Improvement of Lower Urinary Tract Symptoms and Sexual Function after Treatment with Alpha-Blocker

ABSTRACT

PURPOSE: The association of lower urinary tract symptoms (LUTS) and erectile dysfunction has not been investigated comprehensively concerning which LUTS are associated with sexual function. Therefore, we investigated the association of each domain of the International Prostate Symptom Score (IPSS), nocturia, prostate volume, and uroflowmetry with each domain of the International Index of Erectile Function (IIEF)-5. MATERIALS AND METHODS: The correlation of sexual function and LUTS was investigated in 365 men with benign prostatic hyperplasia. To measure the level of LUTS, the IPSS was calculated; uroflowmetry, residual urine measurement, and transrectal ultrasonography (TRUS) were performed; and the level of erectile dysfunction was assessed by the IIEF-5. Three months after treatment with alpha-blocker (tamsulosin 0.2 mg/day), IPSS, uroflowmetry, residual urine, nocturia, and IIEF-5 were assessed again to evaluate the effectiveness of treatment. RESULTS: Erectile function deteriorated more in individuals with severe LUTS (IPSS>20) than in those with mild LUTS (IPSS<8), and IPSS, age, and nocturia correlated significantly with all IIEF-5 domains. The maximal urine velocity and the average urine velocity on uroflowmetry correlated significantly with all IIEF domains. After the administration of alpha-blocker for 3 months, the changed rates of the IPSS-obst domain, average uroflow, and quality of life (QoL) correlated significantly with the improvement in the total IIEF-5. CONCLUSIONS: Changes in the IPSS-obst domain, QoL, and average uroflow rate correlated significantly with changes in the total IIEF-5. Thus, it is expected that the improvement of obstructive symptoms could effectively improve erectile function.