1
|
Roehrborn CG, Rukstalis DB. Prostatic Urethral Lift Versus Medical Therapy: Examining the Impact on Sexual Function in Men with Benign Prostatic Hyperplasia. Eur Urol Focus 2021; 8:217-227. [PMID: 33436276 DOI: 10.1016/j.euf.2020.12.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/17/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Sexual dysfunction is a common side effect of medical therapy for benign prostatic hyperplasia (BPH), whereas prostatic urethral lift (PUL) offers safe and effective relief of lower urinary tract symptoms while preserving sexual function. OBJECTIVE To compare the long-term impact on sexual health of PUL or daily medical therapy of doxazosin or finasteride alone or in combination in BPH patients. DESIGN, SETTING, AND PARTICIPANTS This was a comparative analysis of sexual function outcomes from PUL studies (L.I.F.T. [n=107], Crossover [n=42], and MedLift [n=39]) and the Medical Therapy of Prostatic Symptoms (MTOPS) trial. The men included were sexually active with International Prostate Symptom Score ≥13, Qmax ≤12ml/s, and prostate volume 30-80 cm3. MTOPS subjects completed the Brief Male Sexual Function Inventory, while PUL subjects completed the International Index of Erectile Function and the Male Sexual Health Questionnaire for Ejaculatory Function. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Mean percentage changes from baseline in erectile, ejaculatory, and sexual satisfaction domains were compared at 12, 24, 36, and 48 mo. RESULTS AND LIMITATIONS PUL significantly improved erectile function through 24 mo, and ejaculatory function and sexual satisfaction across all time points. Medical therapy did not improve sexual function at any time point. Finasteride significantly decreased erectile function at 48 mo, and combined therapy significantly reduced ejaculatory function at 12 and 24 mo. Comparatively, PUL was superior to finasteride in preserving erectile function at 24 and 48 mo, and superior to doxazosin and combined therapy at 12 mo. PUL outperformed all three medical therapies at all time points in improving ejaculatory function and sexual satisfaction. Limitations include the use of distinct patient-reported questionnaires and narrowed data on comorbidities that influence male sexual function. CONCLUSIONS Indirect comparison reveals that PUL is superior to BPH medical therapy in preserving erectile and ejaculatory function and sexual satisfaction. PATIENT SUMMARY In our non-head-to-head study, only patients undergoing PUL for an enlarged prostate experienced improvements in sexual health. Conversely, patients on medical therapy experienced worsening of erectile and ejaculatory function.
Collapse
Affiliation(s)
| | - Daniel B Rukstalis
- Prisma Health USC Medical Group, Division of Urology; 300 Palmetto Health Pkwy, Columbia, SC 29212
| |
Collapse
|
2
|
Yeh HF, Li TF, Tsai CH, Wu PW, Huang YH, Huang WJ, Chen FJ, Hwang SJ, Chen FP, Wu TP. The effects of a Chinese herbal medicine (VGHBPH0) on patients with benign prostatic hyperplasia: A pilot study. J Chin Med Assoc 2020; 83:967-971. [PMID: 32649417 PMCID: PMC7526580 DOI: 10.1097/jcma.0000000000000384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The current Western medicine treatment options for benign prostatic hyperplasia (BPH) have various degrees of documented effectiveness. However, the uses of these interventions are limited to specific patient populations or have certain side effects that interfere with patient quality of life. This study evaluated the clinical effects of a Chinese herbal medicine (CHM) on patients with BPH. METHODS This was a single-arm pilot study. Twenty BPH patients were enrolled, and they were required to take the investigated CHM three times a day for 8 weeks, along with their Western medicine. Patients returned to clinics as scheduled and completing international prostate symptoms scores (IPSS), aging male symptoms score, international index of erectile function, and body constitution questionnaire of traditional Chinese medicine. Uroflowmetry and sonography were also applied to evaluate the changes in urinary velocity and post-voiding residual urine volume from the baseline to the end of the study. RESULTS The mean IPSS total score was significantly decreased by 2.5 points after 8 weeks of treatment with the CHM (from 17.5 to 15.0, p = 0.03). The mean IPSS voiding subscore was decreased by 1.7 points (from 10.1 to 8.4, p = 0.02), and the mean incomplete emptying subscore was decreased by 0.8 points (from 2.9 to 2.1, p = 0.02), with both decreases being statistically significant. A descending trend in the post-voiding residual urine volume was also observed (from 52.9 to 30.8 mL, p = 0.07). CONCLUSION This trial indicated that the add-on CHM treatment (VGHBPH0) might be a potential treatment for improving the lower urinary tract symptoms of BPH patients.
