Sexual dysfunction in the patient with prostatitis

Tadalafil monotherapy in management of chronic prostatitis/chronic pelvic pain syndrome: a randomized double-blind placebo controlled clinical trial

Purpose

In this placebo-controlled trial, we aimed to evaluate the clinical results of using PDE-5 inhibitor, tadalafil 5 mg OD, for management of CP/CPPS.

Patients and methods

140 patients ≤ 45 years old with moderate/severe CP/CPPS associated with ED (IIEF-5 < 22) were randomly divided and received either tadalafil 5 mg OD (tadalafil-group) or placebo (control-group) for 6 weeks. Post-treatment CPSI scores were compared to baseline and to placebo. Clinically significant responders (≥ 25% reduction from baseline score) were calculated. Tadalafil-induced changes in IIE-5 were evaluated in correlation to that of CPSI scores.

Results

By the 6th week, 59 and 56 patients were available in both groups respectively. Compared to baseline, tadalafil-group patients showed significant improvement in total, pain, urinary and Qol domains of CPSI (19.1 ± 5.26, 10.42 ± 3.55, 4.2 ± 1.72 and 4.47 ± 1.64 vs. 24.21 ± 5.05, 12.14 ± 3.57, 6.08 ± 1.53 and 6.22 ± 1.76), p < 0.5. When compared to placebo, all 6th week CPSI domains scores, except for pain, were significantly better in tadalafil-group (p < 0.05). Post-treatment pain score didn't significantly differ between both groups (10.42 ± 3.55, vs. 11.71 ± 3.9, p > 0.05). Clinically significant responders were 30 patients (50.8%) in tadalafil-group vs. 3 patients (5.4%) in control. Tadalafil-induced changes in IIEF-5 score had weak but significant correlation to Qol domain (r = − 0.28, p < 0.05).

Conclusion

Tadalafil 5 mg OD can significantly improve all CPSI domains as compared to baseline. Post-treatment CPSI scores, except for pain, were better than placebo. About 50.8% of patients can develop ≥ 25% reduction in their total CPSI scores after treatment. Apart from Qol domain, these changes are not significantly correlated to tadalafil-induced IIEF-5 scores changes.

History of Prostatitis Is an Independent Risk Factor for Erectile Dysfunction: A Cross-Sectional Study

Purpose

To determine the role of history of prostatitis (HP) as an independent risk factor for erectile dysfunction (ED) in Chinese adult males.

Methods

We conducted an online survey using a crowd-sourced questionnaire in Chinese adult males. The participants were separated into two groups as adult participants with HP and with no history of prostatitis (NHP) according to the medical history record. As diagnosis criteria of ED, we used the 5 questions of the International Index for Erectile Function (IIEF-5). The general data including height, weight, monthly income, academic background, smoking history, alcohol drinking, marital status, conjugal affection, and other disease history was asked and recorded. The relationship between HP and ED using the chi-square test and logistic regression analyses was investigated and analyzed.

Results

In total, 1873 participants answered the questionnaire. 95 participants in the HP group and 1778 participants in the NHP group were included in this study. The rate of participants with HP was 5.343%. ED was found in 68.4% of the HP group and 43% of the NHP group (p < 0.001). Regression analysis showed that participants in HP were more likely to have ED (OR 2.135, 95% CI 1.266–3.60) after adjusting for the participant's age, body mass index (BMI), monthly income, academic background, smoking history, alcohol drinking, marital status, conjugal affection, BPH, hypertension, and diabetes mellitus, when compared with NHP.

Conclusions

The present study indicated a high prevalence of ED in Chinese adult males with history of prostatitis, and HP is an independent risk factor for erectile dysfunction.

Aberrantly glycosylated integrin α3β1 is a unique urinary biomarker for the diagnosis of bladder cancer

Bladder cancer (BC) is the most common malignancy of the urinary tract. We developed a new and ELISA kit for detecting aberrantly glycosylated integrin α3β1 (AG31) in human urine. We analysed urine samples (n=408) of patients with BC, renal cell carcinoma (RCC), prostate cancer (PC), cystitis, nephritis, and prostatitis from two centres in China. The subjects in the validation groups (n=2317) were recruited from other centres in China between July 2012 and September 2013. Receiver operating characteristic (ROC) curves were used to determine diagnostic accuracy. AG31 levels in urine samples were significantly higher in patients with BC than in any of the control subjects. Moreover, elevated levels of AG31 in urine could distinguish BC from benign inflammatory diseases. Finally, the urinary AG31 test was much more sensitive and specific than the NMP22 test. Therefore, the urinary AG31 test will provide an ideal and assay for the detection of BCs.

