Srpski arhiv za celokupno lekarstvo 2015 Volume 143, Issue 5-6, Pages: 284-289
https://doi.org/10.2298/SARH1506284S
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Adverse effects of pharmacological therapy of benign prostatic hyperplasia on sexual function in men
Stojanović Nebojša A. (Military Hospital, Urology Department, Niš)
Ignjatović Ivan (Clinical Center, Clinic of Urology, Niš)
Đenić Nebojša (Military Hospital, Surgical Department, Niš)
Bogdanović Dragan (State University of Novi Pazar, Department of Biochemical and Medical Sciences, Novi Pazar)
Introduction. The development of effective medications makes pharmacological
therapy of BPH the dominant mode of treatment today. It improves urinary
symptoms and prevents disease progression while producing side effects on
male sexual function. Objective. The aim of the study is to present the
effects of BPH pharmacological treatment on the occurrence of sexually
adverse effects in men: changes in sexual desire, erectile, ejaculatory and
the orgasmic function. Methods. A prospective study involving 156 BPH
patients. The average age was 61.16±2.97. Four groups of 39 patients each
were formed. The 4 groups were administered tamsulosin (alpha-blocker),
finasteride (5-alpha reductase inhibitor), combination therapy (tamsulosin
and finasteride) respectively, while the control group received no treatment.
IPSS-QoL, IIEF and MSHQ-EjD questionnaires were used to evaluate the symptoms
of voiding and sexual function. Follow-up examinations were performed 3 and 6
months into treatment. Results. Voiding symptoms improved in all groups
receiving therapy. The side effects on the sexual function in all these
groups include significant disorders of ejaculation and the orgasmic
function. Ejaculation disorders: tamsulosin (-4.38±2.55; p<0.001), combined
therapy (-3.89±2.84) and finasteride (-1.49±2.52). Orgasmic function
disorders: tamsulosin (-1.03±1.94), combined therapy (-0.76±2.07) and
finasteride (-0.54±1.68). Complete absence of ejaculation was experienced by
23% of patients on combined therapy, 15% on tamsulosin and 5% on finasteride.
Conclusion. Pharmacological therapy of BPH improved voiding symptoms
producing different effects on male sexual function. The main adverse effect
on sexual function in men is the deterioration in ejaculation or the absence
thereof. Clinical consideration of BPH should include the elements of male
sexual function, patients’ age, the characteristics and effects of each group
of drugs.
Keywords: prostate, ejaculation, erection, orgasm, sexual desire