World J Mens Health.  2014 Dec;32(3):133-138. 10.5534/wjmh.2014.32.3.133.

Efficacy of Long-Term Daily Dosage of Alfuzosin 10 mg upon Sexual Function of Benign Prostatic Hypertrophy Patients: Two-Year Prospective Observational Study

• Yoon S
• Choi JH
• Lee SH
• Choi SM
• Jeh SU
• Kam SC
• Hwa JS
• Chung KH
• Hyun JS

• KMID: 2320776
• DOI: http://doi.org/10.5534/wjmh.2014.32.3.133

Abstract

PURPOSE
To identify sexual function improvement associated with alfuzosin (10 mg daily for 2 years).
MATERIALS AND METHODS
We enrolled 30 men with lower urinary tract symptom (LUTS) who visited Gyeongsang National University Hospital between 2010 and 2012. At first visit, urinalysis, prostate specific antigen, transrectal ultrasound, and uroflowmetry were performed. The nternational Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function (IIEF), and Male Sexual Health Questionnaire Ejaculation Function Domain (MSHQ-EjFD) questionnaires were administered, and the subjects answered the same questionnaires at 1 month, 6 months, 1 year, and 2 years of follow-up.
RESULTS
Twelve men completed of the entire study. After administration of alfuzosin, the median IPSS at first visit, 1 month, 6 months, 1 year, and 2 years was 18.00 (interquatile range [IQR]: 14.00~29.75), 20.00 (IQR: 11.50~30.00), 15.50 (IQR: 8.50~25.25), 14.50 (IQR: 9.25~19.50), and 11.50 (IQR: 5.00~17.75), respectively, which showed an improvement. The median QoL at the same times was 4.50 (IQR: 4.00~5.00), 4.50 (IQR: 4.00~5.00), 3.00 (IQR: 2.00~4.00), 3.50 (IQR: 2.25~4.00), and 3.00 (IQR: 1.00~3.00), respectively, and also showed improvement. Likewise, the median IIEF was 36.50 (IQR: 24.50~46.75), 37.50 (IQR: 26.75~47.25), 45.50 (IQR: 35.00~59.75), 48.50 (IQR: 34.75~62.75), and 47.50 (IQR: 43.25~61.00), while the median MSHQ-EjFD was 19.00 (IQR: 12.0~24.75), 19.50 (IQR: 13.50~27.75), 23.00 (IQR: 19.25~32.25), 26.50 (IQR: 18.25~34.50), 27.00 (IQR: 21.50~32.50), respectively, with both showing improvement.
CONCLUSIONS
After administration of alfuzosin (10 mg daily for 2 years), the IPSS, QoL, IIEF, and MSHQ-EjFD all improved significantly. This means long-term administration of 10 mg of alfuzosin daily would be effective not only for LUTS but also erectile function and ejaculation.

Keyword

Alfuzosin; Ejaculation; Penile erection

MeSH Terms

Ejaculation
Follow-Up Studies
Humans
Male
Observational Study*
Penile Erection
Prospective Studies*
Prostate
Prostate-Specific Antigen
Prostatic Hyperplasia*
Quality of Life
Surveys and Questionnaires
Reproductive Health
Ultrasonography
Urinalysis
Urinary Tract
Prostate-Specific Antigen

Figure

• 

  Fig. 1 Changes in the International Prostate Symptom Score (IPSS) after treatment with 10 mg alfuzosin. p value: compared with the first visit.

• 

  Fig. 2 Changes in quality of life (QoL) after treatment with 10 mg alfuzosin. p value: compared with the first visit.

• 

  Fig. 3 Changes in the International Index of Erectile Function (IIEF) after treatment with 10 mg alfuzosin. p value: compared with the first visit.

• 

  Fig. 4 Changes in the Male Sexual Health Questionnaire Ejaculation Function Domain (MSHQ-EjFD) after treatment with 10 mg alfuzosin. p value: compared with the first visit.

