title: Medical therapy for benign prostatic hyperplasia: sexual dysfunction and impact on quality of life.
abstract: Therapies for benign prostatic hyperplasia (BPH) may either improve or exacerbate sexual function with an ensuing impact on quality of life. Here we review a total of 73 papers on medical therapies for BPH with a focus on the effects of different pharmacological agents on sexual function. For example, certain alpha(1)-adrenergic receptor blockers may improve erectile function; however, ejaculatory dysfunction with one of these agents, tamsulosin, occurs at a rate of 4-18%, rising to 30% with long-term use. In addition, treatment with the 5 alpha-reductase inhibitor finasteride is associated with problems of ejaculation (2.1-7.7%), erection (4.9-15.8%), and libido (3.1-5.4%). Such significant and undesirable complications in relation to sexual function produce a well-documented negative impact on quality of life. Thus, optimal treatment for men with BPH requires the use of agents that demonstrate efficacy and safety with fewer sexual side effects.
authors.affiliation: Department of Urology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157, USA. dcarbone@wfubmc.edu
authors.forename: D J
authors.initials: DJ
authors.lastname: Carbone
authors.forename: S
authors.initials: S
authors.lastname: Hodges
mesh_terms: D013741:3-Oxo-5-alpha-Steroid 4-Dehydrogenase / Q000009:adverse effects*; D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects*; D003075:Coitus; D004542:Ejaculation / Q000187:drug effects; D006801:Humans; D007989:Libido / Q000187:drug effects; D008297:Male; D011470:Prostatic Hyperplasia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D014570:Urologic Diseases / Q000209:etiology
chemical_list: D000317:Adrenergic alpha-Antagonists; D013741:3-Oxo-5-alpha-Steroid 4-Dehydrogenase