title: Change in sexual function in men with lower urinary tract symptoms/benign prostatic hyperplasia associated with long-term treatment with doxazosin, finasteride and combined therapy.
abstract: OBJECTIVE
  We examined the effects of doxazosin, finasteride and combined therapy in men with lower urinary tract symptoms associated with benign prostatic hyperplasia on sexual function, as assessed by the Brief Male Sexual Function Inventory during 4 years.
  
  
  METHODS
  The MTOPS (Medical Therapy of Prostatic Symptoms) study was a multicenter, randomized, double-blind, placebo controlled clinical trial with a primary outcome of time to benign prostatic hyperplasia progression. Change in sexual function was a secondary outcome. We analyzed the records of 2,783 men enrolled in the study who completed the inventory at baseline and at least once during followup.
  
  
  RESULTS
  In men enrolled in MTOPS sexual function decreased with time. Men assigned to finasteride and combined therapy experienced overall statistically significant but slight worsening of ejaculatory function compared with men on placebo. Men assigned to combined therapy also experienced significant worsening in erectile function and sexual problem assessment. There was no significant difference in changes in any inventory domain in men assigned to doxazosin alone compared to placebo.
  
  
  CONCLUSIONS
  This study significantly extends understanding of the effects of long-term treatment with these drugs on sexual function in men with lower urinary tract symptoms associated with benign prostatic hyperplasia. Treatment with finasteride or combined therapy was associated with worsening sexual function while treatment with doxazosin alone was associated with minimal negative impact, if any. Physicians should discuss with their patients the possible long-term effects of these drugs for lower urinary tract symptoms associated with benign prostatic hyperplasia on sexual function.
authors.affiliation: Social & Scientific Systems, Inc., Silver Spring, Maryland. Electronic address: cfwu@s-3.com.
authors.forename: Chyng-Wen
authors.initials: CW
authors.lastname: Fwu
authors.affiliation: Division of Kidney, Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Eggers
authors.affiliation: Division of Kidney, Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.
authors.forename: Ziya
authors.initials: Z
authors.lastname: Kirkali
authors.affiliation: Division of Urology, Southern Illinois University School of Medicine, Springfield, Illinois.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: McVary
authors.affiliation: George Washington University Biostatistics Center, Rockville, Maryland.
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Burrows
authors.affiliation: Division of Kidney, Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.
authors.forename: John W
authors.initials: JW
authors.lastname: Kusek
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000008:administration & dosage; D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D017292:Doxazosin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D018120:Finasteride / Q000008:administration & dosage*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D019529:Sexuality / Q000187:drug effects*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014554:Urination / Q000187:drug effects*
chemical_list: D058891:5-alpha Reductase Inhibitors; D058668:Adrenergic alpha-1 Receptor Antagonists; D018120:Finasteride; D017292:Doxazosin
keywords: doxazosin; finasteride; lower urinary tract symptoms; physiological; prostate; sexual dysfunction