Chronic scrotal pain may lead to reduced sexual function and interest, while sexual activity may worsen chronic scrotal pain: "double jeopardy"

Background

While it is recognized that chronic pain may adversely impact sexual function and activity in men and we also recognize that sexual activity may worsen the pain for men with chronic scrotal pain (CSP), the effect on sexual functioning and conversely the impact of sex on CSP has not previously been documented.

Methods

Retrospective analysis of a prospectively collected database.

Results

From Feb 2014 to Sep 2015, a total of 128 men presenting for assessment of CSP completed all or parts of a standardized questionnaire. Overall 60% (69/116) of the men felt that the CSP had kept them either a "lot" or "some" of the time from sexual activity and 64% (27/43) had evidence of decreased erectile performance. Those with more severe pain (analog pain scores 7-10/10) had more significant sexual dysfunction than those with less severe pain, with 54% (45/83) vs. 0% (0/33, P<0.01: Fisher's exact test) noting that the pain kept them from sexual activity "a lot" and 70% (23/33) vs. 40% (4/10, P<0.01) noting sexual dysfunction. Diminished libido was also common in the men [43% (55/128)] as were the symptoms of testosterone deficiency [76% (97/128)]. Conversely, sexual activity often exacerbated the pain, with 37% (47/128) finding that ejaculation aggravated their pain and another 38% (48/128) patients found sexual activity aggravated their pain.

Conclusions

Men with severe CSP have significantly reduced sexual function and interest compared to men with moderate or minor levels of pain. The majority of men with CSP who were sexually active were faced with worsening pain with sex and ejaculation. Clinicians should be aware of the twin risks of sexual dysfunction occurring in men with CSP and sexual activity worsening the severity of the CSP.

Prevalence of sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome: a meta-analysis

PURPOSE

This study aims to estimate the prevalence of sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) by conducting a meta-analysis.

METHODS

Relevant publications were searched using PubMed, Embase, CBM, China National Knowledge Infrastructure, VIP and Wanfang databases up to August 2015. Studies that reported the prevalence of erectile dysfunction, premature ejaculation and total sexual dysfunction in men with CP/CPPS were included.

RESULTS

A total of 24 studies involving 11,189 men were included. Overall prevalence of sexual dysfunction in men with CP/CPPS was 0.62 (95 % CI 0.48-0.75), while the prevalence of erectile dysfunction and premature ejaculation was 0.29 (95 % CI 0.24-0.33) and 0.40 (95 % CI 0.30-0.50), respectively. From 1999 to 2010, the prevalence of sexual dysfunction, erectile dysfunction and premature ejaculation was 0.65 (95 % CI 0.45-0.83), 0.27 (95 % CI 0.22-0.33) and 0.41 (95 % CI 0.27-0.55), respectively. From 2011 to 2014, the prevalence of sexual dysfunction, erectile dysfunction and premature ejaculation was 0.50 (95 % CI 0.22-0.75), 0.35 (95 % CI 0.29- 0.40) and 0.39 (95 % CI 0.37-0.41), respectively.

CONCLUSION

The prevalence of sexual dysfunction in men with CP/CPPS was high, even though overall sexual dysfunction demonstrated a slightly decreasing trend. Furthermore, erectile dysfunction prevalence rate had an increasing trend in recent years. More prospective studies are needed to evaluate sexual dysfunction improvement with better management of CP/CPPS.

Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline

Objectives

To improve awareness and recognition of chronic bacterial prostatitis (CBP) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) among non‐specialists and patients. To provide guidance to healthcare professionals treating patients with CBP and CP/CPPS, in both non‐specialist and specialist settings. To promote efficient referral of care between non‐specialists and specialists and the involvement of the multidisciplinary team (MDT).

Patients and Methods

The guideline population were men with CBP or CP/CPPS (persistent or recurrent symptoms and no other urogenital pathology for ≥3 of the previous 6 months). Consensus recommendations for the guidelines were based on a search to identify literature on the diagnosis and management of CBP and CP/CPPS (published between 1999 and February 2014). A Delphi panel process was used where high‐quality, published evidence was lacking.

