Prevalencia de disfunción eyaculatoria secundaria al tratamiento con alfa-bloqueantes en pacientes con hiperplasia benigna de próstata
Prevalence of ejaculatory dysfunction secondary to alpha-blocker therapy in patients with benign prostatic hyperplasia
A. Martín-Morales
, G. Meyer**, E. Ramírez***
,1
Autor para correspondencia
amartinmorales@terra.es
Correspondencia autor: Dr. A. Martín Morales Servicio de Urología, Unidad de Andrología. Hospital Carlos Haya. Plaza Hospital Civil, s/n – 29009 Málaga Tel.: 951 290 362
Correspondencia autor: Dr. A. Martín Morales Servicio de Urología, Unidad de Andrología. Hospital Carlos Haya. Plaza Hospital Civil, s/n – 29009 Málaga Tel.: 951 290 362
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"apellidos" => "Martín-Morales" "email" => array:1 [ 0 => "amartinmorales@terra.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "G." "apellidos" => "Meyer" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "E." "apellidos" => "Ramírez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">***</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Urología. Hospital Carlos Haya" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Sanofi-Aventis SA" "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Infociencia SL" "etiqueta" => "<span class="elsevierStyleSup">***</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia autor: Dr. A. Martín Morales Servicio de Urología, Unidad de Andrología. Hospital Carlos Haya. Plaza Hospital Civil, s/n – 29009 Málaga Tel.: 951 290 362" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prevalence of ejaculatory dysfunction secondary to alpha-blocker therapy in patients with benign prostatic hyperplasia" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-12-01" "fechaAceptado" => "2008-04-01" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec88668" "palabras" => array:7 [ 0 => "Hiperplasia benigna de próstata" 1 => "Alfuzosina" 2 => "Alfa-bloqueantes" 3 => "Disfunción eréctil" 4 => "Enfermedad urológica" 5 => "Síntomas prostáticos" 6 => "Tracto urinario inferior" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec88667" "palabras" => array:6 [ 0 => "Adrenergic alpha-Antagonists" 1 => "Ejaculation" 2 => "Prostatic Hyperplasia" 3 => "Sexual Dysfunction" 4 => "Physiological" 5 => "Urologic Diseases" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La hiperplasia benigna de próstata (HBP) se acompaña de síntomas del tracto urinario inferior (STUI) que pueden causar alteraciones eyaculatorias, aunque éstas podrían ser además consecuencia del tratamiento con alfa-bloqueantes</p> <span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Determinar la prevalencia de disfunción eyaculatoria en pacientes con HBP tratados con alfa-bloqueantes. Secundariamente, evaluar el efecto del tipo de fármaco y la relación de las alteraciones eyaculatorias con factores pronósticos y la gravedad de la HBP</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio epidemiológico, transversal, no controlado y abierto en 1.177 pacientes ≥40 años diagnosticados de HBP/STUI con más de 6 meses de evolución, tratados con el mismo alfa-bloqueante durante como mínimo los últimos 3 meses. El grado de disfunción eyaculatoria se determinó mediante el dominio sobre eyaculación del Male Sexual Health Questionnaire (MSHQ). Los resultados se estratificaron según la edad y gravedad de la HBP, establecida mediante el International Prostate Symptoms Score (IPSS)</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se