Collapse
Affiliation(s)
- Hsin-Fu Yeh
- Department of Family Medicine, St. Martin De Porres Hospital, Chiayi, Taiwan, ROC
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Tsai-Feng Li
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Cheng-Hung Tsai
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Pei-Wen Wu
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yi-Hsiu Huang
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - William J. Huang
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Fun-Jou Chen
- School of Chinese Medicine, China Medical University, Taichung, Taiwan, ROC
| | - Shinn-Jang Hwang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Fang-Pey Chen
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Address correspondence. Dr. Fang-Pey Chen, Center for Traditional Chinese Medicine, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail address: (F.-P. Chen)
| | - Ta-Peng Wu
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Address correspondence. Dr. Fang-Pey Chen, Center for Traditional Chinese Medicine, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail address: (F.-P. Chen)
| |
Collapse
|
3
|
Gild P, Dahlem R, Pompe RS, Soave A, Vetterlein MW, Ludwig TA, Maurer V, Marks P, Ahyai SA, Chun FK, Lenke L, Ernst T, Fisch M, Rink M, Meyer CP, Becker A. Retrograde ejaculation after holmium laser enucleation of the prostate (HoLEP)—Impact on sexual function and evaluation of patient bother using validated questionnaires. Andrology 2020; 8:1779-1786. [DOI: 10.1111/andr.12887] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/01/2020] [Accepted: 08/07/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Philipp Gild
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Roland Dahlem
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Raisa S. Pompe
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Armin Soave
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Malte W. Vetterlein
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Tim A. Ludwig
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Valentin Maurer
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Phillip Marks
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Sascha A. Ahyai
- Department of Urology University Medical Center Goettingen Goettingen Germany
| | - Felix K.‐H. Chun
- Department of Urology University Medical Center Frankfurt Germany
| | - Lukas Lenke
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Tabea Ernst
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Margit Fisch
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Michael Rink
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Christian P. Meyer
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Andreas Becker
- Department of Urology University Medical Center Hamburg‐Eppendorf Hamburg Germany
- Department of Urology University Medical Center Frankfurt Germany
| |
Collapse
|
4
|
Cheng BKC, Li TCF, Yu CHT. Sexual outcomes of endoscopic enucleation of prostate. Andrologia 2020; 52:e13724. [PMID: 32557813 DOI: 10.1111/and.13724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/24/2020] [Accepted: 05/30/2020] [Indexed: 12/28/2022] Open
Abstract
The emergence of various endoscopic enucleation techniques in the past decade has provided surgeons with more options and opportunities in performing enucleation. With the same surgical principle as holmium laser enucleation of prostate, the early results of different techniques were comparable. However, sexual outcomes of endoscopic enucleation of the prostate (EEP) were less commonly reported than the voiding and urodynamic outcomes. In this review, the sexual outcomes including erectile function, ejaculatory and orgasmic function of various endoscopic enucleation technique would be studied. The overall sexual outcomes were heterogeneous and inconclusive. Outcomes measurement, sample size calculation, hypothesis generation and selection criteria were not specifically designed for sexual outcomes or even available. There were also limitations in the individual sexual assessment tools. Nonetheless, most studies showed no significant deterioration of erectile function after EEP, and ejaculation dysfunction was common. Looking forward in the field of benign prostatic enlargement surgery, the 'one size fits all' notion should be abandoned. Treatment should be tailor-made according to the prostate size, co-morbidities and sexual needs. The sexual outcomes of enucleation have to be better studied and defined. More prospective controlled studies focusing primarily on sexual functions are needed. For enucleation surgeons, exploring different ejaculatory-sparing technique could be the golden opportunities in further consolidating the role and expanding the indication of enucleation surgery.
Collapse
Affiliation(s)
| | | | - Chloe Hui-Tung Yu
- Department of Surgery, United Christian Hospital, Hong Kong, Hong Kong
| |
Collapse
|
5
|
Lee DS, Kim SW, Sohn DW. Association between Nocturnal Frequency and Erectile Function in Eugonadal Men with Benign Prostatic Obstruction: A Cross Sectional Study. World J Mens Health 2020; 39:338-345. [PMID: 32202080 PMCID: PMC7994652 DOI: 10.5534/wjmh.190146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 12/29/2019] [Indexed: 01/04/2023] Open
Abstract
Purpose We aimed to evaluate the association between nocturnal frequency and erectile dysfunction in patients with benign prostatic obstruction. Materials and Methods To evaluate the association, we simultaneous evaluated urodynamic study, prostate ultrasound, nocturnal tumescence test (nocturnal penile tumescence) for sleep-related erection (SRE) and two questionnaires, international prostate symptom score (IPSS) and 5-item version of the international index of erectile function (IIEF-5). Patients with hypogonadism or nocturnal polyuria were excluded. Results Forty-six patients were registered over 4 years. The mean age, prostate size, IPSS score, and IIEF-5 score were 67.65±5.51 years, 65.10±22.12 mL, 24.67±7.89, and 9.50±7.01, respectively. Among the IPSS subscores, nocturia was most significantly related to the total IIEF-5 score (p<0.001). More severe nocturia was associated with less frequent SRE (p=0.003) and shorter total duration of SRE (p=0.002), which in turn elucidated that nocturia was significantly related to the total amount of rigidity signals (rigidity activity unit, RAU) or tumescence signals (tumescence activity unit, TAU). Among objective urodynamic parameters, bladder compliance also correlated to RAU and TAU. Individual subjective erectile function (IIEF-5) was significantly related to both RAU and TAU. Conclusions Sleep fragmentation due to benign prostate obstruction related nocturnal frequency caused by reduced bladder compliance could decrease the frequency and duration of SRE, which decreases the total amount of SRE and reflects the patient's relevant erectile function.
Collapse
Affiliation(s)
- Dong Sup Lee
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Sae Woong Kim
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Wan Sohn
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
| |
Collapse
|
6
|
Wu B, Li J, Xu Q, Hou R, Jia W, Chen Q. Vaporization of Prostate by 160W GreenLight Laser on Postoperative Erectile Function. Urology 2019; 132:164-169. [DOI: 10.1016/j.urology.2019.06.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/21/2019] [Accepted: 06/26/2019] [Indexed: 11/30/2022]
|
7
|
De Nunzio C, Roehrborn CG, Andersson KE, McVary KT. Erectile Dysfunction and Lower Urinary Tract Symptoms. Eur Urol Focus 2017; 3:352-363. [PMID: 29191671 DOI: 10.1016/j.euf.2017.11.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/12/2017] [Accepted: 11/13/2017] [Indexed: 01/10/2023]
Abstract
CONTEXT Lower urinary tract symptoms (LUTSs) and erectile dysfunction (ED) are substantial health concerns with a significant impact on the overall male quality of life. OBJECTIVE To evaluate the available evidence of the association between LUTSs and ED in patients with benign prostatic hyperplasia (BPH), and discuss possible clinical implications for the management of LUTS/BPH. EVIDENCE ACQUISITION A systematic review of the existing literature published between 1997 and June 2017 and available in the Medline, Scopus, and Web of Science databases was conducted using both the Medical Subject Heading (MeSH) and free-text protocols. The MeSH search was conducted by combining the following terms: "lower urinary tract symptoms," "LUTS," "benign prostatic hyperplasia," "BPH," "erectile dysfunction," "sexual dysfunction," "BPE," and "benign prostatic enlargement." The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. EVIDENCE SYNTHESIS Several community-based studies in different geographical areas have provided strong evidence of an age-independent association between LUTSs and ED. Several biological mechanisms have been proposed to explain this association, but further research is required to better understand the molecular pathways involved. It is necessary to evaluate the possible impact of the metabolic syndrome treatment on LUTS/ED management. Considering the possible relationship between LUTSs and ED, their impact on the quality of life, and the possible adverse effects associated with LUTS medical treatment, clinicians should always evaluate ED in patients with LUTSs and take the opportunity to evaluate patients reporting ED for LUTSs. CONCLUSIONS Data from the peer-reviewed literature suggest the existence of an association between LUTS/BPH and ED, although their casual relationship has not been established yet. Emerging data also suggest that pathophysiological mechanisms involved in the metabolic syndrome are key factors in both disorders. Considering the association, it is also recommended that men presenting with LUTSs or ED should be evaluated for both disorders. A better understanding of the molecular pathways behind this association may also help identify new possible targets and develop novel therapeutic approaches to manage LUTSs and ED. PATIENT SUMMARY In this manuscript, we report on all the available evidence linking erectile dysfunction and lower urinary tract symptoms. Our findings suggest the existence of a strong relationship between these two conditions. On the basis of these findings, we recommend that clinicians always explore both conditions in male patients presenting with either of symptoms.
