Sexual Dysfunction and Lower Urinary Tract Symptoms (LUTS) Associated with Benign Prostatic Hyperplasia (BPH)
Rosen RC, Giuliano F, Carson CC; European Urology 47 (2005) 824-837
KEY WORDS: Benign prostatic hyperplasia; Lower urinary tract symptoms; Sexual dysfunction; mpotence; Erectile dysfunction; Ejaculatory dysfunction; Medical therapy
It was widely assumed that symptoms of male sexual dysfunction were a natural consequence of the aging process. As a result, many older men did not seek help for their sexual problems and health care providers frequently failed to ask their patients about their sexual concerns. However, sexuality is an essential aspect of a couple's relationship and has a significant impact on life satisfaction.
- The results of several recent large-scale studies have shown a consistent and strong relationship between LUTS and both ED and EjD. It appears that the pathophysiological mechanisms of LUTS and the related prostatic enlargement of BPH as well as certain treatments for this condition may have an impact on both the erection and ejaculation components of the sexual response. Validated questionnaires that assess sexual function provide clinicians with valuable information to help guide treatment selection decisions.
- Effective medical therapies for LUTS associated with BPH include a1-adrenergic receptor antagonists (i.e., alfuzosin, doxazosin, tamsulosin, and terazosin) and 5a-reductase inhibitors (i.e., finasteride and dutasteride). The side effects of these medications, including sexual dysfunction, are important distinguishing features. The successful management of patients with LUTS associated with BPH should include assessments of sexual function and monitoring of medication-related sexual side effects. For men with LUTS and sexual dysfunction, an appropriate integrated management approach, based on each patient's symptoms and outcome objectives, is warranted.
