Finasteride, not tamsulosin, increases severity of erectile dysfunction and decreases testosterone levels in men with benign prostatic hyperplasia

2015 ◽  
Vol 23 (3) ◽  
Author(s):  
Abdulmaged M. Traish ◽  
Karim Sultan Haider ◽  
Gheorghe Doros ◽  
Ahmad Haider
Keyword(s):  
Erectile Dysfunction ◽  
Benign Prostatic Hyperplasia ◽  
Side Effects ◽  
Adverse Effects ◽  
Erectile Function ◽  
Prostatic Hyperplasia ◽  
Continuous Treatment ◽  
Plasma Testosterone ◽  
The Impact

Abstract5α-reductase inhibitors (5α-RIs) (finasteride and dutasteride) have been proven useful in treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH). However, these inhibitors exert undesirable sexual side effects and, in some cases, these effects are persistent. There is considerable disagreement with regard to whether the adverse side effects resolve with continuous treatment.To investigate the long-term adverse effects of finasteride treatment in men with BPH on erectile function and to compare these adverse effects in men treated with the α1-adrenergic receptor blocker, tamsolusin.In this retrospective registry study, a cohort of 470 men aged between 47 and 68 years (mean 57.78±4.81) were treated with finasteride (5 mg/day). A second cohort of 230 men aged between 52 and 72 years (mean 62.62±4.65) were treated with tamsulosin (0.4 mg). All men were followed up for 45 months. At intervals of 3 months and at each visit, plasma testosterone (T) levels and the international index of erectile function (IIEF-EF) questionnaire scores were determined.Long-term treatment with finasteride therapy is associated with worsening of erectile dysfunction (ED) as shown by the significant decrease in the IIEF-EF scores in men treated with finasteride. No worsening of ED was observed in men treated with tamsulosin. The increase in ED due to finasteride did not resolve with continued treatment with finasteride. Most importantly, long-term finasteride therapy resulted in reduction in total T levels, contributing to a state of hypogonadism. On the contrary, no changes in T levels were noted in men treated with tamsolusin.Our findings suggest that in men with BPH, long-term finasteride therapy but not tamsulosin results in worsening of ED and reduces total T concentrations. Clinicians are urged to discuss the impact of 5α-RIs therapy on sexual function with their patients before commencing this therapy.

Impact of Preoperative Therapy with 5-α-Reductase Inhibitors in the Treatment of Benign Prostatic Hyperplasia

2012 ◽  
Vol 79 (2) ◽  
pp. 149-151
Author(s):  
Giacomo De Stefano ◽  
Ferdinando Fusco ◽  
Davide Arcaniolo ◽  
Antonio Pistone ◽  
Marco Capece ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Prospective Observational Study ◽  
Progressive Disease ◽  
Prostatic Hyperplasia ◽  
Preoperative Therapy ◽  
Reductase Inhibitors ◽  
Favorable Influence ◽  
The Impact ◽  
5 Alpha Reductase Inhibitors

Benign prostatic hyperplasia is considered a progressive disease intimately linked with aging. The long-term use of combination therapy with a 5-alpha-reductase inhibitor, together with an alpha blocker in men with moderate-severe symptoms, reduces the risk of clinical progression and BPH-related surgery. It is unclear what the impact is of preoperative therapy with 5-ARI in patients that undergo surgery. The aim of our study was to evaluate the impact of preoperative therapy with 5-alpha-reductase inhibitors on: a) indication on the type of surgery; b) surgical and functional outcomes; c) surgical complications. This is a prospective observational study. It will include all patients undergoing surgery by TURP or Open Prostatectomy in a period of 24 months. We expect results that demonstrate significant and favorable influence of pretreatment with 5-alpha-reductase inhibitors on certain outcomes. Therefore, therapy with 5-ARI could be considered as neoadjuvant to surgery, whatever this is.

Impact of functional outcomes on long-term quality of life after open retropubic radical prostectomy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9580-9580
Author(s):  
Bjoern Loeppenberg ◽  
Christian von Bodman ◽  
Marko Brock ◽  
Joachim Noldus ◽  
Jueri Palisaar
Keyword(s):  
Quality Of Life ◽  
Erectile Dysfunction ◽  
Erectile Function ◽  
Functional Outcomes ◽  
Term Survival ◽  
Eortc Qlq C30 ◽  
Eortc Qlq ◽  
The Impact