Collapse
Affiliation(s)
- Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, "La Sapienza" University, Roma, Italy.
| | - Claus G Roehrborn
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Kevin T McVary
- Southern Illinois University School of Medicine, Springfield, IL, USA
| |
Collapse
|
8
|
Association of urinary nerve growth factor levels with erectile function in young men with type 2 diabetes mellitus. Int J Impot Res 2017; 29:101-104. [DOI: 10.1038/ijir.2017.2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 10/31/2016] [Accepted: 01/04/2017] [Indexed: 11/09/2022]
|
9
|
Patient Perception of Ejaculatory Volume Reduction After Holmium Laser Enucleation of the Prostate (HoLEP). Urology 2016; 99:142-147. [PMID: 27725232 DOI: 10.1016/j.urology.2016.09.037] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 09/20/2016] [Accepted: 09/21/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate patient perception of ejaculatory volume reduction after Holmium laser enucleation of the prostate (HoLEP). MATERIALS AND METHODS A total of 192 patients were included in the analysis. All patients completed 6 self-developed, nonvalidated questionnaires. The questionnaires were composed of questions involving overall satisfaction, voiding symptom change, current experience of sexual intercourse, ejaculatory volume change, change of orgasmic intensity, and the patient's perception of postoperative ejaculatory volume reduction. Questionnaire results and clinical parameters were analyzed, and subgroup analysis according to the patient's perception was also performed. RESULTS The median patient age was 66.0 years, and the mean total prostate volume and enucleated prostate volume was 61.9 ± 24.1 mL and 22.4 ± 14.0 mL, respectively. Among 192 patients, 91 patients had had sexual intercourse within the past 3 months. Ejaculatory volume changes after HoLEP were as follows: "total loss" (76.9%), "decreased" (18.7%), and "no change"(4.4%). Among the 87 patients who reported ejaculatory volume reduction, their perceptions of this issue were as follows: "feels better"(2.3%), "not a problem" (16.1%), "disappointed, but able to tolerate, owing to improvement of voiding symptoms" (73.6%), and "dissatisfied and want to reverse the situation"(8.0%). Decreased orgasmic intensity was present in 48 (52.8%) patients. There were significantly more patients who reported decreased orgasmic intensity among those who wanted to reverse the situation compared with the others (P = .027). CONCLUSION Our study showed that most of the patients reported ejaculatory volume reduction and more than half of the patients reported decreased orgasmic intensity after HoLEP. We also found that patients' perceptions of ejaculatory volume reduction and orgasmic intensity were closely related to each other.
Collapse
|
10
|
Li Z, Chen P, Wang J, Mao Q, Xiang H, Wang X, Wang X, Zhang X. The impact of surgical treatments for lower urinary tract symptoms/benign prostatic hyperplasia on male erectile function: A systematic review and network meta-analysis. Medicine (Baltimore) 2016; 95:e3862. [PMID: 27310968 PMCID: PMC4998454 DOI: 10.1097/md.0000000000003862] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) is common in adult men and can impair erectile function (EF). It was believed surgical treatments for this illness can improve EF due to the relief of LUTS while they were also reported harmed EF as heating or injury effect. Current network meta-analysis aimed to elucidate this discrepancy.Randomized controlled trials (RCTs) were identified. Direct comparisons were conducted by STATA and network meta-analysis was conducted by Generate Mixed Treatment Comparison. Random-effects models were used to calculate pooled standard mean difference and 95% confidence intervals and to incorporate variation between studies.Eighteen RCTs with 2433 participants were analyzed. Nine approaches were studied as transurethral resection of the prostate (TURP), plasmakinetic resection of the prostate (PKRP), plasmakinetic enucleation of the prostate (PKEP), Holmium laser enucleation of the prostate (HoLEP), Holmium laser resection of the prostate (HoLRP), photoselective vaporization of the prostate (PVP), Thulium laser, open prostatectomy (OP), and laparoscopic simple prostatectomy (LSP). In direct comparisons, all surgical treatments did not decrease postoperative International Index of Erectile Function (IIEF)-5 score except PVP. Moreover, patients who underwent HoLEP, PKEP, Thulium laser, and TURP had their postoperative EF significantly increased. Network analysis including direct and indirect comparisons ranked LSP at the highest position on the variation of postoperative IIEF-5 score, followed by PKRP, HoLEP, TURP, Thulium laser, PKEP, PVP, HoLRP, and OP. In subgroup analysis, only PVP was found lower postoperative EF in the short term and decreased baseline group, whereas TURP increased postoperative IIEF-5 score only for patients with normal baseline EF. However, HoLEP and PKEP showed pro-erectile effect even for patients with decreased baseline EF and short-term follow-up. Our novel data demonstrating surgical treatments for LUTS/BPH showed no negative impact on postoperative EF except PVP. Moreover, HoLEP and PKEP were found pro-erectile effect for all subgroups. New technologies, such as LSP, PKRP, and Thulium laser, were ranked at top positions in the network analysis, although they had no pro-erectile effect in direct comparison due to limited original studies or poor baseline EF. Therefore, further studies and longer follow-up are required to substantiate our findings.