Results

CBP and CP/CPPS can present with a wide range of clinical manifestations. The four main symptom domains are urogenital pain, lower urinary tract symptoms (LUTS – voiding or storage symptoms), psychological issues and sexual dysfunction. Patients should be managed according to their individual symptom pattern. Options for first‐line treatment include antibiotics, α‐adrenergic antagonists (if voiding LUTS are present) and simple analgesics. Repeated use of antibiotics, such as quinolones, should be avoided if there is no obvious symptomatic benefit from infection control or cultures do not support an infectious cause. Early use of treatments targeting neuropathic pain and/or referral to specialist services should be considered for patients who do not respond to initial measures. An MDT approach (urologists, pain specialists, nurse specialists, specialist physiotherapists, general practitioners, cognitive behavioural therapists/psychologists, and sexual health specialists) is recommended. Patients should be fully informed about the possible underlying causes and treatment options, including an explanation of the chronic pain cycle.

Conclusion

Chronic prostatitis can present with a wide variety of signs and symptoms. Identification of individual symptom patterns and a symptom‐based treatment approach are recommended. Further research is required to evaluate management options for CBP and CP/CPPS.

Increased subsequent risk of erectile dysfunction in patients with irritable bowel syndrome: a nationwide population-based cohort study

This retrospective population-based study aimed to investigate associations between erectile dysfunction (ED) and the irritable bowel syndrome (IBS) using a Taiwanese cohort. We identified 17 608 male patients who were newly diagnosed with IBS from 1997 to 2010. The date that the diagnosis of IBS had been made was the index date. IBS patients with a history of ED before the index date or with incomplete demographic information were excluded. 70 432 age-matched subjects without IBS were selected as comparison cohort. Both cohorts were followed until the end of 2010 or censored. Cox proportional hazard regression model was used to estimate the effects of IBS on ED risks. The incidence rate ratio of ED in the IBS cohort was 2.92 times higher than that in the non-IBS cohort (29.5 vs. 10.1 per 10 000 person-years), with an adjusted hazard ratio (aHR) of 2.58 (95% confidence interval [CI]: 2.24-2.98). The risk of ED increased with increasing age and number of comorbidities. Patients with depression were at a higher risk of ED (aHR: 1.97; 95% CI: 1.49-2.63) compared with the subjects without depression. IBS patients had a higher risk of developing ED compared with non-IBS subjects. Ageing and comorbidities including diabetes, cardiovascular disease, chronic kidney disease and depression were associated with the risk of ED.

Functional bladder problems in children: pathophysiology, diagnosis, and treatment

Functional lower urinary tract problems, bladder and bowel problems, or dysfunctional elimination syndrome are all terms that describe the common array of symptoms that include overactive bladder syndrome, voiding postponement, stress incontinence, giggle incontinence, and dysfunctional voiding in children. This article discusses the nomenclature and looks at the pathophysiology of functional bladder disorders from a different perspective than has been the norm in the past. Some standard medical treatments as well as some newer forms of treatment are outlined. Treatment algorithms for urinary frequency and urinary incontinence have been created to help the practitioner manage the patient.

A case-control study on the association between chronic prostatitis/chronic pelvic pain syndrome and erectile dysfunction

What's known on the subject? and What does the study add? In recent years, a number of studies have reported a high prevalence of erectile dysfunction (ED) among patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Several studies have reported that the prevalence of ED ranges from 15.0 to 40.5% in men in China with CP/CPPS; however, the previous studies focusing on the prevalence of ED among patients with CP/CPPS all neglected to explore the magnitude of this association. Our study found an association between ED and previously diagnosed CP/CPPS. The odds of previous CP/CPPS were 3.62 times greater for cases than for controls, after adjusting for patient socio-demographic characteristics, comorbidities, obesity, and alcohol abuse/alcohol dependence syndrome.

OBJECTIVE

To examine the association between erectile dysfunction (ED) and a previous diagnosis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) using a population-based dataset.

PATIENTS AND METHODS

The data for this case-control study was obtained from the National Health Insurance database. A total of 3194 males, who were ≥18 years of age when they first received a diagnosis of ED, were identified and 15 970 controls were randomly selected. The prevalence and risk of CP/CPPS among cases and controls were calculated by using conditional logistic regression analysis.

