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Bph Jurnal

Bph Jurnal

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Published by: TwiztThaem Phoethrie Purwantoro on Nov 25, 2012
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Urology. 2009 Mar;73(3):562-6. Epub 2009 Jan 23.
Association of sexual dysfunction withlower urinary tract symptoms of BPH andBPH medical therapies: results from theBPH Registry.
New England Research Institutes, Watertown, Massachusetts 02472, USA.rrosen@neriscience.com 
The severity of lower urinary tract symptoms (LUTS) has correlated with erectile dysfunction(ED) and ejaculatory dysfunction (EjD) in large-scale epidemiologic studies. ED and EjD arealso side effects of some medical therapies for LUTS suggestive of benign prostatichyperplasia (LUTS/BPH). These relationships were examined in a physician office-basedpopulation of men enrolled in the BPH Registry.
Enrolled men with LUTS/BPH who completed the International Prostate Symptom Score(IPSS), IPSS bother question, 5-item International Index of Erectile Function, and the 3ejaculatory function items of the Male Sexual Health Questionnaire-EjD short form atbaseline were eligible. The relationship between sexual dysfunction and LUTS/BPH andBPH medical therapies were examined using multivariate analyses.
Of 6924 men enrolled, 5042 (mean age 65 years) completed all 4 baseline assessments. Of 3084 sexually active men, age, total IPSS, IPSS bother score, hypertension, diabetes, andblack race/ethnicity were independent predictors of both ED and EjD (all P < .05). For thesubset of 1362 men receiving BPH medical therapy, a significant association (P < .0001) wasdemonstrated for ED and EjD with specific BPH medical therapies. The alpha(1A)-subtypenonsuperselective quinazoline alpha(1)-blockers alfuzosin, doxazosin, and terazosin appearedto be associated with better ejaculatory function than were the alpha(1A)-subtypesuperselective sulfonamide alpha(1)-blocker tamsulosin, 5alpha-reductase inhibitors, andalpha(1)-blocker plus 5alpha-reductase inhibitor combination therapy.
These results have provided additional evidence of the link between LUTS/BPH and sexualdysfunction in aging men and support clinical trial results indicating different rates of sexualside effects for BPH medical therapies.PMID:19167031[PubMed - indexed for MEDLINE]
BJU Int. 2009 Oct;104(7):974-83. Epub 2009 May 7.
Ejaculatory dysfunction in men with lowerurinary tract symptoms suggestive of benign prostatic hyperplasia.
New England Research Institutes, Watertown, MA 02472, USA. rrosen@neriscience.com 
To assess, using the psychometrically validated Male Sexual Health Questionnaire (MSHQ),the prevalence of ejaculatory dysfunction (EjD) and bother due to EjD in men with lowerurinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH), and toassess predictors of EjD in this population.
In all, 5999 sexually active men with LUTS completed the International Prostate SymptomScore (IPSS) which rates LUTS severity, and the MSHQ long-form, which evaluates sevenEjD symptoms and bother due to EjD. Concomitant intake of medical treatments for BPHand previous BPH-related surgery were collected. The impact of treatments on EjD wascompared to a control group (i.e. no previous BPH-related surgery and no medical treatmentfor BPH). The relationship between EjD, bother due to EjD and selected clinicalcharacteristics was analysed using multiple regression analysis.
EjD was highly prevalent and bothersome in men with LUTS, with decreased force of ejaculation (77.9%) and decreased amount of semen (74.4%) being the most commonlyreported symptoms. LUTS severity was the strongest predictor of EjD and bother due to EjD.EjD was considered a problem by 35.6%, 51.6% and 64.1% of men with mild, moderate andsevere LUTS, respectively (P < 0.001). EjD (except pain/discomfort on ejaculation) andbother due to EjD were also strongly related to age. Men with previous BPH-related surgery
and men treated with a 5α
reductase inhibitor plus an α(1)
-blocker or tamsulosin aloneshowed the highest rates of dry ejaculation (67.4%, 57.2% and 52.3%, respectively)compared to controls (31.6%, P < 0.001). Conversely, in men treated with alfuzosin, mostEjD symptoms were significantly lower than in controls. Bother due to EjD was alsosignificantly lower with alfuzosin than in controls (34.4% vs 53.1%, P < 0.001) while therewas no significant difference for other treatments.
EjD is highly prevalent and bothersome in sexually active men with LUTS, and is stronglyrelated to LUTS severity and age. Treatment options for BPH do not have the same effect onEjD. EjD should be considered in the initial evaluation and clinical management of men withLUTS.PMID:19426189[PubMed - indexed for MEDLINE]

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