Seo Deok Ha, Kam Sung Chul, Hyun Jae Seog
Department of Urology, College of Medicine, Gyeongsang National University, Jinju, Korea.
Korean J Urol. 2011 Jan;52(1):49-54. doi: 10.4111/kju.2011.52.1.49. Epub 2011 Jan 24.
To examine the effects on erectile function of concomitant treatment with an alpha-blocker (tamsulosin) and an antimuscarinic agent (solifenacin) in patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH).
Fifty-seven male patients with LUTS/BPH were assessed for the degree of LUTS and erectile function. In group 1 (tamsulosin) and group 2 (tamsulosin and solifenacin), changes in the International Prostate Symptom Score [IPSS: total scores, storage symptoms (ST), voiding symptoms (VD), and quality of life (QoL)], prostate-specific antigen, trans-rectal ultrasonography, urine flowmetry, residual urine, and a 5-item version of the International Index of Erectile Function (IIEF-5) were assessed after a 3-month treatment period. In both groups, it was determined whether treatment was associated with changes in LUTS and erectile function and whether improvement in the IPSS was correlated with the IIEF-5. Comparative analysis was also done to examine the linear relationship between improved IPSS scores and IIEF-5 scores.
A comparison of the degree of improvement in all the parameters indicated that both groups showed significant improvement in total IPSS, IPSS-ST, IPSS-VD, and IPSS-QoL (p<0.05). A comparison of the degree of improved sexual function associated with improved LUTS in each patient showed significant improvement in the IIEF-5 score associated with the degree of improvement in the IPSS-ST domain in group 1, but no significant associations were found in group 2. In cases in which tamsulosin was administered, the IIEF-5 score significantly improved as the IPSS-ST domain score improved. In the group in which tamsulosin and solifenacin were concomitantly administered, improvement of the IPSS-ST domain score had no significant effect on the IIEF-5 score.
In patients with LUTS/BPH, tamsulosin and solifenacin combination therapy was effective for LUTS, but erectile function was not significantly improved. Therefore, although effective for improving LUTS, combination therapy with an alpha-blocker and an antimuscarinic agent was not effective for improving erectile function.
研究α受体阻滞剂（坦索罗辛）与抗毒蕈碱药物（索利那新）联合治疗对下尿路症状（LUTS）/良性前列腺增生（BPH）患者勃起功能的影响。
对57例LUTS/BPH男性患者的LUTS程度和勃起功能进行评估。在第1组（坦索罗辛）和第2组（坦索罗辛和索利那新）中，在3个月的治疗期后评估国际前列腺症状评分[IPSS：总分、储尿期症状（ST）、排尿期症状（VD）和生活质量（QoL）]、前列腺特异性抗原、经直肠超声检查、尿流率、残余尿量以及国际勃起功能指数5项版本（IIEF-5）的变化。在两组中，确定治疗是否与LUTS和勃起功能的变化相关，以及IPSS的改善是否与IIEF-5相关。还进行了比较分析，以检查IPSS改善评分与IIEF-5评分之间的线性关系。
所有参数改善程度的比较表明，两组的总IPSS、IPSS-ST、IPSS-VD和IPSS-QoL均有显著改善（p<0.05）。对每位患者中与LUTS改善相关的性功能改善程度进行比较，结果显示第1组中与IPSS-ST领域改善程度相关的IIEF-5评分有显著改善，但第2组未发现显著相关性。在使用坦索罗辛的病例中，随着IPSS-ST领域评分的改善，IIEF-5评分显著提高。在同时使用坦索罗辛和索利那新的组中，IPSS-ST领域评分的改善对IIEF-5评分没有显著影响。
在LUTS/BPH患者中，坦索罗辛和索利那新联合治疗对LUTS有效，但勃起功能未得到显著改善。因此，虽然对改善LUTS有效，但α受体阻滞剂与抗毒蕈碱药物联合治疗对改善勃起功能无效。
