Older Men and Sexual Function: Is BPH Treatment a High Stakes Decision?

Abstract

How the possibility of treatment-induced sexual dysfunction affects men’s decision making about benign prostatic hyperplasia (BPH) treatment has not been well studied. As part of a study (N = 188) of older men’s reactions to a videotape BPH treatment decision aid, narrative data were analyzed for 74 men who stated concerns about treatment-induced sexual dysfunction. Collegeeducated men (n = 54) were more likely than non-college educated men (n = 20) to mention sexual concerns. A substantial proportion of men appeared to view BPH treatment decision making as “high stakes” due to the risk of sexual dysfunction, including 23% who preferred watchful waiting to “riskier” medications or surgery. The extent to which these concerns also occur but are not necessarily stated by non-college educated men requires additional investigation. Within a partnership health care approach, clinicians who are counseling men about BPH treatment options should ask about possible concerns about treatment-induced sexual dysfunction.