Hellstrom Wayne J G, Sikka Suresh C
Department of Urology, Tulane University Health Sciences Center, 1430 Tulane Avenue; SL-42, New Orleans, LA 70112, USA.
J Androl. 2009 Jul-Aug;30(4):469-74. doi: 10.2164/jandrol.108.006874. Epub 2009 Feb 5.
Ejaculation disorders are associated with tamsulosin treatment for lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH). To assess whether tamsulosin has any effect on semen, sperm parameters were evaluated in healthy men receiving tamsulosin, alfuzosin, and placebo. Forty-eight healthy men received 5 days of tamsulosin 0.8 mg once daily (QD), alfuzosin 10 mg QD, and placebo in a randomized, double-blind, 3-way crossover study with a 10-14-day washout period between treatments. The changes (x +/- SE) from baseline in semen sperm concentration, semen sperm count, semen viscosity, semen fructose, sperm motility, and sperm morphology on day 5 of treatment were assessed. The change from baseline in semen sperm concentration was 3.1 +/- 8.3 million/mL with tamsulosin, 15.0 +/- 6.5 million/mL with alfuzosin, and 24.4 +/- 6.5 million/mL with placebo. The total sperm count in semen decreased from baseline with tamsulosin (-54.6 +/- 24.0 million) but not with placebo (81.5 +/- 18.8 million) or alfuzosin (46.2 +/- 19.0 million). The percentage of men with normal semen viscosity was lower with tamsulosin (65%) than with placebo (98%) or alfuzosin (92%). The change from baseline in semen fructose was comparable for all treatments. The percentage of motile sperm decreased 13.8% from baseline to day 5 of treatment with tamsulosin compared with decreases of 2.3% with placebo and 0.4% with alfuzosin. The percentage of abnormal sperm increased marginally with tamsulosin (0.6%) but not with placebo (-2.8%) or alfuzosin (-3.9%). The most common adverse events were dizziness (alfuzosin 11%, tamsulosin 14%, placebo 0%) and orthostatic hypotension (alfuzosin 25%, tamsulosin 11%, placebo 5%). The results suggest that tamsulosin has a negative effect on sperm in healthy men. Studies on the effects of alpha(1)-adrenergic blockers on sperm in men with BPH are warranted.
射精功能障碍与坦索罗辛治疗提示良性前列腺增生（BPH）的下尿路症状有关。为评估坦索罗辛对精液是否有任何影响，对接受坦索罗辛、阿夫唑嗪和安慰剂的健康男性的精子参数进行了评估。48名健康男性在一项随机、双盲、三交叉研究中接受了5天的坦索罗辛0.8毫克每日一次（QD）、阿夫唑嗪10毫克QD和安慰剂治疗，治疗之间有10 - 14天的洗脱期。评估了治疗第5天精液精子浓度、精液精子计数、精液粘度、精液果糖、精子活力和精子形态相对于基线的变化（x +/- SE）。坦索罗辛治疗时精液精子浓度相对于基线的变化为3.1 +/- 830万/毫升，阿夫唑嗪为15.0 +/- 650万/毫升，安慰剂为24.4 +/- 650万/毫升。坦索罗辛治疗时精液中的总精子数相对于基线减少（-5460 +/- 2400万），而安慰剂（8150 +/- 1880万）和阿夫唑嗪（4620 +/- 1900万）则未减少。精液粘度正常的男性比例，坦索罗辛组（65%）低于安慰剂组（98%）和阿夫唑嗪组（92%）。所有治疗组精液果糖相对于基线的变化相当。与安慰剂组（2.3%）和阿夫唑嗪组（0.4%）相比，坦索罗辛治疗从基线到第5天活动精子的百分比下降了13.8%。异常精子的百分比坦索罗辛组略有增加（0.6%），而安慰剂组（-2.8%）和阿夫唑嗪组（-3.9%）则未增加。最常见的不良事件是头晕（阿夫唑嗪11%，坦索罗辛14%，安慰剂0%）和体位性低血压（阿夫唑嗪25%，坦索罗辛11%，安慰剂5%）。结果表明坦索罗辛对健康男性的精子有负面影响。有必要对α1 - 肾上腺素能阻滞剂对BPH男性精子的影响进行研究。
