Effect of Improvement in Lower Urinary Tract Symptoms on Sexual Function in Men: Tamsulosin Monotherapy vs. Combination Therapy of Tamsulosin and Solifenacin

Abstract

Purpose: To evaluate how much the improvement of lower urinary tract symptoms(LUTS) affects sexual function and which storage symptoms or voiding symptoms havethe greatest effect on sexual function. Materials and Methods: A total of 187 patients were enrolled in this study. Patientswere randomly assigned to receive either tamsulosin 0.2 mg (group A) or tamsulosin0.2 mg and solifenacin 5 mg (group B). At 4 weeks and 12 weeks, the LUTS and sexualfunction of the patients were evaluated by use of the International Index of ErectileFunction-5 (IIEF5), International Prostate Symptom Score (IPSS), Overactive BladderSymptom Score (OABSS) questionnaire, uroflowmetry, and bladder scan. Results: Both groups A and B showed statistically significant improvements in IPSS,OABSS, and quality of life (QoL). Group A showed improved maximum flow rate, meanflow rate, and residual urine volume by time. Group B did not show an improvementin flow rate or residual urine volume but total voiding volume increased with time. TheIIEF5 score was not improved in either group. In group A, the IIEF5 score dropped from13.66±4.97 to 11.93±6.14 after 12 weeks (p=0.072). Group B showed a decline in theIIEF5 score from 13.19±5.91 to 12.45±6.38 (p=0.299). Although group B showed a relativelysmaller decrease in the IIEF5 score, the difference between the two groups wasnot significant (p=0.696). Conclusions: Tamsulosin monotherapy and combination therapy with solifenacin didnot improve erectile function despite improvements in voiding symptoms and QoL. Theimprovement in storage symptoms did not affect erectile function.