Abstract
Nocebo effect is known in patients refered to side effects of drugs that cause more side effects than expected. Side effects on sexual function have been reported in about 60% of patients using silodosin. To investigate whether there was nocebo effect of silodosin in the side effects on sexual function. Between May 2014 and March 2017, 129 moderate-to-severe LUTS patients were included in the study. For the patients, PSA (ng/mL), prostate volume (cc), uroflowmetry test IIEF-15 and IPSS questionnaires were filled at the time of before and after treatment. Patients were divided into two groups, referred to as side effects that was mentioned and not mentioned. After 3 months control, all patients were asked whether they had sexual side effects. It was analyzed whether there was significantly differences between two groups. The groups were compared in terms of the frequency of androgenic side effects, low semen volume was 40.9% in Group 1 and 22.2% in Group 2 (p=0.04). Anejaculation rates were 6% and 4%, respectively (p=0.12); loss of libido and erectile dysfunction were observed in one patient in both groups (p=0.42). There was no statistically significant difference between the groups for anejaculation, decreased libido and erectile dysfunction. 9 patients (7%) who left medication due to side effects were excluded from the study. In patients, mentioned about the sexual side effects, low semen volume was seen more frequantly, but anejaculation, decreased libido and erectile dysfunction were same. Therefore, be informed about the side effects before treatment is a matter of debate.
Highlights
Sexual function is a condition in which couples expect each other in an interrelated fashion, and it has an important influence on enjoyment [1]
Numerous large-scale studies have demonstrated that sexual dysfunctions such as erectile dysfunction (ED), ejaculatory disorders (EjD), and decreased libido are associated with moderate-to-severe lower urinary tract symptoms (LUTS) [2, 3]
We examined the occurrence of a nocebo effect linked to sexual side effects observed in patients treated with silodosin
Summary
Sexual function is a condition in which couples expect each other in an interrelated fashion, and it has an important influence on enjoyment [1]. Benign prostatic hyperplasia (BPH) is most commonly associated with lower urinary tract symptoms (LUTS) and sexual dysfunction in the elderly. Numerous large-scale studies have demonstrated that sexual dysfunctions such as erectile dysfunction (ED), ejaculatory disorders (EjD), and decreased libido are associated with moderate-to-severe LUTS [2, 3]. Alpha-blockers are the first-line option for the treatment of LUTS [4]. Treating sexual dysfunction associated with treatment of LUTS is expected. Compared with other alpha-blockers, treatment with silodosin results in the loss of ejaculation, which frequently leads to treatment discontinuation [6]
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