A Prospective study of Sexual Dysfunction in Patients with Benign Prostatic Hyperplasia

OBJECTIVES : The severity of lower urinary tract symptoms (LUTS) has been identified as an important risk factor for sexual dysfunction, independent of age and comorbidities. Lower urinary tract symptoms (LUTS), which are often caused by benign prostatic hyperplasia (BPH), and sexual dysfunction are common in older men, with an overall prevalence of >50% in men aged > or =50 years. Men with LUTS have been reported to experience sexual dysfunction, including ejaculatory loss, painful ejaculation, and erectile dysfunction. Most patients with LUTS/BPH experience a negative effect of LUTS symptoms due to BPH on their sex life. This study was carried out to investigate the association between LUTS and sexual function in aging males. METHODS : A Prospective clinical study was carried out in patients attending the Urology department at Kilpauk Medical College Hospital and Government Royapettah Hospital during the period October 2013 to October 2014. Patients with co morbid conditions were excluded from the study. Questionnaires were used to assess LUTS ans sexual function in these patients both before treatment and after treatment. RESULTS : 120 patients were included in the study after excluding 98 patients using the exclusion criteria. Majority of the patients were in the 60-69 age group. Around 55% in the study group had bothersome severe LUTS, mostly seen in the 60-69 group. Sexual function was affected in the majority of the study group. All aspects including erectile function, ejaculatory function, sexual desire, sexual satisfaction were affected. The severity of LUTS had a bearing on the sexual dysfunction among the study group. Patients with moderate and severe LUTS had significant alterations in their sexual function which was statistically significant and comparable to other studies worldwide. The treatment given also had a significant impact on sexual function of these patients. Only the erectile function and ejaculatory function were evaluated post treatment and both were significantly affected in a certain subset of patients. CONCLUSION : Sexual activity is common in a majority of men over age 50 in our country and is an important component of overall quality of life. The presence and severity of LUTS are independent risk factors for sexual dysfunction in older men other than the age and co morbid conditions. These results highlight the clinical importance of evaluating LUTS in patients with sexual dysfunction, and the need to consider sexual issues in the management of patients with LUTS due to BPH