Jo Hyun Wook, Yoo Dae Seon, Ju Hyun Taek, Whang Ha Wook, Park Jinsung, Kim Eun Tak, Kim Dae Kyung, Woo Seung Hyo
Department of Urology, Eulji University School of Medicine, Daejeon, Korea.
Korean J Urol. 2013 Feb;54(2):100-5. doi: 10.4111/kju.2013.54.2.100. Epub 2013 Feb 18.
To investigate the relationship of improvement in erectile function (EF) with improvement in lower urinary tract symptoms (LUTS) and to assess the contribution of tamsulosin dose to the improvement of EF apart from the indirect influence of LUTS improvement in men with LUTS and erectile dysfunction (ED).
Fifty patients received tamsulosin 0.2 mg/d for the first 4 weeks and were subsequently divided into two groups by patient-reported outcomes. Nonescalators were maintained starting dose and escalators increased to 0.4 mg for the remaining 8 weeks. International Prostatic Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5), and underwent uroflowmetry were evaluated at baseline, and weeks 4 and 12.
LUTS parameters were significantly improved in both groups but insignificant between the 2 groups. The degree of the improvement in the total IPSS and in the voiding, storage, and quality of life (QoL) subscores were significantly correlated with the degree of the improvement in EF; this was especially prominent in patients successfully treated LUTS. The escalators experienced a significantly greater increase in IIEF-5 scores than did the nonescalators (3.3 vs. 1.5).
Dose escalation provided similar LUTS improvement in patients with refractory to starting dose. The improvements of LUTS were correlated with the improvement of EF. The increase in the IIEF-5 score was significantly higher in escalators. These findings imply that tamsulosin may contribute to the improvement in EF through the improvement of LUTS and QoL and direct relaxation of the corpus cavernosum in a dose-dependent fashion.
探讨勃起功能（EF）改善与下尿路症状（LUTS）改善之间的关系，并评估坦索罗辛剂量对EF改善的贡献，排除LUTS改善对伴有LUTS和勃起功能障碍（ED）男性EF改善的间接影响。
50例患者在开始的4周内接受0.2mg/d的坦索罗辛治疗，随后根据患者报告的结果分为两组。非递增组维持起始剂量，递增组在接下来的8周内剂量增加至0.4mg。在基线、第4周和第12周评估国际前列腺症状评分（IPSS）、国际勃起功能指数（IIEF-5），并进行尿流率测定。
两组的LUTS参数均有显著改善，但两组之间无显著差异。总IPSS以及排尿、储尿和生活质量（QoL）子评分的改善程度与EF的改善程度显著相关；这在成功治疗LUTS的患者中尤为突出。递增组的IIEF-5评分增加显著高于非递增组（3.3对1.5）。
剂量递增在起始剂量难治的患者中提供了相似的LUTS改善。LUTS的改善与EF的改善相关。递增组的IIEF-5评分增加显著更高。这些发现表明，坦索罗辛可能通过改善LUTS和QoL以及以剂量依赖方式直接松弛海绵体来促进EF的改善。
