Improvement of sexual function in men with benign prostatic hyperplasia by pharmacologic therapy.

INTRODUCTION: Benign prostatic hyperplasia (BPH) causes disorders of voiding and sexual function. Phar- macologic therapy reduces symptoms of voiding thus impacting sexual function. OBJECTIVE: To determine sex life status in men with BPH before and after pharmacologic treatment adapted to achieve satisfactory sexual function. METHODS: We studied 117 sexually active BPH patients, not previously treated for BPH. After clinical examinations, symptoms of voiding, sexual and ejaculatory function were measured using standardized IPSS, IIEF and MSHQ-EjD questionnaires. After obtaining patients' personal opinion about the importance of their sex life, therapy was chosen and possible side effects explained. Three groups of 39 patients each were formed.The first group was treated with alpha-blocker, tamsulosin, the second with 5-alpha reductase inhibitor, finasteride, while the third group was administered a combination therapy. The complete examination procedure was repeated after 3 and 6 months of therapy. RESULTS: The average age of patients was 61.34 ± 3.04 years. Eighty-seven percent reported that their sex life was important to a certain degree. Satisfaction with their sex life was reported by 47% of patients before treatment and by 67% of respondents 6 months after treatment. Questionnaire scores indicated general improvement of sexual function in all groups, which was statistically significant compared to baseline only in the group on tamsulosin alpha-blocker (2.95 ± 7.81; p = 0.028). The overall satisfaction with sex life as a component of sexual function, improved significantly in the group on the combined therapy (0.78 ± 1.81; p = 0.012). CONCLUSION: Before BPH treatment sexual function should be assessed and therapy customized to the patient's expectations. Side effects of drugs should be presented especially to patients who emphasize the importance of sex life. In the manifested stages of the disease overall satisfaction with sex life may be improved by combined therapy comprising 5-alpha reductase inhibitors and third generation alpha blockers. In earlier stages, BPH alpha blockers monotherapy may improve overall sexual function.