Collapse
Affiliation(s)
- Zhuo Li
- Department of Urology, Zhongnan Hospital of Wuhan University
| | - Ping Chen
- Department of Urology, Zhongnan Hospital of Wuhan University
| | - Jun Wang
- Department of Urology, Children's Hospital of Wuhan
| | - Qi Mao
- Department of Urology, Zhongnan Hospital of Wuhan University
| | - Han Xiang
- Department of Urology, Zhongnan Hospital of Wuhan University
| | - Xiao Wang
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, P.R. China
| | - Xinghuan Wang
- Department of Urology, Zhongnan Hospital of Wuhan University
| | - Xinhua Zhang
- Department of Urology, Zhongnan Hospital of Wuhan University
| |
Collapse
|
11
|
Furukawa S, Sakai T, Niiya T, Miyaoka H, Miyake T, Yamamoto S, Maruyama K, Tanaka K, Ueda T, Senba H, Torisu M, Minami H, Onji M, Tanigawa T, Matsuura B, Hiasa Y, Miyake Y. Nocturia and prevalence of erectile dysfunction in Japanese patients with type 2 diabetes mellitus: The Dogo Study. J Diabetes Investig 2016; 7:786-90. [PMID: 27180646 PMCID: PMC5009143 DOI: 10.1111/jdi.12503] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 01/26/2016] [Accepted: 02/15/2016] [Indexed: 12/02/2022] Open
Abstract
Aims/Introduction Several epidemiological studies have reported a positive association between nocturia and erectile dysfunction (ED). Yet only limited evidence exists regarding the association between nocturia and ED among patients with type 2 diabetes mellitus, although nocturia and ED are common among type 2 diabetes mellitus patients. Material and Methods Study participants were 332 male Japanese patients with type 2 diabetes mellitus, aged 19–70 years, who had undergone blood tests at our institutions. A self‐administered questionnaire was used to collect information on the variables under study. Adjustment was made for age, body mass index, hypertension, stroke, ischemic heart disease, glycated hemoglobin and diabetic neuropathy. ED, moderate to severe ED and severe ED were defined as present when a participant had a Sexual Health Inventory for Men score <22, <12 and <8, respectively. Study participants were considered to have nocturia if they answered ‘once or more’ to the question: ‘Within 1 week, how many times do you typically wake up to urinate from sleeping at night until waking in the morning?’ Results The prevalence of nocturia was 79.8%. Nocturia was independently positively associated with ED and moderate to severe ED: the adjusted odds ratios were 7.86 (95% confidence interval 2.11–33.56) and 2.17 (95% confidence interval 1.16–4.12), respectively. The positive association between nocturia and severe ED fell just short of significance. Conclusions In Japanese men with type 2 diabetes mellitus, nocturia might be associated with ED and moderate to severe ED. Several epidemiological studies have reported a positive association between nocturia and erectile dysfunction (ED). Yet only limited evidence exists regarding the association between nocturia and ED among patients with type 2 diabetes mellitus, although nocturia and ED are common among type 2 diabetes mellitus patients.
Collapse
Affiliation(s)
- Shinya Furukawa
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Toon, Japan
| | - Takenori Sakai
- Department of Internal Medicine, Yawatahama General City Hospital, Yawatahama, Japan
| | - Tetsuji Niiya
- Department of Internal Medicine, Matsuyama Shimin Hospital, Matsuyama, Japan
| | - Hiroaki Miyaoka
- Department of Internal Medicine, Saiseikai Matsuyama Hospital, Matsuyama, Japan
| | - Teruki Miyake
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Shin Yamamoto
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Koutatsu Maruyama
- Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan
| | - Keiko Tanaka
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Toon, Japan
| | - Teruhisa Ueda
- Department of Internal Medicine, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Hidenori Senba
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Japan.,Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Masamoto Torisu
- Department of Internal Medicine, Saiseikai Saijo Hospital, Saijo, Japan
| | - Hisaka Minami
- Department of Internal Medicine, Ehime Niihama Hospital, Niihama, Japan
| | - Morikazu Onji
- Department of Internal Medicine, Saiseikai Imabari Hospital, Imabari, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan
| | - Bunzo Matsuura
- Department of Lifestyle-related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yoshihiro Miyake
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Toon, Japan
| |
Collapse
|
12
|
|
13
|
Kim SH, Yang HK, Lee HE, Paick JS, Oh SJ. HoLEP does not affect the overall sexual function of BPH patients: a prospective study. Asian J Androl 2015; 16:873-7. [PMID: 25038179 PMCID: PMC4236332 DOI: 10.4103/1008-682x.132469] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
We aimed to prospectively evaluate the influence of holmium laser enucleation of the prostate (HoLEP) on the overall postoperative sexual function of benign prostatic hyperplasia (BPH) patients with lower urinary tract symptoms (LUTS) and to explore the relationship between sexual function and LUTS. From January 2010 to December 2011, sixty sexually active consecutive patients with BPH who underwent HoLEP were prospectively enrolled in the study. All patients filled out the Male Sexual Health Questionnaire (MSHQ) for evaluation of their overall sexual function and the International Prostatic Symptom Score (IPSS) for pre- and post-operative 6 months evaluation of their voiding symptoms. The LUTS and sexual function changes were statistically analyzed. The preoperative and 6 months postoperative status of the patients was compared using uroflowmetry and IPSS questionnaires. The analysis revealed significant improvements following HoLEP. Among the sub-domains of the MSHQ, postoperative sexual function, including erection, ejaculation, sexual satisfaction, anxiety or sexual desire, did not significantly change after HoLEP (P > 0.05), whereas satisfaction scores decreased slightly due to retrograde ejaculation in 38 patients (63.3%). Sexual satisfaction improved significantly and was correlated with the improvements of all LUTS and the quality-of-life (QoL) domains in IPSS after surgery (QoL; relative risk [RR]: −0.293; total symptoms, RR: −0.411; P < 0.05). The nocturia score was associated with the erectile function score (odds ratio 0.318, P = 0.029). The change in ejaculatory scores did not show significant association with IPSS scores. HoLEP did not influence overall sexual function, including erectile function. In addition, sexual satisfaction improved in proportion with the improvement of LUTS.
