Re: Improvement of Lower Urinary Tract Symptoms and Sexual Activity after Open Simple Prostatectomy: Prospective Analysis of 50 Cases

Objectives: To evaluate the improvement of Lower Urinary Tract Symptoms (LUTS) and Erectile Function (EF) evaluated before and after Open Simple Prostatectomy, focusing on which patients this procedure allows better outcomes in term of sexual activity. Material and methods: 50 men with large size benign prostatic hyperplasia (BHP) greater than 80 gr were prospectively evaluated before and 6 months after Open Simple Prostatectomy (Freyer procedure) between October 2012 to September 2013. Patients had a pre-operative transrectal ultrasound (TRUS) for volume evaluation and filled pre and post operative questionnaires for International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5) score. Results: Mean patients age was 71 years (D.S. 3,5), mean prostate volume results 103 ml (D.S. 23,7); regarding LUTS and EF, mean improvement of IPSS score was 15,3 (D.S. 4) and mean increase of IIEF-5 score was 3,4 (D.S.3). This study highlights a correlation between patients’ age and increase of IIEF-5 score; no correlation with prostate size was found. Conclusion: According to the EAU Guidelines 2014, large size BPH (over 80-100 mL) with LUTS refractory to medical management continue to have open prostatectomy as the treatment of choice. In our experience we found not only an reduction of LUTS after the procedure but also an improvement of erectile function; this improvement was related with patient’s age.

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Associations between sexual satisfaction and function and the severity of lower urinary tract symptoms among men in a rural sub-Saharan African community

Canadian Urological Association Journal ◽

10.5489/cuaj.5603 ◽

2019 ◽

Vol 13 (11) ◽

Author(s):

Andrew J. Macnab ◽

Lynn Stothers ◽

Jonathan Berkowitz ◽

Stacy Elliott ◽

Francis Bajunirwe

Keyword(s):

Urinary Tract ◽

Sexual Function ◽

Sexual Activity ◽

Lower Urinary Tract Symptoms ◽

Sexual Satisfaction ◽

Sexual Functioning ◽

Lower Urinary Tract ◽

Sexual Drive ◽

Urinary Tract Symptoms ◽

Lower Urinary

Introduction: The recognized association between erectile dysfunction (ED) with lower urinary tract symptoms (LUTS) from high-income countries is unreported from Africa. Authentic figures on prevalence of ED and LUTS from Africa are scarce in the literature. This study was conducted to quantify sexual function and satisfaction among Ugandan men in relation to LUTS severity. Methods: A convenience sample of men participating in a parallel, cross-sectional survey was used. The population, men >55 years living in Sheema district, Uganda, were recruited into two cohorts: those living in the community and those seeking clinic care due to bother from LUTS. This was to ensure inclusion of a full spectrum of LUTS. The instruments were the International Prostate Symptom Score (IPSS) to quantify LUTS and the Epstein Inventory (EI) to assess four measures of sexual functioning. Bivariate analysis compared community and clinic cohort participants, LUTS severity, and each sexual functioning item with two-sample t-tests for means and Chi-square tests of independence for categorical versions. Results: Participants included 415 men (238 community and 177 clinic) at mean age of 67.5 years vs. 62.9 (p<0.001) with mean IPSS of 9.32 vs. 17.07 (p≤0.001). Lower mean satisfaction with sexual activity and frequency of erections occurred in the clinic cohort (p≤0.001). Overall, all four questions assessing dissatisfaction with sexual function were significantly correlated with worsening LUTS; sexual satisfaction and frequency of sexual drive were also influenced by age and low levels of education. Conclusions: These are the first data describing the severity relationship between LUTS and ED in African men. Respondents reported dissatisfaction in the past year with the level of their sexual activity, frequency of sexual drive, ability to have erections, and sexual performance that related statistically to the severity of their LUTS.

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