Diagnosis and treatment of lower urinary tract symptoms and erectile dysfunction in patients with benign prostate hyperplasia

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Abstract

The efficacy and safety of alpha-1-adrenergic blocker alfuprost MP (alfuzosin) at a dose of 10 mg once a day and a fifth-type phosphodiesterase inhibitor viatile (sildenafil) 50 mg once a day in the combined treatment of 75 patients with benign prostate hyperplasia (BPH) with low urinary tract symptoms and erectile dysfunction (ED). Patients were divided into 3 groups, depending on the severity of ED and urination disorders. The 1st (main) group included 34 (45.3%) patients with moderate-stage ED (IIEF 11-15 points, IPSS 10-12 points) who got a combination therapy that included the intake of viatile (sildenafil) 50 mg in day daily and alfuprost MP (alfuzosin) 10 mg once a day for 12 weeks. The second group included 21 (28%) patients with a mild degree of ED (IIEF 16-20 points, IPSS-10-12 points), who received only viatile (sildenafil) 50 mg daily once a day with the same duration. The third group included 20 (26.6%) patients with mild ED (IIEF 16-20, IPSS 7-8), who received only alfuprost MP (alfuzosin) 10 mg once a day for 12 weeks. After the end of treatment 29 (85.3%) patients of the 1st group, 16 (76.2%) patients of the 2nd group and 11 (55%) patients of the 3rd group noted high efficiency. The patients of the 1st group had the greatest clinical effect of treatment – an increase in the quality of erection by an average of 7.0 according to IIEF, an increase in blood flow in the vessels of the penis by 3.5 times, decrease in the IPSS index by 5 points, and an increase in the rate of urination. The results of the study indicate the advisability of prescribing patients with BPH with low unitary tract symptoms and erectile dysfunction of combined therapy with alpha-blockers and phosphodiesterase type 5 inhibitors.

About the authors

Svetlana N. Kalinina

North-Western State Medical university named after I.I. Mechnikov

Author for correspondence.
Email: kalinina_sn@mail.ru

Doctor of Medical Science, Professor, Urology Department

Russian Federation, Saint Petersburg

Oleg O. Burlaka

Aleksandrovskaya Hospital

Email: burlaka@list.ru

Candidate of Medical Science, Head of Department of Urology

Russian Federation, Saint Petersburg

Mikhail S. Aleksandrov

Aleksandrovskaya Hospital

Email: burlaka@list.ru

Urologist, Department of Urology

Russian Federation, Saint Petersburg

Pavel S. Vydryn

Aleksandrovskaya Hospital

Email: burlaka@list.ru

Urologist, Department of Urology

Russian Federation, Saint Petersburg

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2. Fig. 1. Ultrasound doplerography of the penis of the patient M., 68 years old, with benign prostatic hyperplasia and arteriogenic erectile dysfunction who received combination therapy for 12 weeks (group 1): a-Vmax (peak systolic blood flow velocity) in cavernous arteries decreased up to 6.8 cm / s; b - after treatment, Vmax increased to 24 cm / s

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3. Fig. 2. Ultrasonic doplerography of the penis of the patient A., 54 years old, with benign prostatic hyperplasia and venous erectile dysfunction in the stage of compensation (2nd group). After 4 weeks, the peak systolic blood flow velocity was 11.2 cm / s, the Valsalva test (+), in the dorsal vein - 26 ml / min

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Copyright (c) 2018 Kalinina S.N., Burlaka O.O., Aleksandrov M.S., Vydryn P.S.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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