Collapse
Affiliation(s)
| | | | | | | | - Seung-June Oh
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
14
|
Zhang X, Tang D, Xu C, Gao P, Hao Z, Zhou J, Liang C. The relationship between self-estimated intravaginal ejaculatory latency time and International Prostate Symptom Score in middle-aged men complaining of ejaculating prematurely in China. J Sex Med 2015; 12:705-12. [PMID: 25630352 DOI: 10.1111/jsm.12811] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Some factors associated with the four premature ejaculation (PE) syndromes have been studied, but the association between International Prostate Symptom Score (IPSS) and the four PE syndromes has not been investigated. AIMS We performed this study to evaluate the association between IPSS and intravaginal ejaculatory latency time (IELT) in men with the four PE syndromes. METHODS From June 2012 to January 2014, a total of 690 men aged 40-59 years complaining of ejaculating prematurely and another 452 male healthy subjects of the same age without these complaints were included in this study. Men with the complaints of ejaculating prematurely were classified as one of the four PE syndromes: lifelong PE, acquired PE (APE), variable PE, and subjective PE. Each of them completed a detailed questionnaire including information on demographics, medical and sexual history (e.g., self-estimated IELT), IPSS, and International Index of Erectile Function-5. MAIN OUTCOME MEASURES Associations between IPSS and self-estimated IELT in middle-aged men with the four PE syndromes. RESULTS Men complaining of ejaculating prematurely reported higher IPSS (11.2 ± 6.0 vs. 5.5 ± 3.3 ) and shorter self-estimated IELT (2.1 ± 1.6 minutes vs. 4.8 ± 3.3) than men without complaints (P < 0.001 for each). By unilabiate analysis, self-estimated IELT in men with the four PE syndromes showed significant correlations with IPSS (P < 0.001 for all). After adjusting for age, self-estimated IELT was negatively associated with IPSS in men with PE complaints (adjusted r = -0.378, P < 0.001). Also, the association was stronger in men with APE (adjusted r = -0.502, P < 0.001). CONCLUSIONS Men complaining of ejaculating prematurely reported worse IPSS than men without these complaints. Self-estimated IELT was negatively associated with IPSS in men complaining of ejaculating prematurely, and the correlation was the strongest in men with APE.
Collapse
Affiliation(s)
- Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | | | | | | | | | | | | |
Collapse
|
15
|
Gacci M, Carini M, Salvi M, Sebastianelli A, Vignozzi L, Corona G, Maggi M, McVary KT, Kaplan SA, Oelke M, Serni S. Management of benign prostatic hyperplasia: role of phosphodiesterase-5 inhibitors. Drugs Aging 2015; 31:425-39. [PMID: 24811735 DOI: 10.1007/s40266-014-0177-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Several studies have highlighted a strong association between benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) and erectile dysfunction (ED), particularly in elderly men. Many epidemiological trials, such as in vitro and in vivo studies, have reported the emerging role of metabolic syndrome, including abdominal obesity, impaired glucose metabolism, hypertriglyceridemia, low high-density lipoprotein cholesterol, and hypertension, in the development and progression of urinary and sexual symptoms. Moreover, many authors have focused their studies on the identification of all the shared pathogenetic mechanisms of LUTS/BPH and ED, including alteration of cyclic guanosine monophosphate and RhoA-ROCK pathways or vascular and neurogenic dysfunction. All these are potential targets for proposed phosphodiesterase type 5 inhibitors (PDE5-Is). Therefore, several trials have recently been designed to evaluate the role of PDE5-Is alone or in combination with conventional treatment for BPH, such as α-adrenergic blockers, in men affected by LUTS/BPH, with or without ED. Different PDE5-Is are in clinical use worldwide and currently six of them are licensed for the oral treatment of ED. All these compounds differ in pharmacokinetic factors, with influence on drug action, and subsequently in the overall safety and efficacy profile.
Collapse
Affiliation(s)
- M Gacci
- Department of Urology, University of Florence, Careggi Hospital, Viale Pieraccini 18, 50139, Florence, Italy,
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Song J, Shao Q, Tian Y, Chen S. Lower urinary tract symptoms, erectile dysfunction, and their correlation in men aged 50 years and above: a cross-sectional survey in Beijing, China. Med Sci Monit 2014; 20:2806-10. [PMID: 25543209 PMCID: PMC4285920 DOI: 10.12659/msm.891180] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background The aim of this study was to investigate the correlation between incidence of lower urinary tract symptoms and erectile dysfunction in men aged ≥50 years. Material/Methods A cross-sectional study was performed in 1644 men aged >50 years in Beijing. The International Index of Erectile Function (IIEF)-5 and International Prostate Symptom Score were recorded for each patient. Pearson’s chi-square test and Spearman correlation coefficients were used to analyze the International Prostate Symptom Scores and lower urinary tract symptoms, and their correlations with erectile dysfunction. Results The incidence rates of erectile dysfunction among men with mild, moderate, and severe lower urinary tract symptoms were 85.7, 93.7, and 97.9%, respectively. Interestingly, the total IIEF-5 score significantly correlated with the total International Prostate Symptom Score (r=−0.335; P<0.01), obstructive symptoms (r=−0.276; P<0.01), and irritative symptoms (r=−0.326; P<0.01). The correlation between the severity of lower urinary tract symptoms and that of erectile dysfunction was consistently maintained (r=0.304; P<0.01). Age significantly correlated with International Prostate Symptom Score (r=0.388; P<0.01), lower urinary tract symptoms severity (r=0.457; P<0.01), total IIEF-5 score (r=−0.533; P<0.01), and erectile dysfunction severity (r=0.529; P<0.01). Conclusions The incidence of lower urinary tract symptoms and erectile dysfunction in aging men increase with age, and the severity of erectile dysfunction is positively correlated with the severity of lower urinary tract symptoms.