ha estimado una prevalencia de disfunción eyaculatoria del 82,6% en pacientes con HBP/STUI en tratamiento con alfa-bloqueantes. Aunque generalmente leve, un amplio porcentaje de quienes la sufren la consideran un problema. La edad avanzada es el factor más influyente en la gravedad tanto de las alteraciones eyaculatorias como de los síntomas prostáticos. Entre ambos parámetros se ha establecido una sólida correlación. Finalmente, entre los alfa-bloqueantes evaluados, la alfuzosina se ha asociado a una mejor función sexual</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Más del 80% de pacientes con HBP sufren alteraciones eyaculatorias, estrechamente relacionadas con la severidad de los síntomas prostáticos y la edad del individuo. Al establecer tratamiento con alfa-bloqueantes, deberíamos tener en cuenta que la alfuzosina es el que menos impacto tiene sobre la función eyaculatoria</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Benign prostatic hyperplasia (BPH) is characterized by lower urinary tract symptoms (LUTS) that may cause ejaculatory disorders, although they could be also a consequence of alpha-blocker treatment</p> <span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To determine the prevalence of ejaculatory dysfunction in patients with HBP undergoing alpha-blocker therapy. Secondary objectives were to evaluate the effect of different drugs on normal ejaculation and the relationship of dysfunction degree to prognostic factors and BPH severity</p> <span class="elsevierStyleSectionTitle">Materials and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Epidemiologic, transversal, uncontrolled and open-label study in 1.177 patients older than 40, who had been diagnosed of BPH/LUTS with more than 6 months of evolution and treated with the same alpha-blocker for at least the last 3 months. Severity of ejaculatory dysfunction was determined by the domain on ejaculation of the Male Sexual Health Questionnaire (MSHQ). Results were stratified by age and BPH severity, determined by the International Prostate Symptoms Score (IPSS)</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The prevalence of ejaculatory dysfunction has been estimated to be 82.6% in patients with BPH/LUTS treated with alpha-blockers. Although usually mild, the dysfunction is considered as bothersome by a high percentage of those who suffer it. Advanced age is the most influential factor in the severity of both ejaculatory abnormalities and prostate symptoms. Moreover, a solid correlation between these two parameters has been established. Finally, among the analyzed alpha-blockers, alfuzosin has been associated with the best sexual function</p> <span class="elsevierStyleSectionTitle">Conclussions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">More than 80% of patients with BPH suffer ejaculatory abnormalities, which are closely related to the severity of prostate symptoms and increased age. When initiating alpha-blocker treatment, we should consider that alfuzosin is the one with less negative impact on ejaculatory function</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hiperplasia prostática benigna y medicina basada en la evidencia. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Octubre | 0 | 12 | 12 |
| 2024 Septiembre | 0 | 10 | 10 |
| 2024 Agosto | 0 | 6 | 6 |
| 2024 Julio | 0 | 9 | 9 |
| 2024 Junio | 0 | 8 | 8 |
| 2024 Mayo | 0 | 2 | 2 |
| 2024 Abril | 0 | 28 | 28 |
| 2024 Marzo | 0 | 23 | 23 |
| 2024 Febrero | 0 | 20 | 20 |
