Treatment with a Uroselective α1‐Blocker Improves Voiding and Sexual Function: A Study in Thai Men with Lower Urinary Tract Symptoms

Abstract

Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) negatively affect quality of life. The α1-blockers are effective for LUTS suggestive of benign prostatic hypertrophy. To analyze the effect of a uroselective α1-blocker on both voiding and sexual dysfunction in Thai men with LUTS. Of 488 men with LUTS who received 10 mg alfuzosin monotherapy once daily (OD) at a men's health clinic, 313 men (64%) completed 8 months of alfuzosin treatment and filled the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function (IIEF)-5 questionnaires. The relationships among the IPSS, IIEF-5 score, and select clinical characteristics were analyzed using multiple regression analysis. To identify changes from the baseline, the chi-square or Fisher's exact test was used for categorical or dichotomous variables and a paired Student's t-test was used for continuous variables. The 313 men were followed up for a mean (standard deviation [SD]) of 35.6 (2.2) weeks. LUTS were categorized by IPSS as moderate in 100 patients (31.9%) and severe in 213 patients (68.1%). ED was graded according to the IIEF-5 as normal in 46 patients (14.7%), mild in 29 patients (9.3%), mild to moderate in 81 patients (25.9%), moderate in 47 patients (15.0%), and severe in 110 patients (35.1%). ED is associated with LUTS (P=0.008). After 8 months of alfuzosin treatment, the mean (SD) IPSS and IIEF-5 score significantly improved from 19.95 (6.4) to 11.13 (4.6) (P<0.001) and from 11.5 (6.9) to 14.9 (5.7) (P<0.001), respectively. However, the IIEF-5 score did not improve significantly in patients with severe LUTS as determined using the IPSS. The most common adverse event with alfuzosin treatment was mild (dizziness, 2.2%). Treatment with 10 mg alfuzosin OD is safe and effective in improving voiding and sexual function in Thai men with LUTS and ED.