The effects on sexual function (SF) by the drugs commonly used in the treatment of benign prostatic hyperplasia (BPH) and prostate cancer (PC) have been analyzed. BPH therapy: alpha-blockers have no adverse effects on SF; the only one without significant hypotensive effect, Tamsulosin, can cause retrograde ejaculation in 4–8% of cases. 5-Alpha-reductase (Finasteride and Dutasteride) inhibitors could have detrimental effects on erectile function, libido and ejaculation in a small percentage of cases rarely exceeding 10%; these effects are reversible and their incidence reduces after 1 yr. Phytotherapy (extracts from pygeum africanum and serenoa repens) and mepartricin have no unfavorable action on SF. PC therapy: Loss of erectile function and libido are the norm with the use of LH-RH analogues, estrogens and steroidal antiandrogens (cyproterone acetate). Non-steroidal antiandrogens (Flutamide, Bicalutamide and Nilutamide) allow the preservation of SF in two-thirds of cases.
SeftelA.D., RosenR.Physician perceptions of BPH-related sexual dysfunction and drug-related sexual side effects.J Urol2004; 171(Suppl. 4): 36.
2.
RoehrbornC.G.Efficacy and safety of once-daily alfuzosin in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia: a randomized, placebo-controlled trial.Urology2001; 58: 953–9.
3.
LutherR.R., GlassmannH.N., EstepCB. Terazosin, a new selective alpha 1-adrenergic blocking agent. Results of long-term treatment in patients with essential hypertension.Am J Hypertens1988; 1: 237S–240S.
4.
SchulmanC.Impact of treatment of BPH on sexuality.Prostate Cancer Prostatic Dis42001 (Suppl 1): S12–S16.
5.
McKeageK., PloskerG.L.Alfuzosin: a review of the therapeutic use of the prolonged-release formulation given once daily in the management of benign prostatic hyperplasia.Drugs2002; 62: 633–53.
6.
Mc VaryK.T., Foley-BrookeJ., SlawinK.M., KusekJ.W.The long term effects of doxazosin, finasteride, and the combination on sexual function in men participating the MTOPS study.J Urol2004; 171(Suppl. 4): 315.
7.
LeliefeldH.H., StovelaarH.J., McDonnellJ.Sexual function before and after various treatments for symptomatic benign prostatic hyperplasia.BJU Int2002; 89: 208–13.
8.
KassabianV.S.Sexual function in patients treated for benign prostatic hyperplasia.Lancet2003; 361: 60–2.
9.
ChappleC.R.Medical therapy and quality of life.Eur Urol1998; 34: 10–17.
10.
HofnerK., ClaesH., De ReijkeT.M., FolkestadB., SpeakmanM.J.Tamsulosin 0.4 mg daily: effect on sexual function in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction.Eur Urol361999: 335–341.
11.
KirbyR.S., AndersonM., GratzkeP., DahlstrandC., HoyeK.A combined analysis of the efficacy and tolerability of doxazosin-gastrointestinal therapeutic system, doxazosin standard and placebo in patients with benign prostatic hyperplasia.BJU Int2001; 87: 192–200.
12.
De RoseA.F., CarmignaniG., CorbuC. Observational multicentric trial performed with doxazosin: evaluation of sexual effects on patients with diagnosed benign prostatic hyperplasia.Urol Int2002; 68: 95–8.
13.
Van MorselaarR., EmbertonM., HarvingNAlfuzosin 10 mg once daily improves sexual function in men with LUTS and concomitant sexual dysfunction.Eur Urol2003; 2(Suppl): 74.
CarboneDJJr., HodgesS.Medical therapy for benign prostatic hyperplasia: sexual dysfunction and impact on quality of life.Int J Impot Res2003; 15: 299–306.
16.
PaleaS., BarasM.Comparison of the relaxant effects of alfuzosin, phentolamine and sildenafil on rabbit isolated corpus cavernosum.BJU Int2003; 91: 873–77.
17.
O'LearyM.P.Quality of life and alpha-blocker therapy: an important consideration for both the patient and the physician.Urology2002; 59(Suppl. 2A): 7–11.
18.
VallancienG., EmbertonM., HarvingN., van MorselaarR.Sexual dysfunction in 1274 European men suffering from lower urinary tract symptoms.J Urol2003; 169: 2257–61.
19.
RosenR., AltweinJ., BoyleP. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of ageing male.Eur Urol2003; 44: 637–49.
20.