| 2024 Enero | 0 | 23 | 23 |
| 2023 Diciembre | 0 | 16 | 16 |
| 2023 Noviembre | 0 | 30 | 30 |
| 2023 Octubre | 0 | 18 | 18 |
| 2023 Septiembre | 0 | 18 | 18 |
| 2023 Agosto | 0 | 2 | 2 |
| 2023 Julio | 0 | 26 | 26 |
| 2023 Junio | 0 | 7 | 7 |
| 2023 Mayo | 0 | 3 | 3 |
| 2023 Abril | 0 | 1 | 1 |
| 2023 Marzo | 0 | 4 | 4 |
| 2023 Febrero | 0 | 6 | 6 |
| 2023 Enero | 0 | 3 | 3 |
| 2022 Diciembre | 0 | 4 | 4 |
| 2022 Noviembre | 0 | 4 | 4 |
| 2022 Octubre | 0 | 5 | 5 |
| 2022 Septiembre | 0 | 15 | 15 |
| 2022 Agosto | 0 | 4 | 4 |
| 2022 Julio | 0 | 1 | 1 |
| 2022 Junio | 0 | 10 | 10 |
| 2022 Mayo | 0 | 1 | 1 |
| 2022 Abril | 0 | 16 | 16 |
| 2022 Marzo | 0 | 20 | 20 |
| 2022 Febrero | 0 | 20 | 20 |
| 2022 Enero | 0 | 45 | 45 |
| 2021 Diciembre | 0 | 20 | 20 |
| 2021 Noviembre | 0 | 5 | 5 |
| 2021 Octubre | 0 | 3 | 3 |
| 2021 Agosto | 0 | 3 | 3 |
| 2021 Julio | 0 | 4 | 4 |
| 2021 Junio | 0 | 3 | 3 |
| 2021 Mayo | 0 | 8 | 8 |
| 2021 Marzo | 0 | 7 | 7 |
| 2021 Febrero | 0 | 1 | 1 |
| 2020 Noviembre | 0 | 2 | 2 |
| 2020 Octubre | 0 | 4 | 4 |
| 2020 Septiembre | 0 | 5 | 5 |
| 2020 Agosto | 0 | 8 | 8 |
| 2020 Julio | 0 | 5 | 5 |
| 2020 Junio | 0 | 3 | 3 |
| 2020 Mayo | 0 | 3 | 3 |
| 2020 Abril | 0 | 1 | 1 |
| 2020 Marzo | 0 | 9 | 9 |
| 2020 Febrero | 0 | 3 | 3 |
| 2020 Enero | 0 | 9 | 9 |
| 2019 Diciembre | 0 | 10 | 10 |
| 2019 Noviembre | 0 | 6 | 6 |
| 2019 Octubre | 0 | 1 | 1 |
| 2019 Septiembre | 0 | 9 | 9 |
| 2019 Agosto | 0 | 4 | 4 |
| 2019 Julio | 0 | 14 | 14 |
| 2019 Junio | 0 | 21 | 21 |
| 2019 Mayo | 0 | 54 | 54 |
| 2019 Abril | 0 | 43 | 43 |
| 2019 Marzo | 0 | 8 | 8 |
| 2019 Febrero | 0 | 11 | 11 |
| 2019 Enero | 0 | 1 | 1 |
| 2018 Diciembre | 0 | 8 | 8 |
| 2018 Noviembre | 0 | 13 | 13 |
| 2018 Octubre | 0 | 16 | 16 |
| 2018 Abril | 2 | 0 | 2 |
| 2018 Febrero | 2 | 1 | 3 |
| 2018 Enero | 4 | 1 | 5 |
| 2017 Diciembre | 1 | 1 | 2 |
| 2017 Noviembre | 5 | 5 | 10 |
| 2017 Octubre | 5 | 4 | 9 |
| 2017 Septiembre | 4 | 6 | 10 |
| 2017 Agosto | 5 | 1 | 6 |
| 2017 Julio | 3 | 13 | 16 |
| 2017 Junio | 8 | 3 | 11 |
| 2017 Mayo | 22 | 5 | 27 |
| 2017 Abril | 8 | 4 | 12 |
| 2017 Marzo | 6 | 16 | 22 |
| 2017 Febrero | 19 | 3 | 22 |
| 2017 Enero | 23 | 2 | 25 |
| 2016 Diciembre | 26 | 0 | 26 |
| 2016 Noviembre | 28 | 6 | 34 |
| 2016 Octubre | 32 | 10 | 42 |
| 2016 Septiembre | 14 | 4 | 18 |
| 2016 Agosto | 14 | 9 | 23 |
| 2016 Julio | 8 | 2 | 10 |
| 2016 Junio | 10 | 6 | 16 |
| 2016 Mayo | 19 | 13 | 32 |
| 2016 Abril | 8 | 9 | 17 |
| 2016 Marzo | 9 | 6 | 15 |
| 2016 Febrero | 10 | 10 | 20 |
| 2016 Enero | 10 | 12 | 22 |
| 2015 Diciembre | 5 | 8 | 13 |
| 2015 Noviembre | 11 | 5 | 16 |
| 2015 Octubre | 10 | 0 | 10 |
| 2015 Septiembre | 11 | 8 | 19 |
| 2015 Agosto | 7 | 0 | 7 |
| 2015 Julio | 7 | 5 | 12 |
| 2015 Junio | 1 | 2 | 3 |
| 2015 Mayo | 7 | 3 | 10 |
| 2015 Abril | 8 | 4 | 12 |
| 2015 Marzo | 3 | 2 | 5 |
| 2015 Febrero | 4 | 1 | 5 |
| 2015 Enero | 3 | 4 | 7 |
| 2014 Diciembre | 4 | 4 | 8 |
| 2014 Noviembre | 3 | 5 | 8 |
| 2014 Octubre | 14 | 2 | 16 |
| 2014 Septiembre | 10 | 3 | 13 |
| 2014 Agosto | 7 | 4 | 11 |
| 2014 Julio | 8 | 4 | 12 |
| 2014 Junio | 2 | 1 | 3 |
| 2014 Mayo | 1 | 2 | 3 |
| 2014 Abril | 0 | 3 | 3 |
| 2014 Marzo | 1 | 2 | 3 |
| 2014 Febrero | 3 | 3 | 6 |
| 2014 Enero | 3 | 1 | 4 |
| 2013 Diciembre | 12 | 7 | 19 |
| 2013 Noviembre | 9 | 10 | 19 |
| 2013 Octubre | 4 | 7 | 11 |
| 2013 Septiembre | 5 | 6 | 11 |
| 2013 Agosto | 4 | 6 | 10 |
| 2013 Julio | 1 | 0 | 1 |
| 2008 Junio | 287 | 0 | 287 |
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