Collapse
Affiliation(s)
- Jian Song
- Department of Urology, Beijing Friendship Hospital, Capital Medical Universty, Beijing, China (mainland)
| | - Qiang Shao
- Department of Urology, Beijing Friendship Hospital, Capital Medical Universty, Beijing, China (mainland)
| | - Ye Tian
- Department of Urology, Beijing Friendship Hospital, Capital Medical Universty, Beijing, China (mainland)
| | - Shan Chen
- Department of Urology, Beijing Friendship Hospital, Capital Medical Universty, Beijing, China (mainland)
| |
Collapse
|
17
|
Favilla V, Cimino S, Salamone C, Fragalà E, Madonia M, Condorelli R, La Vignera S, Mongioì L, Pirozzi Farina F, Russo GI, Morgia G. Risk factors of sexual dysfunction after transurethral resection of the prostate (TURP): a 12 months follow-up. J Endocrinol Invest 2013; 36:1094-8. [PMID: 24445123 DOI: 10.1007/bf03346761] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim of this study was to evaluate the impact of risk factors of erectile dysfunction (ED) after transurethral resection of the prostate (TURP) in men with lower urinary tract symptoms caused by bladder outlet obstruction secondary to benign prostatic hyperplasia. The study was conducted prospectively on 178 consecutive patients (normal IIEF-5 before surgery, ≥ 22) who underwent TURP. Patients were assessed before surgery and at 12 months. At 12 months, the IIEF-5 score significantly decreased from24 to 18 (p<0.0001). No statistical associations were found between hypertension, diabetes, dyslipidemia and capsular perforation and the development of ED after TURP. Operating time, duration of catheterization, and BMI did not determine a significant decrease of the IIEF-5 score after TURP. On univariable and multivariable linear regression analysis, age was the only risk factor associated with newly-reported ED 12 months after TURP (p<0.0001). On univariable andmultivariable logistic regression analysis, patients older than 65 yr had an higher risk of developing ED after TURP (p<0.0001) and they developed a lower IIEF-5 score (p<0.0001) at followup when compared with those ≤ 65 yr. These results suggest that age of patients represents an independent risk factor of ED at 12 months follow-up after TURP.
Collapse
Affiliation(s)
- V Favilla
- Department of Urology, University of Catania, Catania, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Fusco F, D'Anzeo G, Sessa A, Pace G, Rossi A, Capece M, d'Emmanuele di Villa Bianca R. BPH/LUTS and ED: Common Pharmacological Pathways for a Common Treatment. J Sex Med 2013; 10:2382-93. [DOI: 10.1111/jsm.12261] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
19
|
Komiya A, Kino M, Kato T, Suzuki H, Ichikawa T, Fuse H. Correlations Among Urinary, Sexual, and Testicular Functions and Health-Related Quality of Life. JOURNAL OF MEN'S HEALTH 2013. [DOI: 10.1089/jomh.2012.00040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
20
|
Ryu JK, Cho KS, Kim SJ, Oh KJ, Kam SC, Seo KK, Shin HS, Kim SW. Korean Society for Sexual Medicine and Andrology (KSSMA) Guideline on Erectile Dysfunction. World J Mens Health 2013; 31:83-102. [PMID: 24044105 PMCID: PMC3770856 DOI: 10.5534/wjmh.2013.31.2.83] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 05/20/2013] [Accepted: 06/04/2013] [Indexed: 11/20/2022] Open
Abstract
In February 2011, the Korean Society for Sexual Medicine and Andrology (KSSMA) realized the necessity of developing a guideline on erectile dysfunction (ED) appropriate for the local context, and established a committee for the development of a guideline on ED. As many international guidelines based on objective evidence are available, the committee decided to adapt these guidelines for local needs instead of developing a new guideline. Considering the extensive research activities on ED in Korea, data with a high level of evidence among those reported by Korean researchers have been collected and included in the guideline development process. The latest KSSMA guideline on ED has been developed for urologists. The KSSMA hopes that this guideline will help urologists in clinical practice.
Collapse
Affiliation(s)
- Ji Kan Ryu
- Department of Urology, Inha University School of Medicine, Incheon, Korea
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Glina S, Glina FPA. Pathogenic mechanisms linking benign prostatic hyperplasia, lower urinary tract symptoms and erectile dysfunction. Ther Adv Urol 2013; 5:211-8. [PMID: 23904860 DOI: 10.1177/1756287213488236] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) are clinical entities very prevalent in men aged over 50 years. There is evidence that both may have a common pathophysiology. OBJECTIVE The objective of this study was to conduct a literature review aiming to show theories and hypotheses that justify a single pathophysiology for ED and LUTS/BPH. METHODS A search in Medline using the keywords of the Medical Subject Headings (MESH) 'erectile dysfunction' and 'lower urinary tract symptoms' in all fields of the database up to 15 December 2012. This search found 198 relevant articles that were analyzed. RESULTS The data and articles were divided according to the type of evidence found. There are strong epidemiological data showing that LUTS/BPH is a risk factor for developing ED. Several experimental models demonstrated partial obstruction of the bladder in animals causes voiding disorders as well as a negative impact on erectile function of the operated animals. The increased adrenergic tonus in animals leads to prostate growth and urodynamic conditions similar to those found in men with LUTS and ED. Arteriosclerosis may lead to loss of vesical complacency, urinary tract obstruction and fibrosis of the cavernous bodies. The use of phosphodiesterase type 5 inhibitors (PDE-5i) and/or alpha-adrenergic blockers to treat ED and LUTS/BPH reinforces the hypothesis that, at least in some patients, both clinical pictures may have the same pathophysiology.
