Korean J Urol.  2014 Sep;55(9):608-614. 10.4111/kju.2014.55.9.608.

Effect of Improvement in Lower Urinary Tract Symptoms on Sexual Function in Men: Tamsulosin Monotherapy vs. Combination Therapy of Tamsulosin and Solifenacin

• Ko K
• Yang DY
• Lee WK
• Kim SW
• Moon DG
• Moon KH
• Park NC
• Park JK
• Son HC
• Lee SW
• Hyun JS
• Park K

• KMID: 2069779
• DOI: http://doi.org/10.4111/kju.2014.55.9.608

Abstract

PURPOSE
To evaluate how much the improvement of lower urinary tract symptoms (LUTS) affects sexual function and which storage symptoms or voiding symptoms have the greatest effect on sexual function.
MATERIALS AND METHODS
A total of 187 patients were enrolled in this study. Patients were randomly assigned to receive either tamsulosin 0.2 mg (group A) or tamsulosin 0.2 mg and solifenacin 5 mg (group B). At 4 weeks and 12 weeks, the LUTS and sexual function of the patients were evaluated by use of the International Index of Erectile Function-5 (IIEF5), International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS) questionnaire, uroflowmetry, and bladder scan.
RESULTS
Both groups A and B showed statistically significant improvements in IPSS, OABSS, and quality of life (QoL). Group A showed improved maximum flow rate, mean flow rate, and residual urine volume by time. Group B did not show an improvement in flow rate or residual urine volume but total voiding volume increased with time. The IIEF5 score was not improved in either group. In group A, the IIEF5 score dropped from 13.66+/-4.97 to 11.93+/-6.14 after 12 weeks (p=0.072). Group B showed a decline in the IIEF5 score from 13.19+/-5.91 to 12.45+/-6.38 (p=0.299). Although group B showed a relatively smaller decrease in the IIEF5 score, the difference between the two groups was not significant (p=0.696).
CONCLUSIONS
Tamsulosin monotherapy and combination therapy with solifenacin did not improve erectile function despite improvements in voiding symptoms and QoL. The improvement in storage symptoms did not affect erectile function.

Keyword

Erectile dysfunction; Lower urinary tract symptoms; Overactive urinary bladder

MeSH Terms

Aged
Drug Therapy, Combination/methods
Erectile Dysfunction/*drug therapy/etiology
Humans
Lower Urinary Tract Symptoms/complications/*drug therapy
Male
Middle Aged
Quality of Life
Questionnaires
Quinuclidines/*administration & dosage
Rheology
Sulfonamides/*administration & dosage
Tetrahydroisoquinolines/*administration & dosage
Treatment Outcome
Urological Agents/*administration & dosage
Quinuclidines
Sulfonamides
Tetrahydroisoquinolines
Urological Agents

Figure

• 

  FIG. 1 Flow of the study.

• 

  FIG. 2 (A-C) The groups did not differ significantly on variables of the uroflowmetry scale except for residual urine volume. (D) Because residual urine volume did not decrease, group B showed a much greater residual urine volume than that in group A (p=0.013). Group A: tamsulosin 0.2 mg only. Group B: tamsulosin 0.2 mg+solifenacin 5 mg. *Statistically significant by time (p<0.05).

• 

  FIG. 3 Both groups showed a statistically significant improvement in the International Prostate Symptom Score (IPSS), overactive bladder symptom score (OABSS), and quality of life (QoL) score. However, a statistically significant difference was not observed between the two groups. Group A: tamsulosin 0.2 mg only. Group B: tamsulosin 0.2 mg+solifenacin 5 mg. *Statistically significant by time (p<0.05).

• 

  FIG. 4 Neither group of patients with lower urinary tract symptoms showed an improvement in sexual dysfunction. Although the International Index of Erectile Function-5 (IIEF5) score decreased relatively less in group B compared with group A, the difference between the two groups was not statistically significant (p=0.696). Group A: tamsulosin 0.2 mg only. Group B: tamsulosin 0.2 mg+solifenacin 5 mg.

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