RoehrbornC.G.Are all alpha-blockers created equal? An update.Urology2002; 59(Suppl. 2a): 3–6.
21.
De MeyC.: Alpha 1-blocker therapy for lower urinary tract symptoms suggestive of benign prostatic obstruction: what are the relevant differences in randomized controlled trials?Eur Urol2000; 38 (Suppl 1): 25–39.
22.
SchulmanC., LockTNTW, BuzelinJM. Long-term use of tamsulosin to treat lower urinary tract symptoms/Benign Prostatic Hyperplasia.J Urol2001; 166: 1958–63.
23.
NarayanP., LeporH.Long-term, open-label, phase III multicenter study of Tamsulosin in Benign Prostatic Hyperplasia.Urology2001; 57: 466–67.
24.
SchulmanC.C., CortvriendJ., JonasU. Tamsulosin: 3-year long-term efficay and safety in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction: analysis of a European, multinational, multicenter, open-label study. European Tamsulosin Study Group.Eur Urol1999; 36: 609–620.
25.
DebruyneF.M., Van der PoelH.G.Clinical experience in Europe with uroselective alpha 1 - antagonists.Eur Urol1999; 36(Suppl. 1): 54–58.
26.
LeeM.Tamsulosin for the treatment of benign prostatic hypertrophy.Ann Pharmacother2000; 34: 188–99.
27.
MichelM.C., FlanneryM.T., NarayanP.: Worldwide experience with alfuzosin and terazosin.Urology2001; 58: 508–516.
28.
DebruyneF., KochG., BoyleP. Comparison of a phytoterapeutic agent (Permixon. with an alpha-blocker (Tamsulosin. in the treatment of benign prostatic hyperplasia: a 1-year randomized international study; Urol2002 Eur 41: 497–507.
29.
Tamsulosin.Drugs & Therapy Perspectives2002; Vol 18, n. 10: 1–4.
30.
ChappleC.R., BaertL., ThindP., HofnerK., KhoeG.S., SpangbergA.Tamsulosin 0.4 mg daily: tolerability in older and younger patients with lower urinary tract symptoms of benign prostatic obstruction (symptomatic BPH. The European Tamsulosin Study Group.Eur Urol1997; 32: 462–70.
31.
SpeakmanM.J., SnijderR.J., AnthonijsG., DoyleC.A.Patients on tamsulosin experiencing abnormal ejaculation choose to remain longer in clinical trials and have slightly better improvement in symptom score than other patients.J Urol2003; 169(Suppl. 4): 334.
32.
CarsonC., RittmasterR.: The role of dihydrtestosterone in benign prostatic hyperplasia.Urology2003 (4 Suppl 1) 61: 2–7.
33.
AndrioleG., BruchovskyN., ChungLW. Dihydrotestosterone and the prostate: the scientific rationale for 5-alpha-reductase inhibitors in the treatment of Benign prostatic hyperplasia.J Urol2004; 172: 1399–1403.
34.
DesgrandchampsF.Who will benefit from combination therapy? The role of 5 alpha reductase inhibitors and alpha blockade: a reflection from MTOPS.Curr Opin Urol2004; 14: 17–20.
35.
WildeM.I., GoaK.L.Finasteride: an update of its use in the management of symptomatic benign prostatic hyperplasia.Drugs1999; 57: 557–81.
36.
KirbyR.S., McConnellJ.D.Iperplasia prostatica benigna. Edizione Italiana, da “Benign Prostatic Hyperplasia”Fourth Edition by Health Press LimitedOxford (UK. 2004, Salerno Momento Medico s.r.l., p. 45, 2004.
37.
McConnellJ.D., BruskewitzA., WalshP.The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride long-term Efficacy and Safety Study Group.N Engl J Med1998; 338: 557–63.
38.
WesselsH., RoyJ., BannowJ. Incidence and severity of sexual adverse experiences in finasteride and placebo-treated men with benign prostatic hyperplasia.Urology2003; 61: 579–84.
RoehrbornC.G., MarksL.S., FenterT. Efficacy and safety of dutasteride in the four-year treatment of men with benign prostatic hyperplasia.Urology2004; 63: 709–15.
41.
DebruyneF., BarkinJ., van ErpsP., ReisM., TammelaT.L., RoehrbornC.Efficacy and safety of long-term treatment with the alpha –reductase inhibitor dutasteride in men with symptomatic benign prostatic hyperplasia.Eur Urol46: 488–94.
42.
