Effect of tamsulosin on ejaculatory function in BPH/LUTS

Abstract

This study was undertaken to determine the impact on ejaculatory function of tamsulosin (0.2 mg) given once daily (OD) for 12 weeks and to identify risk factors for ejaculatory dysfunction in patients undergoing this treatment. Males with an International Prostatic Symptom Score (IPSS) ≥8 were enrolled in this study. All participants completed questionnaires, including the IPSS and the Male Sexual Health Questionnaire (MSHQ), and serum prostate-specific antigen, transrectal ultrasound and uroflowmetry with post-void residual were measured. After initiating 0.2 mg OD tamsulosin, patients were re-evaluated on the fourth and twelfth weeks of medication. The chi-squared test, the independent t-test and one-way ANOVA were used to compare means. Binary logistic regression analysis was used to calculate the odds ratio for all risk factors. A total of 177 men constituted the study cohort. No significant difference was observed between baseline and follow-up for the erectile function, ejaculatory function, satisfaction, sexual activity and desire domains (EFD, EjFD, SDA and ADD) or for erectile or ejaculatory bother mean scores. After 12 weeks, the overall incidence of ejaculatory dysfunction (EjD) was 13.4%. Incidences of the seven different types of EjD (decreased frequency, delay, dryness, decreased strength/force, decreased volume, decreased pleasure and pain at ejaculation) were 2.4%, 3.1%, 3.9%, 3.9%, 6.3%, 7.1% and 3.1%, respectively. Baseline EjFD scores were higher for IPSS responders than for non-responders (26.09 vs. 24.06, P=0.03). An EjFD score reduction was more frequent in IPSS responders. The incidence of EjD was small, but not negligible and was more frequent in patients with less lower urinary tract symptoms, a smaller prostate, higher baseline MSHQ totals and higher EjFD scores.

Figure 1

Plots demonstrating MSHQ ejaculatory function domain item scores evaluated at baseline and after 4 and 12 weeks of treatment. Differences were not statistically significant except for the seventh item (pain) at 12 weeks of treatment (P=0.013). Q1–Q7: ejaculatory function domain item numbers 1–7; Bother: MSHQ ejaculatory bother item score. MSHQ, Male Sexual Health Questionnaire.

Figure 2

MSHQ domain score reductions after 12 weeks of tamsulosin treatment were more common among IPSS responders than IPSS non-responders, but this difference was significant for EjFD scores only (42.5% vs. 25.5%, P=0.017). (a) Erectile function domain (EFD); (b) ejaculatory function domain (EjFD); (c) satisfaction domain (SAD); (d) activity and desire domain (ADD). IPSS, International Prostatic Symptom Score; MSHQ, Male Sexual Health Questionnaire.