Reference

1. Braun M, Wassmer G, Klotz T, Reifenrath B, Mathers M, Engelmann U. Epidemiology of erectile dysfunction: results of the 'Cologne Male Survey'. Int J Impot Res. 2000; 12:305–311.

2. Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol. 2003; 44:637–649.

3. Rosen RC, Wei JT, Althof SE, Seftel AD, Miner M, Perelman MA. Association of sexual dysfunction with lower urinary tract symptoms of BPH and BPH medical therapies: results from the BPH Registry. BPH Registry and Patient Survey Steering Committee. Urology. 2009; 73:562–566.

4. McVary KT. Sexual dysfunction in men with lower urinary tract symptoms and benign prostatic hyperplasia: an emerging link. BJU Int. 2003; 91:770–771.

5. Roehrborn CG, Van Kerrebroeck P, Nordling J. Safety and efficacy of alfuzosin 10 mg once-daily in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia: a pooled analysis of three double-blind, placebo-controlled studies. BJU Int. 2003; 92:257–261.

6. Lepor H. Phase III multicenter placebo-controlled study of tamsulosin in benign prostatic hyperplasia. Tamsulosin Investigator Group. Urology. 1998; 51:892–900.

7. Kobayashi S, Tang R, Shapiro E, Lepor H. Characterization and localization of prostatic alpha 1 adrenoceptors using radioligand receptor binding on slide-mounted tissue section. J Urol. 1993; 150:2002–2006.

8. Walden PD, Durkin MM, Lepor H, Wetzel JM, Gluchowski C, Gustafson EL. Localization of mRNA and receptor binding sites for the alpha 1a-adrenoceptor subtype in the rat, monkey and human urinary bladder and prostate. J Urol. 1997; 157:1032–1038.

9. Dausse JP, Leriche A, Yablonsky F. Patterns of messenger RNA expression for alpha1-adrenoceptor subtypes in human corpus cavernosum. J Urol. 1998; 160:597–600.

10. Goepel M, Krege S, Price DT, Michelotti GA, Schwinn DA, Michel MC. Characterization of alpha-adrenoceptor subtypes in the corpus cavernosum of patients undergoing sex change surgery. J Urol. 1999; 162:1793–1799.

11. Becker AJ, Stief CG, Machtens S, Schultheiss D, Hartmann U, Truss MC, et al. Oral phentolamine as treatment for erectile dysfunction. J Urol. 1998; 159:1214–1216.

12. Kaplan SA, Reis RB, Kohn IJ, Shabsigh R, Te AE. Combination therapy using oral alpha-blockers and intracavernosal injection in men with erectile dysfunction. Urology. 1998; 52:739–743.

13. Gacci M, Vittori G, Tosi N, Siena G, Rossetti MA, Lapini A, et al. A randomized, placebo-controlled study to assess safety and efficacy of vardenafil 10 mg and tamsulosin 0.4 mg vs. tamsulosin 0.4 mg alone in the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Sex Med. 2012; 9:1624–1633.

14. Wilt TJ, Mac Donald R, Rutks I. Tamsulosin for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2003; (1):CD002081.

15. Marks LS, Gittelman MC, Hill LA, Volinn W, Hoel G. Rapid efficacy of the highly selective alpha1A-adrenoceptor antagonist silodosin in men with signs and symptoms of benign prostatic hyperplasia: pooled results of 2 phase 3 studies. J Urol. 2009; 181:2634–2640.

16. Lee E, Lee C. Clinical comparison of selective and non-selective alpha 1A-adrenoreceptor antagonists in benign prostatic hyperplasia: studies on tamsulosin in a fixed dose and terazosin in increasing doses. Br J Urol. 1997; 80:606–611.

17. Cho SH, Lee SK. The experience with combination of finasteride and tamsulosin on benign prostatic hyperplasia. Korean J Urol. 2003; 44:1110–1115.