McConnellJ.D., RoehrbornC.G., BautistaOM. The long-term effect of doxazosin, finasteride and combination therapy on the clinical progression of benign prostatic hyperplasia.N Engl J Med2003; 18: 349: 2387–98.
43.
LoweF.C., FagelmanE.Phytotherapy in the treatment of benign prostatic hyperplasia.Curr Opin Urol2002; 12: 15–8.
44.
BrezaJ., DzurnyO., BorowkaA.Efficacy and acceptability of tadenan (Pygeum africanum extract. in the treatment of benign prostatic hyperplasia: a multicenter trial in central Europe.Curr Med Res Opin1998; 14: 127–39.
45.
IshaniA., MacDonaldR., NelsonD., RutksI., WiltT.J.Pygeum africanum for the treatment of patients with benign prosatic hyperplasia: a systematic review and quantitative meta-analysis.Am J2000; 109: 654–64.
46.
CaraniC., SalvioliV., ScuteriA. Urological and sexual evaluation of treatment of benign prostatic disease using Pygeum africanum at high doses.Arch Ital Urol Nephrol Androl1991; 63: 341–5.
47.
GerberG.S., FitzpatrickJ.M.The role of a lipido-sterolic extract of Serenoa repens in the management of lower urinary tract symptoms associated with benign prostatic hyperplasia.BJU Int2004; 94: 338–44.
48.
BoyleP., RobertsonC., LoweF., RoehrbornC.Meta-analysis of clinical trials of permixon in the treatment of symptomatic benign prostatic hyperplasia.Urology2000; 55: 533–39.
49.
ManciniM., RanzatoL., TagliapietraC., BassiF., BernardiP., PaganoF.Serenoa epens extract auses opening of the mithocondrial permeability transition pore and apoptosis in a human prostate cancer cell line.Abstract book of the 16th Congress of the European Society for Urological Research2002; 81.
50.
VacherotF., AzzouzM., Gil-Diez-De-MedinaS.Induction of apoptosis and cell proliferation by the lipido-sterolic extract of Serenoa epens (LSESr, Permixon.in benign prostatic hyperplasia.Prostate2000; 45: 259–66.
51.
Vela-NavarreteR., Garcia CardosoJ.V., BaratA., ManzarbeitiaF., Lopez FarreA.BPH and inflammation: pharmacological effects of ermixon on histological and molecular inflammatory markers. Results of a double blind pilot clinical assay.Eur Urol2003; 44: 549–55.
52.
PytelY.A., VinarovA., LopatkinN., SivkovA., GorilovskyN., RaynaudJ.P.Long-term chemical and biological effects of the lipidosterolic extract of Serenoa Repens in patients with symptomatic benign prostatic hyperplasia.Adv Ther2002; 19: 297–306.
53.
ShakutouS., BandohK., YoshinakaY., KobayashyH., YamanakaH.Effects of mepartricin, a polyene macrolide agent, on fecal excretion and serum concentration of estrogen and number of prostatic estrogen receptors in immature rats.Prostate1999; 38: 18–27.
54.
BaroneD., PeroglioF., TosoE., BruzzeseT.Binding of mepartricin to sex hormones, a key factor of its activity on benign prostatic hyperplasia.Arzneimittelforschung2001; 51: 984–90.
55.
ReG., BadinoP., OdoreR.Effects of mepartricin on estradiol and testosterone serum levels and on prostatic estrogen, androgen and adrenergic receptor concentrations in adult rats.Pharmacol Res2001; 44: 141–7.
56.
BoehmS., NirnbergerG., FerrariP.Estrogen suppression as pharmacotherapeutic strategy in the medical treatment of benign prostatic hyperplasia: evidence for its efficacy from studies with mepartricin.Wien Klin Wochenschr1998; 110: 817–23.
57.
DenisL., PaganoF., NonisA., RobertsonC., RomanoP., BoyleP.Double-blind, placebo-controlled trial to assess the efficacy and tolerability of mepartricin in the treatment of BPH.Prostate1998; 37: 246–52.
58.
HugginsC., HodgesC.V.Studies on prostate cancer I: the effect of castration, of estrogen and of androgen injection on serum phosphatase in metastatic carcinoma of the prostate.Cancer Res1941; 1: 293–7.
59.
SalmimiesP., KockottG., PirkeK.M., VogtH.J., SchillV.B.Effects of testosterone replacement on sexual behavior in hypogonadal men.Arch Sex Behav1982; 11: 345–53.
