Sexual function in 131 patients with benign prostatic hyperplasia before prostatectomy

Objective: The aim of the present study was to ascertain the frequency of s exual dysfunction in patients with benign prostatic hyperplasia (BPH) befor e prostatectomy. Methods: The study population included 131 patients aged 55-74 years (mean 61.4+/-2.7) with BPH. The patients had been complaining of daytime urgency and nocturia for the last 1-14 years (average 4.5+/-1.5 years). The diagnos is of BPH was based on the anamnestic data, the International Prostate Symp tom Score (IPSS0-35) and quality of life assessment (L0-6), and results of digital rectal examination, transrectal ultrasound, and uroflowmetry. Sexua l dysfunction was determined by retrospective analysis of the psychosexual history (with and separately from the spouse), penile brachial index (PBI), nocturnal penile tumescence (NPT), and blood hormone levels (testosterone) . Results: The patients were divided into two groups by severity of the urina ry disorder: group I, severe (IPSS0-35-L-6; n = 70); and group II, mild rel ative to group I (IPSS32-34-L4-5; n = 61). In group 1, 15 patients (21.4%) performed normal coitus, 24 (34.2%) had weak coitus with incomplete penetra tion, and 21 (44.2%) had unsuccessful coitus because of a weak erection. In group II, 28 patients (45.9%) had normal coitus, 25 (40.9%) incomplete pen etration, and 8 (13.1%) unsuccessful coitus. There was no significant corre lation between sexual function and the patients' general health condition. The quantitative assessment of sexual dysfunction yielded the following res ults in groups 1 and 2, respectively: negative NPT in 32.4+/-1.8 and 24.4+/ -2.1% (p<0.05); PBI <0.6 in 33.4+/-1.7 and 22.3+/-1.2% (p<0.001); and testo sterone decrease to <12 nmol/l in 36.4+/-1.2 and 28.5+/-1.2% (p<0.05), resp ectively. The differences between the groups were significant (p<0.05) for all th ree parameters. Conclusions: Considering the 44.2% rate of unsuccessful coitus in the patie nts with a severe urinary dysfunction compared to only 13.1% in those with a milder dysfunction and the significant correlation between severe urinary dysfunction and measures of sexual dysfunction, we suggest that BPH may be a risk factor for sexual dysfunction. Copyright (C) 2000 S. Karger AG, Bas el.