Collapse
Affiliation(s)
- Sidney Glina
- Instituto H.Ellis, Rua Cincinato Braga, 37 cj 102, Sao Paulo, 01333-011, Brazil
| | | |
Collapse
|
22
|
Jo HW, Yoo DS, Ju HT, Whang HW, Park J, Kim ET, Kim DK, Woo SH. Effect of patient-optimized doses of tamsulosin on erectile function in men with erectile dysfunction and lower urinary tract symptoms. Korean J Urol 2013; 54:100-5. [PMID: 23550146 PMCID: PMC3580298 DOI: 10.4111/kju.2013.54.2.100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 10/17/2012] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To investigate the relationship of improvement in erectile function (EF) with improvement in lower urinary tract symptoms (LUTS) and to assess the contribution of tamsulosin dose to the improvement of EF apart from the indirect influence of LUTS improvement in men with LUTS and erectile dysfunction (ED). MATERIALS AND METHODS Fifty patients received tamsulosin 0.2 mg/d for the first 4 weeks and were subsequently divided into two groups by patient-reported outcomes. Nonescalators were maintained starting dose and escalators increased to 0.4 mg for the remaining 8 weeks. International Prostatic Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5), and underwent uroflowmetry were evaluated at baseline, and weeks 4 and 12. RESULTS LUTS parameters were significantly improved in both groups but insignificant between the 2 groups. The degree of the improvement in the total IPSS and in the voiding, storage, and quality of life (QoL) subscores were significantly correlated with the degree of the improvement in EF; this was especially prominent in patients successfully treated LUTS. The escalators experienced a significantly greater increase in IIEF-5 scores than did the nonescalators (3.3 vs. 1.5). CONCLUSIONS Dose escalation provided similar LUTS improvement in patients with refractory to starting dose. The improvements of LUTS were correlated with the improvement of EF. The increase in the IIEF-5 score was significantly higher in escalators. These findings imply that tamsulosin may contribute to the improvement in EF through the improvement of LUTS and QoL and direct relaxation of the corpus cavernosum in a dose-dependent fashion.
Collapse
Affiliation(s)
- Hyun Wook Jo
- Department of Urology, Eulji University School of Medicine, Daejeon, Korea
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Zhang HM, Zheng JH, Xu YF, Peng B, Yan Y, Gao QR. Improvement of erectile function in patients with benign prostatic hyperplasia undergoing transurethral plasmakinetic resection of the prostate. Int J Urol 2013; 20:724-8. [PMID: 23305506 DOI: 10.1111/iju.12024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 10/29/2012] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Although transurethral resection of the prostate remains the gold standard surgical treatment for benign prostatic hyperplasia, transurethral plasmakinetic resection of the prostate has become a popular alternative. This study investigated the effects of plasmakinetic resection of the prostate on erectile function. METHODS A total of 400 patients that underwent plasmakinetic resection of the prostate or transurethral resection of the prostate were prospectively enrolled in this study. Of these, 384 patients met the inclusion criteria. One experienced surgeon carried out all the procedures. The International Prostate Symptom Score, International Index of Erectile Function-5, maximum flow rate and ultrasound postvoid residual volume were determined, and evaluated preoperatively and at 12 months postoperatively. Prostate-specific antigen, age and prostate volume of each patient were recorded. RESULTS The median International Index of Erectile Function-5 score of plasmakinetic resection of the prostate patients significantly increased from 8.0 (interquartile range 7.0-9.0) preoperatively to 21.0 (19.0-22.0) at 12 months postoperatively (P < 0.05). The score of plasmakinetic resection of the prostate patients was significantly higher than that of the transurethral resection of the prostate group (P < 0.05); however, the International Prostate Symptom Score of the plasmakinetic resection of the prostate group was not significantly different from that of the transurethral resection of the prostate group (P > 0.05). CONCLUSIONS A significant improvement in erectile function can be observed at 12 months in patients undergoing plasmakinetic resection of the prostate. Despite these encouraging findings, the effects of plasma kinetic resection of the prostate on erectile function remain to be further studied.
Collapse
Affiliation(s)
- Hai-Min Zhang
- Department of Urology, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China
| | | | | | | | | | | |
Collapse
|
24
|
Zhao Z, Ma W, Xuan X, Ou L, Liang Y, Zeng G. Impact of Plasmakinetic Enucleation of the Prostate (PKEP) on Sexual Function: Results of a Prospective Trial. J Sex Med 2012; 9:1473-81. [DOI: 10.1111/j.1743-6109.2011.02522.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
25
|
Hwa JS, Kam SC, Choi JH, Do JM, Seo DH, Hyun JS. Impact of erectile function and age in men with lower urinary tract symptoms on ejaculatory dysfunction and premature ejaculation. Int J Impot Res 2012; 24:101-5. [PMID: 22357535 DOI: 10.1038/ijir.2012.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Lower urinary tract symptoms (LUTSs) and ED are clearly correlated, but to date no correlation with ejaculatory dysfunction (EjD) has been identified. Therefore, this study evaluated the impact of erectile function in men with LUTS on EjD and premature ejaculation (PE). Erectile function, PE and EjD of 239 men (mean age, 53.0 ± 10.65 years), International Prostate Symptom Score (IPSS), International Index of Erection Function (IIEF), intravaginal ejaculatory latency time (IELT) and the seven-item Male Sexual Health questionnaire (MSHQ)-EjD were used to compare with the degree of LUTS. Ages were divided into five groups (<40, 40-49, 50-59, 60-69 and >70 years). The IPSS categorized patients into three symptom groups: mild, 1-7; moderate, 8-19; and severe, >19. ED was classified into five categories based on IIEF-EF scores: severe (0-6), moderate (7-12), mild-to-moderate (13-18), mild (19-24) and normal (25-30). The correlations among age, IIEF-EF, IELT and the MSHQ-EjD domain were studied through regression and cross-tabulation analyses. The results revealed that aging significantly affected each item of the MSHQ-EjD (P<0.05). The IIEF-EF domain was also correlated with each question on the MSHQ-EjD (P<0.05). PE (IELT <1 min) increased in incidence as patients got older but was not linked to IIEF-EF (P>0.05). These results indicate that EjD is closely related to age and erectile function, and that PE is closely related to age, although PE is not related to erectile function.