60.
BuffumJ.Pharmacosexology update: prescription drugs and sexual function.J Psychoact Drugs1986; 18: 97–106.
61.
RousseauL., DupontA., LabrieF., CoutureM.Sexuality changes in prostate cancer patients receiving antihormonal therapy combining the antiandrogen flutamide with medical (LHRH agonist or surgical castration).Arch Sex Behav1988; 17: 87–98.
62.
LucasM.D., StrijdomS.C., BerkM., HartG.A.D.Quality of life, sexual functioning and sex role identity after surgical orchidectomy in patients with prostatic cancer.Scand J Urol Nephrol1995; 29: 497–500.
ClarkJ.A., WrayN.P., AshtonC.M.Living with treatment decisions: regrets and quality of life among men treated for metastatic prostate cancer.J Clin Oncol2001; 19: 72–80.
65.
TraishA.M., MunarrizR., O'ConnelL.Effects of medical or surgical castration on erectile function in an animal model.J Androl2003; 24: 381–7.
66.
IversenP., MelezinekI., SchmidtA.Nonsteroidal antiandrogens: a therapeutic option for patients with advanced prostate cancer who wish to retain sexual interest and function.BJU Int2001; 87: 47–56.
67.
AndersonJ.The role of antiandrogen monotherapy in the treatment of prostate cancer.BJU Int2003; 91: 455–61.
68.
TunnU., KurekR., KienleE., MaubachL.Intermittent is as effective as continuous androgen deprivation in patients with PSA-relapse after Radical Prostatectomy (RP).J Urol2004; 171(Suppl. 4): 384.
69.
PetherM., GoldenbergS.L., BhagirathK., GleaveM.Intermittent androgen suppression in prostate cancer: an update of the Vancouver experience.Can J Urol2003; 10: 1809–14.
70.
GoldenbergS., BruchovskyN., GeaveM.E., SullivanL.D., AkakuraK.Intermittent androgen suppression in the treatment of prostate cancer: a preliminary report.Urology1995; 45: 839–44.
de LevalJ., BocaP., YousefE.Intermitent versus continuous total androgen blockade in the treatment of patients with advanced hormone-naïve prostate cancer: results of a prospective randomised multicenter trial.Clin Prostate Cancer2002; 1: 163–71.
TomicR.Some effects of orchiectomy, oestrogen treatment and radiation therapy in patients with prostatic carcinoma.Scand J Urol Nephrol1983; (Suppl 77): 1–37.
78.
JacobiG.H., AltweinJ.E., KurthK.H., BastingR., HohenfellnerR.Treatment of advanced prostatic cancer with parenteral cyproterone acetate: a phase III randomized trial.Brit J Urol1980; 52: 208–15.
79.
SchroederF., ColletteL., De ReikeT.M., WhelanP.Prostate cancer treated by anti-androgens: is sexual function preserved?Brit J Cancer2000; 82: 283–90.
80.
LundF., RasmussenF.Flutamide versus stilboestrol in the management of advanced prostatic cancer: a controlled prospective study.Br J Urol1988; 61: 140–2.
81.
FleshnerN.E., TrachtenbergJ.Combination finasteride and flutamide in advanced carcinoma of the prostate: effective therapy with minimal side effects.J Urol1995; 154: 1642–5.
82.
OrnsteinD.K., RaoG.S., JohnsonB., CharltonE.T., AndrioleG.L.Combined finasteride and flutamide therapy in men with advanced prostate cancer.Urology1996; 48: 901–5.
83.
DeKernionJ.N., MurphyG.P., PrioreR.Comparison of flutamide and Emcyt in hormone-refractory metastatic prostatic cancer.Urology1988; 31: 312–7.
84.
SeeW.A., WirthM.P., McLeodDG. Casodex early prostate cancer trialist group. Bicalutamide as immediate therapy either alone or as adjuvant to standard care in patients with localized or locally advanced prostate cancer: first analysis of the Early Prostate Cancer Program.J Urol2002; 168: 429–35.
85.
KennealeyG.T., FurrB.J.Use of nonsteroidal antiandrogen Casodex in advanced prostatic carcinoma.Urol Clin N Am1991; 18: 99–110.
86.
DecensiA.V., BoccardoF., GuarneriD. Monotherapy with nilutamide, a pure non steroidal antiandrogen, in untreated patients with metastatic carcinoma of the prostate. The Italian Prostatic Cancer Project.J Urol1991; 146: 377–81.
