The effect of alpha-blocker and 5alpha-reductase inhibitor intake on sexual health in men with lower urinary tract symptoms.

摘要

OBJECTIVE To assess the effect of tamsulosin on the Sexual Health Inventory for Men (SHIM) score in men diagnosed with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). PATIENTS AND METHODS Analysis from the national database of a programme of the Prostate Cancer Educational Council identified 7974 men who completed the American Urologic Association Symptom Score (AUA-SS) and SHIM questionnaires. The patients were divided into three groups; group 1, men taking tamsulosin; group 2, men on other prescription medications for treating BPH symptoms; and group 3, men not currently taking any BPH medications. Linear regression was used to assess the association of tamsulosin and other alpha-blocker prescriptions for treating BPH symptoms with the decline in SHIM score. The interaction terms between AUA and the intake of tamsulosin was also adjusted for in the final analysis. RESULTS The median age of the men was 60 years. In groups 1, 2 and 3, (234, 291 and 7449 men, respectively)the mean (sd) AUA-SS was 13.0 (7.2), 12.1 (7.2) and 6.9 (5.8), and the mean SHIM scores 11.7 (6.8), 12.7 (6.5) and 15.9 (6.0), respectively. Adjusting for the AUA-SS, men in group 1 on tamsulosin had a significantly higher SHIM score with increasing AUA-SS score than men on other medications (P < 0.01), offsetting the negative correlation between the AUA-SS and SHIM (P < 0.01). Moreover, men in group 1 were more likely to have a higher AUA-SS and lower SHIM score than men in the other two groups, suggesting more severe symptoms in these men. CONCLUSIONS Men taking tamsulosin to treat LUTS appear to be at an advantage over men taking other alpha-blockers when the effect of LUTS on sexual health is considered. Furthermore, this effect was more profound in patients with more severe LUTS than those with mild and moderate symptoms. Future prospective trials are warranted to confirm this effect.