9580 Background: Patients who underwent open retropubic radical prostatectomy (ORRP) for prostate-cancer (PCA) have excellent long-term survival. Besides oncologic safety, recovery of continence and erectile function are highly important, as adverse functional outcomes may have a detrimental effect on health-related quality of life (HRQOL). We report the long-term HRQOL of PCA survivors after ORRP using standardized tools. Methods: Men treated between August 2003 and December 2007 with ORRP for localized PCA at a single academic hospital received validated questionnaires (International consultation on incontinence questionnaire (ICIQ), International index of erectile function (IIEF-5), Erection hardness score (EHS), EORTC QLQ-C30) to assess functional outcomes and HRQOL. Results were correlated with the global-health score (GHS) of the EORTC QLQ-C30 to assess the impact of ORRP on HRQOL. Results: In the study period 1936 men underwent ORRP of whom 1156 (59.7%) received a nerve-sparing (NS) procedure. Questionnaire return-rate was 59% (n=1141) comprising the final study cohort. Median follow-up (FU) was 62 months. Mean age at surgery and FU was 63.7±6.2 and 69.2±6.2 years, respectively. Biochemical recurrence (BCR) occurred in 17.5% (n=200/1141) and 2% (n=40/1936) deceased. Mean GHS in the study population was 71.5±20.8. In the ICIQ 28% (n=320) scored 0 indicating complete continence and 9.9% (n=113) scored ≥11 indicating severe incontinence. The corresponding GHS was 78.1±19.5 and 55.4±21.8, respectively. 68.5% (n=782) of patients used no pads and 17.9% (n=204) ≥2 pads. Corresponding GHS scores were 74.9±19.8 and 58.9±20.7. Using the IIEF-5 in men who received NS, 24.1% (n=154) had no erectile dysfunction versus 50% (n=318) using the EHS. Corresponding GHS scores were 82.2±16.3 and 74.7±19.8, respectively. Patients with BCR had a GHS of 66.8±21.8 versus 72.5±20.5 for patients without. Men who achieved the Trifecta and Pentafecta criteria had a GHS of 83.1±15.1 and 83.3±15, respectively. Conclusions: Incontinence severely impacts the HRQOL of long-term survivors after ORRP while erectile dysfunction and BCR have a lesser effect. Every effort should be undertaken to maintain functional integrity.

scholarly journals Relationship between Dietary Patterns with Benign Prostatic Hyperplasia and Erectile Dysfunction: A Collaborative Review

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4148
Author(s):  
Giorgio Russo ◽  
Giuseppe Broggi ◽  
Andrea Cocci ◽  
Paolo Capogrosso ◽  
Marco Falcone ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Benign Prostatic Hyperplasia ◽  
Dietary Patterns ◽  
Muscle Tone ◽  
Prostatic Hyperplasia ◽  
Beneficial Effects ◽  
Search Terms ◽  
Regulatory Effects ◽  
English Articles ◽  
The Impact

Interest in the role of dietary patterns has been consistently emerging in recent years due to much research that has documented the impact of metabolism on erectile dysfunction (ED) and/or benign prostatic hyperplasia (BPH). We conducted a non-systematic review of English articles published from 1964 to September 2021. The search terms were: (“dietary patterns” OR “diet”) AND/OR (“erectile dysfunction”) AND/OR (“benign prostatic hyperplasia”). In the present review, we have highlighted how the association between dietary patterns and two of the most frequent pathologies in urology, namely erectile dysfunction and benign prostatic hyperplasia, is present in the literature. The data suggested that a diet that is more adherent to the Mediterranean diet or that emphasizes the presence of vegetables, fruits, nuts, legumes, and fish or other sources of long-chain (n-3) fats, in addition to reduced content of red meat, may have a beneficial role on erectile function. At the same time, the same beneficial effects can be transferred to BPH as a result of the indirect regulatory effects on prostatic growth and smooth muscle tone, thus determining an improvement in symptoms. Certainly, in-depth studies and translational medicine are needed to confirm these encouraging data.

scholarly journals Post-COVID-19 transient hypogonadism and erectile dysfunction

2021 ◽  
Vol 14 (3) ◽  
pp. 112-118
Author(s):  
F.R. Asfandiyarov ◽  
◽  
V.A. Kruglov ◽  
S.V. Vybornov ◽  
K.S. Seidov ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Testosterone Level ◽  
Erectile Function ◽  
Hormone Replacement ◽  
Severe Illness ◽  
Hormonal Profile ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Introduction. The SARS-CoV-2 virus pandemic is one of the biggest public health challenges in the modern era. Currently, along with the continuing high incidence rate, the immediate and long-term consequences of COVID-19 are predictably becoming increasingly important. The impact of the COVID-19 on andrological health and erectile function has been studied insufficiently. The aim of this study was to assess the impact of COVID-19 infection on erectile function. Material and methods. From May 2020 to April 2021 44 men after COVID-19 pneumonia were consulted for decrease in libido, erectile function and the quality of sexual intercourse in three Astrakhan medical centers. The examination of patients included standard general clinical methods, hormonal profile studying (testosterone, luteinizing homone, prolactin) and number of standardized questionnaires. Results. No changes in the levels of luteinizing hormone and prolactin were observed. Total testosterone levels ranged from 8.0 to 14.8 nmol / L. According the testosterone level patients were divided into two groups. In group 1 patients testosterone level was 12.0 nmol/L and more, in group 2 patients – less than 12 nmol/L. In patients of the group 1 erectile dysfunction was regarded as one of the manifestations of asthenic syndrome and was relatively easily corrected by the administration of PDE-5 inhibitors and antiasthenic therapy. Patients of the group 2 had more severe complaints, «worse» scores on questionnaire scales and more significant asthenic syndrome. Discussion. The possible mechanisms of androgen deficiency and hormonal profile changes in those patients may be a direct damaging of gonadal cells by virus and nonspecific suppression of the hypothalamic-pituitary system caused by a severe illness. In some cases, testosterone preparations were prescribed to those patients to achieve a therapeutic effect. Conclusions. COVID infection may have a negative impact on erectile function. The main causes of this are decrease of testosterone level, endothelial dysfunction, and long-term asthenization. Those changes may be reversible by rehabilitation and drug correction. One should not rush to begin hormone replacement therapy. It makes sense to start treatment with antiasthenic drugs, and add testosterone preparations in the absence of an effect only. This study addresses only some aspects of the COVID-19 influence on the men's health. In the context of the ongoing pandemic and the inevitable increase in the number of ill patients, further comprehensive studies are needed to clarify all the details and organize adequate andrological care for these patients.

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