[Prevalence of ejaculatory dysfunction secondary to alpha-blocker therapy in patients with benign prostatic hyperplasia].
BACKGROUND
Benign prostatic hyperplasia (BPH) is characterized by lower urinary tract symptoms (LUTS) that may cause ejaculatory disorders, although they could be also a consequence of alpha-blocker treatment.


OBJECTIVE
To determine the prevalence of ejaculatory dysfunction in patients with HBP undergoing alpha-blocker therapy. Secondary objectives were to evaluate the effect of different drugs on normal ejaculation and the relationship of dysfunction degree to prognostic factors and BPH severity.


METHODS
Epidemiologic, transversal, uncontrolled and open-label study in 1.177 patients older than 40, who had been diagnosed of BPH/LUTS with more than 6 months of evolution and treated with the same alpha-blocker for at least the last 3 months. Severity of ejaculatory dysfunction was determined by the domain on ejaculation of the Male Sexual Health Questionnaire (MSHQ). Results were stratified by age and BPH severity, determined by the International Prostate Symptoms Score (IPSS).


RESULTS
The prevalence of ejaculatory dysfunction has been estimated to be 82.6% in patients with BPH/LUTS treated with alpha-blockers. Although usually mild, the dysfunction is considered as bothersome by a high percentage of those who suffer it. Advanced age is the most influential factor in the severity of both ejaculatory abnormalities and prostate symptoms. Moreover, a solid correlation between these two parameters has been established. Finally, among the analyzed alpha-blockers, alfuzosin has been associated with the best sexual function.


CONCLUSIONS
More than 80% of patients with BPH suffer ejaculatory abnormalities, which are closely related to the severity of prostate symptoms and increased age. When initiating alpha-blocker treatment, we should consider that alfuzosin is the one with less negative impact on ejaculatory function.
Martín-Morales
A
A
Servicio de Urología, Hospital Carlos Haya, Málaga. amartinmorales@terra.es
Meyer
G
G
Ramírez
E
E
D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004542:Ejaculation; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced* / Q000453:epidemiology*
D000317:Adrenergic alpha-Antagonists