Sexual function before and after various treatments for symptomatic benign prostatic hyperplasia

Abstract

OBJECTIVE: To determine the effect of various treatments for benign prostatic hyperplasia (BPH) on sexual function. PATIENTS AND METHODS: In a longitudinal multicentre study carried out in the Netherlands, 670 consecutive patients with BPH (aged > or = 50 years) were examined at baseline and 9 months after inclusion. All patients completed a questionnaire about symptomatology, bothersomeness and sexual function before and after treatment. Other diagnostic information was retrieved from the medical records. RESULTS: At baseline, 49-59% of the population (mean age 66 years) reported normal potency and 69% a normal libido. Outcomes at 9 months were stratified by type of treatment, i.e. surgery in 207, alpha-blockers in 43, finasteride in 47 and watchful waiting in 234 men. Patients with multiple or other treatments (131) or recent surgery (eight) were excluded from the analyses. For the four sexual items included, 84% of the patients reported no changes. All treatments showed both improvement and deterioration in 3-14% and 0-16% of the patients, respectively. CONCLUSION: For sexual function, most patients remained stable after treatment for BPH, while positive and negative changes occurred in equal proportions for all treatments. These results question the previously reported high incidence of sexual adverse events, particularly after surgical intervention.