, no. 7, 2009, pp. 974-83.
Rosen RC, Fitzpatrick JM, ALF-LIFE Study Group. Ejaculatory dysfunction in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. BJU Int. 2009;104(7):974-83.
Rosen, R. C., & Fitzpatrick, J. M. (2009). Ejaculatory dysfunction in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. BJU International, 104(7), 974-83. https://doi.org/10.1111/j.1464-410X.2009.08503.x
Rosen RC, Fitzpatrick JM, ALF-LIFE Study Group. Ejaculatory Dysfunction in Men With Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia. BJU Int. 2009;104(7):974-83. PubMed PMID: 19426189.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ejaculatory dysfunction in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. AU - Rosen,Raymond C, AU - Fitzpatrick,John M, AU - ,, Y1 - 2009/05/07/ PY - 2009/5/12/entrez PY - 2009/5/12/pubmed PY - 2010/10/15/medline SP - 974 EP - 83 JF - BJU international JO - BJU Int. VL - 104 IS - 7 N2 - OBJECTIVE: To assess, using the psychometrically validated Male Sexual Health Questionnaire (MSHQ), the prevalence of ejaculatory dysfunction (EjD) and bother due to EjD in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH), and to assess predictors of EjD in this population. PATIENTS AND METHODS: In all, 5999 sexually active men with LUTS completed the International Prostate Symptom Score (IPSS) which rates LUTS severity, and the MSHQ long-form, which evaluates seven EjD symptoms and bother due to EjD. Concomitant intake of medical treatments for BPH and previous BPH-related surgery were collected. The impact of treatments on EjD was compared to a control group (i.e. no previous BPH-related surgery and no medical treatment for BPH). The relationship between EjD, bother due to EjD and selected clinical characteristics was analysed using multiple regression analysis. RESULTS: EjD was highly prevalent and bothersome in men with LUTS, with decreased force of ejaculation (77.9%) and decreased amount of semen (74.4%) being the most commonly reported symptoms. LUTS severity was the strongest predictor of EjD and bother due to EjD. EjD was considered a problem by 35.6%, 51.6% and 64.1% of men with mild, moderate and severe LUTS, respectively (P < 0.001). EjD (except pain/discomfort on ejaculation) and bother due to EjD were also strongly related to age. Men with previous BPH-related surgery and men treated with a 5α-reductase inhibitor plus an α(1)-blocker or tamsulosin alone showed the highest rates of dry ejaculation (67.4%, 57.2% and 52.3%, respectively) compared to controls (31.6%, P < 0.001). Conversely, in men treated with alfuzosin, most EjD symptoms were significantly lower than in controls. Bother due to EjD was also significantly lower with alfuzosin than in controls (34.4% vs 53.1%, P < 0.001) while there was no significant difference for other treatments. CONCLUSIONS: EjD is highly prevalent and bothersome in sexually active men with LUTS, and is strongly related to LUTS severity and age. Treatment options for BPH do not have the same effect on EjD. EjD should be considered in the initial evaluation and clinical management of men with LUTS. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/19426189/Ejaculatory_dysfunction_in_men_with_lower_urinary_tract_symptoms_suggestive_of_benign_prostatic_hyperplasia_ L2 - https://doi.org/10.1111/j.1464-410X.2009.08503.x DB - PRIME DP - Unbound Medicine ER -