RESULTS

In total, 667 (3.5%) of the 19 164 sampled subjects had been diagnosed with CP/CPPS before the index date; CP/CPPS was found in 276 (8.6%) cases and in 391 (2.5%) controls (P < 0.001). Regression analysis indicated that cases were more likely to have had previous CP/CPPS (odd ratio 3.62, 95% confidence interval 3.07-4.26) after adjusting for patient monthly income, geographical location and urbanization level, as well as hypertension, diabetes, coronary heart disease, renal disease, obesity and alcohol abuse/alcohol dependence syndrome status, when compared with controls.

CONCLUSIONS

We conclude that there was an association between ED and having been previously diagnosed with CP/CPPS. Urologists should be alert to the association between CP/CPPS and ED, and assess the erectile function of patients suffering from CP/CPPS.

Evaluation of sexual function in men with orchialgia

This study examined the effect of chronic scrotal pain on sexual function using the International Index of Erectile Function (IIEF). We enrolled 50 patients with symptoms consistent with orchialgia and 50 control subjects without orchialgia, who were healthy, sexually active, married, and age-matched. Both groups were evaluated using the IIEF questions for sexual function, and quality of life was investigated using the abbreviated version of the World Health Organization Quality of Life Questionnaire. A significant difference was found in the values of orgasmic function, intercourse satisfaction, sexual desire, overall sexual satisfaction, and total IIEF scores between the patient and control groups; however, there were no significant group differences in the IIEF scores related to erectile function. In the patient group, 39 of 50 subjects reported decreased sexual desire and satisfaction due to a decrease in frequency of sexual activities. Thus, investigation of sexual function was essential for these patients in order to determine the adequate management and treatment of chronic orchialgia.

Sexual dysfunction in type III chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS) observed in Turkish patients

AIM

Chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS) is a common disabling condition that is primarily associated with pain in the urogenital region and disturbances in urinary and sexual function. Chronic pelvic pain symptoms are the most common presentation, especially perineal, lower abdominal, testicular, penile as well as ejaculatory pain. Other genitourinary tract complaints include voiding disorders and sexual dysfunction. We aimed in the study at examining the prevalence rates of premature ejaculation and erectile dysfunction in patients with chronic pelvic pain syndrome and comparing these rates with those of healthy control subjects.

MATERIALS AND METHODS

Between November 2006 and January 2008, 85 patients with the diagnosis of CP/CPPS were chosen for the study; 30 patients without regular sexual activity and 12 patients without inclusion criteria were excluded from the study. A total of 43 patients were included in the study. Twenty healthy volunteers without prostatitis-like syndromes were used as a control group. The sexual function of the patients and the healthy volunteers were evaluated using Arizona Sexual Function Questionary Form and International Index of Erectile Function (IIEF). Erectile dysfunction (ED), ejaculatio precox (EP) and pain on ejaculation (PEP) were investigated as sexual dysfunction.

RESULTS

The mean age of the patients was 33.7 (22-48) years; the mean symptom period was 37.7 (6-120) months, while the mean age of the control group was 32.4 (24-48) years. The mean NIH-CPSI score of the patient group was 26.1 (16-34). Patient group was classified as CPPS type IIIa and CPPS type IIIb. Mild and moderate erectile dysfunction (ED) was found in [9] 23.2% patients at the patient group and [2] 10% at the control group (P: 0.185). Severe erectile dysfunction was not found in both groups. Ejaculatio Precox (EP) was found at (29) 67.4% of the patient group and [7] 40% of the control group. Pain on ejaculation (PEP) was detected in [15] 37.2% of the patient group, while none of the control group had pain on ejaculation. More than one sexual dysfunction was found in [17] 41.8% of the patient group and none of the control group. Comparing patient group versus control group, ejaculation disorders (EP and PEP) and more than one sexual dysfunction disorder were statistically significant. According to ED, there is no statistical difference between the groups (P > 0.05).

CONCLUSION

Sexual function disorders, especially ejaculation disorders (EP and PEP), are frequently seen in CP/CPPS patients versus normal population. Age, symptoms period, symptom score and CP/CPPS subgroups are not risk factors for sexual function disorders. Patients with the diagnosis of CP/CPPS should be evaluated for sexual function disorders.

