The impact of medical treatment of benign prostatic hyperplasia on sexual life, function and lower urinary tract symptoms

Introduction. Benign prostatic hyperplasia (BPH) causes disorders of voiding and sexual function. Pharmacologic therapy reduces symptoms of voiding thus impacting sexual function. Objective. Determining sex life status in men with BPH before and after pharmacologic treatment adapted to achieve satisfactory sexual function, and the impact this treatment on the function and lower urinary tract symptoms. Methods. 156 sexually active patients not previously treated for BPH were studied. After clinical examinations, symptoms of voiding, sexual and ejaculatory function were measured using standardized IPSS, IIEF and MSHQ-EjD questionnaires. After obtaining patients’ opinion about the importance of their sex life, the therapy was chosen and possible side effects explained. Four groups each of 39 respondents were formed. One group used alphablockers, tamsulosin, the second 5-alpha reductase inhibitor, finasteride, the third was administered combination therapy and the fourth control group without therapy. The complete examination procedure was repeated after 3 and 6 months of therapy. Results. The mean age of patients was 61.16 2.97. In the therapy groups 87% reported their sex life was important to some degree. Satisfaction with their sex life was reported by 47% of patients before treatment and 67% 6 months after treatment. Questionnaire indicated general improvement of sexual function (IIEF) in all groups statistically significant compared to baseline only in the group on alpha-blockers (2.95 7.81; p=0.028). Overall satisfaction with sex life compared to the beginning of treatment is significantly improved only in the group with combined therapy. Conclusion. Before treatment BHP, should be evaluated sexual function. Customize therapy to patient’s expectations. Present side effects of drugs, especially to those emphasizing the importance of sex life in order to improve it