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Keywords:

  • bladder outlet obstruction;
  • signs and symptoms;
  • impotence;
  • ejaculation;
  • extended-release alfuzosin;
  • α1-blockers

Associate Editor

Michael G. Wyllie

Editorial Board

Ian Eardley, UK

Jean Fourcroy, USA

Sidney Glina, Brazil

Julia Heiman, USA

Chris McMahon, Australia

Bob Millar, UK

Alvaro Morales, Canada

Michael Perelman, USA

Marcel Waldinger, Netherlands

OBJECTIVE

To assess the effect on sexual function of alfuzosin 10 mg once daily, a uroselective α1-blocker, in men with lower urinary tract symptoms (LUTS) suggestive of bladder outlet obstruction.

PATIENTS AND METHODS

In all, 3076 men (mean age 65.9 years) were treated for 1 year with alfuzosin 10 mg in ‘real life’ practice. They were asked to complete the International Prostatic Symptom Score (IPSS), its appended eighth question (bother score) and the Danish Prostatic Symptom Score questionnaire for sexual dysfunction (DAN-PSSsex). The results were analysed at the endpoint in the intent-to-treat population.

RESULTS

At baseline, 2434 (79.1%) men were sexually active and answered correctly at least one item of the DAN-PSSsex. Sexual dysfunction was highly prevalent (reduced stiffness of erection, 65.3%; reduced volume of ejaculate, 63.2%; pain/discomfort on ejaculation, 20.2%), and was strongly related to the severity of LUTS and impairment of quality of life. At the endpoint, alfuzosin significantly improved the total IPSS (−6.1, − 32%) and bother score (−1.4, − 33.2%, both P < 0.001) over baseline. In those men with sexual dysfunction there were significant improvements in weighted scores related to reduced rigidity of erection (−0.5), reduced amount of ejaculate (−0.4) and pain/discomfort on ejaculation (−1.2, all P < 0.001) over baseline. The perceived improvements were more marked in men with severe LUTS or a severe bother score at baseline.

CONCLUSIONS

Sexual dysfunction is highly prevalent in men with LUTS and related to the baseline IPSS and bother score. Alfuzosin 10 mg once daily for 1 year is effective in improving LUTS and quality of life, and is well tolerated. It may even improve sexual function in those men with concomitant erectile and/or ejaculatory dysfunction.