BARCELONA—Alfuzosin 10 mg once-daily (OD) improves ejaculatory dysfunction in sexually active men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH), according to new findings presented here at the 25th Anniversary European Association of Urology Congress.

John M. Fitzpatrick, MD, Professor of Surgery and Consultant Urologist at Mater Hospital and University College in Dublin, Ireland, and colleagues assessed the impact of alfuzosin administered without dose titration on ejaculatory dysfunction in real-life practice. The study was conducted in Europe, Asia, South America, and Russia.

“Sexual dysfunction is highly prevalent in aging men with LUTS suggestive of BPH, with significant adverse effects on quality of life an overall wellbeing,” Dr. Fitzpatrick said.

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He added: “Sexual dysfunction is a complex phenomenon which is not limited to erectile dysfunction. In fact, several clinical studies have shown that ejaculatory dysfunction is almost as prevalent as erectile dysfunction.”

Although the condition reportedly affects roughly half of all men who are 50 years of age or older and causes significant bother in most cases, validated questionnaires that assess male sexual function focus largely on erectile dysfunction with few or no questions that aim to elicit information on ejaculation, he said.

In the present analysis, the investigators used the Male Sexual Health Questionnaire (MSHQ-EjD) short-form. The questionnaire is a validated tool that assesses seven functional ejaculatory dysfunction symptoms as well as bother resulting from ejaculatory dysfunction.

The MSHQ-EjD includes four questions:

  1. In the past month, how often have you been able to ejaculate when having sexual activity?
  2. In the past month, how would you rate the strength or force of your ejaculation?
  3. In the past month, how would you rate the amount or volume of semen when you ejaculate?
  4. In the past month, have you had any ejaculation difficulties or have been unable to ejaculate, have you been bothered by this?

Study participants were classified as follows on the basis of their responses:  

  • no ejaculatory dysfunction (consistently able to  ejaculate all or most of the time with force as strong or slightly less strong than usual and volume as much as usual or a little less than usual);
  • partial ejaculatory dysfunction (decreased frequency, force, and volume of their ejaculate);
  • complete ejaculatory dysfunction (unable to ejaculate)

Overall, 1,123 men completed the six-month treatment period. Alfuzosin was associated with a significant 7.9 point (41%) decrease in International Prostate Symptom Score.

Overall, 48.1% of men reported waking up at least three times a night at enrollment versus 16.8% at end point. Bother due to LUTS also improved significantly. The percentage of men strongly bothered by LUTS decreased from 67% to 19%.

Results on the MSHQ-EjD revealed that bother due to ejaculatory dysfunction, which was highly prevalent at enrollment, significantly improved with alfuzosin.

The improvement in ejaculatory dysfunction and bother due to ejaculatory dysfunction was significant in men less than 70 years of age compared with baseline. Alfuzosin was well tolerated from a cardiovascular and sexual standpoint.

Dr. Fitzpatrick said that while he is encouraged by the findings, more studies are needed to “unambiguously” confirm this benefit of alfuzosin on ejaculation.