Erectile Function in Prostate Cancer–Free Patients Who Underwent Prostate Saturation Biopsy

OBJECTIVE

To evaluate the erectile function following transrectal ultrasound-guided saturation biopsies of the prostate.

MATERIALS AND METHODS

Of the 150 patients included in the study, those with persistently elevated prostate-specific antigen (PSA) level underwent saturation biopsy. A median of 22-core (minimum: 20; maximum: 30) prostate saturation biopsies was taken. Patients were evaluated for erectile function prebiopsy with the 5-item version of the International Index of Erectile Function (IIEF-5) and the IIEF-Erectile Function (IIEF-EF) domain scoring. Concomitant systemic diseases and medications that would interfere with erectile function were recorded. Eighty-eight patients reported to be prostate cancer-free underwent further evaluation with the IIEF-5 questionnaire at 1 and 6 mo postbiopsy. Severity of erectile dysfunction (ED) was classified into four categories.

RESULTS

The patients' ages, serum PSA levels, prostate volumes, and number of cores showed no significant correlation with changes in ED scores after the prostate saturation biopsies. According to the IIEF-5, for patients who were previously potent and found to be free of prostate cancer, the ED rates were 11.6% at the first month, and no ED was reported at the sixth month of evaluation. IIEF-5 and IIEF-EF domain scores displayed a statistically significant difference between baseline and first-month scores, but not between baseline and sixth-month scores, which returned to baseline values.

CONCLUSIONS

Although saturation biopsy of the prostate is a safe procedure on the basis of erectile function, the minimal risk of temporary postbiopsy ED should be discussed with previously potent patients.

Pediatric overactive bladder syndrome: pathophysiology and management

Detrusor overactivity, also known as the overactive bladder syndrome (OAB), urge syndrome, hyperactive bladder syndrome, persistent infantile bladder, and detrusor hypertonia, is the most common voiding dysfunction in children. Until recently, the concepts that had been used to dictate the management of this problem in children were based on the foundation that this was a primary bladder problem and or a delay in maturation in the nervous system of children. The expectation that children would outgrow their problems led many pediatric urologists and other practitioners to tell the parents of these children 'that they would not be wetting themselves on their wedding day.' However, it has become apparent from recent studies in adult patients with voiding dysfunctions that they had symptoms present as children. Recent findings of associations between lower urinary tract symptoms and sexual dysfunction and between voiding dysfunctions and neuropsychiatric problems have opened up a new frontier into the possible mechanisms of OAB in children that would explain these problems, link them together, and explain the continued problems that adult patients face. These findings point to OAB as a symptom of a more centrally located dysfunction that affects multiple systems. The objective of this review was to evaluate the neuroanatomy and neurophysiology of voiding and neuropharmacologic effects. We considered not only the available research and clinical data within the urologic field but also outside the field so that these data could be combined to generate a unified theory that could possibly explain many of the associated symptoms that are commonly found in pediatric OAB. Treatment modalities that are currently available for managing OAB were also explored. Currently available data indicate that pediatric OAB and many pediatric voiding dysfunctions may be part of a more generalized problem that affects multiple systems: notably bowels, bladder, sexual and ejaculatory function, control of blood pressure, and even mood and behavior. We explain the relationship that the bowel has with pediatric OAB and also the link that other neuropsychiatric problems have with OAB. This article describes which drug may be best suited to treat OAB in children and what treatment modalities are available when first-line drugs fail. In conclusion, the movement away from a vesicocentric way of thinking to a more corticocentric mode of thinking along with new imaging modalities that can examine the brain as it works will be of great value in determining future treatments of OAB. Medications generated from these evidence-based studies will hopefully treat the underlying disease process and not just the symptoms.

