PD22-10 IMPACT OF COMBINATION THERAPY 5 - ARI + ALPHA - BLOCKERS ON ERECTILE DYSFUNCTION AND ALTERATION OF LIBIDO IN PATIENTS WITH LUTS / BPH: A SYSTEMATIC REVIEW WITH META-ANALYSIS

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Medical & Non-surgical Therapy1 Apr 2016PD22-10 IMPACT OF COMBINATION THERAPY 5 - ARI + ALPHA - BLOCKERS ON ERECTILE DYSFUNCTION AND ALTERATION OF LIBIDO IN PATIENTS WITH LUTS / BPH: A SYSTEMATIC REVIEW WITH META-ANALYSIS Giorgio Ivan Russo, Vincenzo Favilla, Tommaso Castelli, Salvatore Privitera, Sebastiano Cimino, and Giuseppe Morgia Giorgio Ivan RussoGiorgio Ivan Russo More articles by this author , Vincenzo FavillaVincenzo Favilla More articles by this author , Tommaso CastelliTommaso Castelli More articles by this author , Salvatore PriviteraSalvatore Privitera More articles by this author , Sebastiano CiminoSebastiano Cimino More articles by this author , and Giuseppe MorgiaGiuseppe Morgia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1503AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Combination therapy with of 5-alpha reductase inhibitors (5-ARI) and alpha-blockers (AB) is the gold standard for the treatment of moderate-severe secondary to benign prostatic hyperplasia (BPH). Several clinical trials have already analyzed the overall impact of the medical treatment of LUTS/BPH on sexual sphere, but any one investigated the overall impact on erectile dysfunction (ED) and libido alterations (LA). The aim of this this systematic review and meta-analysis was to evaluate the impact of combination therapy on ED and LA from randomized clinical trial (RCT) METHODS We performed a search of the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Cochrane Database of Systematic Review, and Web of Science, until December 2014. We conducted a meta-analysis to determine the impact of combination therapy (5ARI + AB) in determining the onset of ED or LA. A p value < 0.10 was used to denote the presence of heterogeneity. RESULTS Of the 103 studies reviewed, only five RCT were included, involving 6131 participants. The overall prevalence of erectile dysfunction was of 7.93%, 6.47% and4.66%in patients treated with combination therapy, 5ARI and AB respectively. The overall prevalence of altered libido was of 3.69%, 3.37% and 2.37% in patients treated with combination therapy, 5ARI and AB respectively. Combination therapy 5ARI + AB was found to be associated with increased risk of ED (OR = 1.81; p <0.00001) and LA (OR = 1:58; p = 0.03) compared to monotherapy with AB. The combination therapy was found to increase the risk of ED (OR = 1.25; p = 0.04) compared to monotherapy with 5ARI, but not the risk of LA (OR = 1:03; p = 0.84). Analyzing the individual monotherapies, therapy with alpha-blockers significantly reduces the risk of ED (OR = 0.70; p <0.01) and LA (OR = 0.67; p = 0.0.1) compared to treatment with 5ARI. CONCLUSIONS Combination therapy 5ARI + ABis associated with a higher risk of ED. In addition, 5ARI monotherapy has the same risk of the combination of having LA. These results could be taken into account during the counseling therapy in patients with LUTS/BPH. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e465 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Giorgio Ivan Russo More articles by this author Vincenzo Favilla More articles by this author Tommaso Castelli More articles by this author Salvatore Privitera More articles by this author Sebastiano Cimino More articles by this author Giuseppe Morgia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...