Collapse
Affiliation(s)
- J S Hwa
- Department of Urology, School of Medicine, Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea
| | | | | | | | | | | |
Collapse
|
26
|
Permpongkosol S, Krilad‐O‐Larn S, Ratana‐O‐Larn K. Treatment with a Uroselective α1‐Blocker Improves Voiding and Sexual Function: A Study in Thai Men with Lower Urinary Tract Symptoms. J Sex Med 2011; 8:2582-9. [DOI: 10.1111/j.1743-6109.2011.02359.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
27
|
Orabi H, Albersen M, Lue TF. Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management. Int J Impot Res 2011; 23:99-108. [PMID: 21593760 DOI: 10.1038/ijir.2011.14] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
28
|
Seo DH, Kam SC, Hyun JS. Impact of lower urinary tract symptoms/benign prostatic hyperplasia treatment with tamsulosin and solifenacin combination therapy on erectile function. Korean J Urol 2011; 52:49-54. [PMID: 21344031 PMCID: PMC3037507 DOI: 10.4111/kju.2011.52.1.49] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Accepted: 12/20/2010] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To examine the effects on erectile function of concomitant treatment with an alpha-blocker (tamsulosin) and an antimuscarinic agent (solifenacin) in patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). MATERIALS AND METHODS Fifty-seven male patients with LUTS/BPH were assessed for the degree of LUTS and erectile function. In group 1 (tamsulosin) and group 2 (tamsulosin and solifenacin), changes in the International Prostate Symptom Score [IPSS: total scores, storage symptoms (ST), voiding symptoms (VD), and quality of life (QoL)], prostate-specific antigen, trans-rectal ultrasonography, urine flowmetry, residual urine, and a 5-item version of the International Index of Erectile Function (IIEF-5) were assessed after a 3-month treatment period. In both groups, it was determined whether treatment was associated with changes in LUTS and erectile function and whether improvement in the IPSS was correlated with the IIEF-5. Comparative analysis was also done to examine the linear relationship between improved IPSS scores and IIEF-5 scores. RESULTS A comparison of the degree of improvement in all the parameters indicated that both groups showed significant improvement in total IPSS, IPSS-ST, IPSS-VD, and IPSS-QoL (p<0.05). A comparison of the degree of improved sexual function associated with improved LUTS in each patient showed significant improvement in the IIEF-5 score associated with the degree of improvement in the IPSS-ST domain in group 1, but no significant associations were found in group 2. In cases in which tamsulosin was administered, the IIEF-5 score significantly improved as the IPSS-ST domain score improved. In the group in which tamsulosin and solifenacin were concomitantly administered, improvement of the IPSS-ST domain score had no significant effect on the IIEF-5 score. CONCLUSIONS In patients with LUTS/BPH, tamsulosin and solifenacin combination therapy was effective for LUTS, but erectile function was not significantly improved. Therefore, although effective for improving LUTS, combination therapy with an alpha-blocker and an antimuscarinic agent was not effective for improving erectile function.
Collapse
Affiliation(s)
- Deok Ha Seo
- Department of Urology, College of Medicine, Gyeongsang National University, Jinju, Korea
| | | | | |
Collapse
|
29
|
Silva J, Pinto R, Carvalho T, Botelho F, Silva P, Silva C, Cruz F, Dinis P. Intraprostatic botulinum toxin type A administration: evaluation of the effects on sexual function. BJU Int 2010; 107:1950-4. [DOI: 10.1111/j.1464-410x.2010.09841.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
30
|
Leungwattanakij S, Watanachote D, Noppakulsatit P, Petchpaibuol T, Choeypunt N, Tongbai T, Wanamkang T, Lojanapiwat B, Permpongkosol S, Tantiwong A, Pripatnanont C, Akarasakul D, Kongwiwatanakul S, Chotikawanich E. Sexuality and Management of Benign Prostatic Hyperplasia with Alfuzosin: SAMBA Thailand. J Sex Med 2010; 7:3115-26. [DOI: 10.1111/j.1743-6109.2010.01743.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
31
|
Jaidane M, Arfa NB, Hmida W, Hidoussi A, Slama A, Sorba NB, Mosbah F. Effect of transurethral resection of the prostate on erectile function: a prospective comparative study. Int J Impot Res 2009; 22:146-51. [PMID: 19940854 DOI: 10.1038/ijir.2009.56] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The effect of transurethral resection of the prostate (TURP) on erectile function is still controversial, and available evidence is conflicting. One of the possible mechanisms of post-TURP erectile dysfunction (ED) is direct thermal injury to the erectile nerves. The aim of this study was to investigate the effect of TURP on erectile function. Fifty patients undergoing TURP for obstructive benign prostatic hyperplasia (HBP) were prospectively included in the study, and 50 age-matched patients undergoing transurethral resection of the superficial bladder tumor were also prospectively included as a control group. All patients completed the international index of erectile function (IIEF-15), the international prostatic symptom score (IPSS) and the Hospital Anxiety and Depression Scale at inclusion in the study and then at the 3- and 6-month follow-up evaluation. Capsular perforations during TURP were prospectively reported by the operating surgeon. There was a significant improvement of erectile function in the TURP group despite the onset of ejaculation disorders in 70% of the patients. Improvement of erectile function was also found in the subgroup of patients with capsular perforation during TURP. Comparison with the control group showed that at preoperative evaluation, patients in the TURP group had more severe urinary symptoms and worse erectile function than did those of the control group. At the postoperative period, the IPSS score became comparable in the two groups, with major improvement of erectile function in the TURP group. We concluded that TURP improved erectile function in HBP patients with severe urinary symptoms. This improvement of erectile function was observed even in case of capsular perforation.
Collapse
Affiliation(s)
- M Jaidane
- Department of Urology, Sahloul University Hospital, Sousse, Tunisia.
| | | | | | | | | | | | | |
Collapse
|