Overactive Bladder in Children. Part 1: Pathophysiology

PURPOSE

Detrusor overactivity is the most common voiding dysfunction in children. Detrusor overactivity is also known as overactive bladder syndrome, urge syndrome, hyperactive bladder syndrome, persistent infantile bladder and detrusor hypertonia. It has become apparent that the ideas that had been used to dictate the management of this problem in children were based on the foundation that this is a primary bladder problem and/or a delay in maturation in the nervous system of children. The expectation that children would outgrow the problems led many pediatric urologists and other practitioners to tell the parents of these children that they would not be wetting themselves on their wedding day. It has become apparent from recent studies in adults with voiding dysfunction that they had symptoms present as children. The recent findings of associations with lower urinary tract symptoms and sexual dysfunction, and the association of voiding dysfunction and neuropsychiatric problems has opened up a new frontier into the possible mechanisms of overactive bladder syndrome in children that would explain these problems, tie them together and explain the continued problems that adults face. These findings point to overactive bladder syndrome as a symptom of a more centrally located dysfunction that affects multiple systems, notably bowels, bladder, sexual and ejaculatory function, control of blood pressure, and even mood and behavior.

MATERIALS AND METHODS

We looked at the neuroanatomy, neurophysiology and neuropharmacology of voiding. Available research and clinical data in the urological field as well as outside of the field were combined to generate a unified theory that could possibly explain many associated symptoms that are commonly found in pediatric overactive bladder syndrome.

RESULTS

The available data indicate that pediatric overactive bladder syndrome and many pediatric voiding dysfunctions may be part of a more generalized problem that affects multiple systems, notably bowels, bladder, sexual and ejaculatory function, control of blood pressure, and even mood and behavior. We explained the relationship that the bowel has with pediatric overactive bladder syndrome and also the link that other neuropsychiatric problems have with overactive bladder syndrome.

CONCLUSIONS

The movement away from a vesicocentric way of thinking to a more corticocentric mode of thinking along with new imaging modalities that can look at the brain and examine it as it works will be of great value for determining future treatments. Medications generated from these evidence based studies will hopefully treat the underlying disease process and not just the symptoms.

Symptoms Suggestive of Chronic Pelvic Pain Syndrome in an Urban Population: Prevalence and Associations With Lower Urinary Tract Symptoms and Erectile Function

PURPOSE

We determined the prevalence of symptoms suggestive of chronic pelvic pain syndrome in an urban population and assessed associations with lower urinary tract symptoms and erectile dysfunction.

MATERIALS AND METHODS

Men participating in a voluntary health examination free of charge that was organized by the Department of Preventive Health of the City of Vienna were analyzed. All participants completed 3 validated questionnaires on chronic pelvic pain syndrome (National Institutes of Health-Chronic Prostatitis Symptom Index), lower urinary tract symptoms (International Prostate Symptom Score) and erectile dysfunction (International Index of Erectile Function-5).

RESULTS

A total of 1,765 men with a mean +/- SD age of 46.3 +/- 0.3 years (range 20 to 79) entered this study. The mean National Institutes of Health-Chronic Prostatitis Symptom Index score increased from 4.0 +/- 0.3 in the youngest age group of 20 to 29-year-old men to 6.3 +/- 0.6 in those 70 to 79 years old. The overall prevalence of symptoms suggestive of chronic pelvic pain syndrome, defined by a pain score of 4 or greater and perineal/ejaculatory pain, was 2.7% and it revealed no age dependence, such as the pain score. In contrast, urinary symptom and quality of life scores increased with age. International Index of Erectile Function-5 score was 20.6 +/- 0.3 for men without chronic pelvic pain symptoms vs 18.3 +/- 0.7 for men with mild symptoms and 16.5 +/- 1.1 for men with moderate/severe symptoms. A National Institutes of Health-Chronic Prostatitis Symptom Index score in the upper quartile was associated with 8.3-fold increased odds of erectile dysfunction.

CONCLUSIONS

The prevalence of symptoms suggestive of chronic pelvic pain syndrome in this large cohort of men participating in a health screening project was 2.7% and it revealed no age dependence. Our study suggests that chronic pelvic pain syndrome has a negative impact on erectile function.

Sexual dysfunction and prostatitis

Despite a large number of reports exploring the links between diseases of the prostate and effects on sexuality, the relationship between prostatitis and sexual dysfunction has not been as thoroughly investigated. A number of reports have focused on the adverse effects of prostatitis on quality of life, with resultant indirect effects on sexuality. More detailed studies are available on the links between ejaculation and the chronic prostatitis/chronic pelvic pain syndrome subgroup of prostatitis. Improvement of sexual dysfunction following treatment of prostatitis has been reported in a few studies, most notably in association with alpha-blocker therapy. This review addresses some of the more relevant reported links between prostatitis and sexual function.