Introduction Benign prostatic hyperplasia (BPH) is a common condition among elderly men. The aim of therapy is to improve lower urinary tract symptoms (LUTS) and quality of life (QoL) and to prevent complications. Aim The primary objective was to assess the effect on ejaculatory dysfunction (EjD) of 6 months treatment with alfuzosin (XATRAL) 10 mg once daily (OD) in men with LUTS suggestive of BPH in Thailand. Secondary objectives were to evaluate the efficacy of alfuzosin on LUTS, bother score (International Prostate Symptom Score [IPSS] 8th question), erectile dysfunction (ED), onset of action, and tolerability. Methods Overall, 99 men with moderate to severe LUTS suggestive of BPH (mean IPSS 18.9, bother score 4.3) were enrolled in an open-label study. Sexual function was evaluated at baseline and after 6 months treatment, using the International Index of Erectile Function-5 and the Male Sexual Health Questionnaire (MSHQ) ejaculation score, a new validated questionnaire assessing seven EjD symptoms. Main Outcome Measure The main outcome measure is mean change from baseline to the end of treatment in the MSHQ Ejaculation score. Results MHSQ ejaculation score significantly improved from 23.09 at baseline to 21.54 at 6 months (P = 0.022). Overall, 70% of patients perceived an improvement in LUTS within 1 week (36.3% within 3 days). IPSS total score significantly improved from 18.93 at baseline to 9.59 at 6 months (P <0.001). IPSS voiding and irritative subscores also significantly improved. The percentage of patients with moderate or severe ED decreased from 35.3% at baseline to 21.8% at 6 months. Most adverse events were dizziness (3%) and orthostatic hypotension (1%) with minor intensity. No significant change in blood pressure and heart rate was observed. Conclusions Alfuzosin 10 mg OD administered for 6 months provides a marked and rapid (within 1 week) improvement in LUTS and bother score while improving both ED and EjD.
Objectives: To study the prevalence of fluoroquinolone-resistant and extended spectrum β-lactamase-producing isolates at Phramongkutklao Hospital, Thailand, and to identify the risk factors predicting the carriage of these organisms. Methods: Menundergoing transrectal ultrasound-guided prostate biopsy were prospectively enrolled between February and October2015. Rectal swab culture was obtained before antimicrobial prophylaxis andprostate biopsy. Univariate and multivariate analyses were performed to identify the independent risk factors associated with antimicrobial-resistant flora. Results: In total, 99 patients underwent biopsy, of whom 38 (38.4%) had antimicrobial-resistant rectal flora,with 26 (26.3%) having fluoroquinolone-resistant rectal flora and12 (12.1%) having both fluoroquinolone-resistant rectal flora and extended spectrum β-lactamase.The incidence of postbiopsy infections was 6.1%. The use of antibiotics in the past 6 months was found in 23.7% of the resistant group vs.6.6% of the sensitive group(odds ratio = 4.86,p= 0.030),with the previous biopsy history being 31.6% and14.8% (odds ratio = 3.17, p= 0.036),respectively. Postbiopsy infectionsoccurred in13.2% and1% (odds ratio = 10.69,p= 0.045) of patients in the resistant and sensitive groups, respectively. Conclusions: The prevalence offluoroquinolone-resistant rectal flora increased in patients undergoing transrectal prostate biopsyat Phramongkutklao Hospital, Thailand. A history of antibiotics in the past 6 months, previous biopsy, andpostbiopsy infections were associated with antimicrobialresistance. Culture-directed prophylaxis antibiotics may reduce postbiopsy infections after transrectal prostate biopsy.
The aim of the study was to investigate the safety and efficacy of apomorphine SL (apo SL) 2 and 3 mg, using a dose-optimisation regime in 110 Asian men with erectile dysfunction (ED) during a 10-week open-label study. Based on daily diaries kept by each patient, 63% showed an improvement in their sexual life. Patient responses to the International Index for Erection Function 15 questionnaires showed that there was an improvement in erectile function from baseline score after treatment with apo SL (from 15.9 to 20.4), and intercourse satisfaction (from 7.7 to 9.9), as well as slight improvements in orgasmic function (from 6.8 to 7.5) and total satisfaction (from 41.9 to 50.8). There was no marked improvement seen in sexual desire. In conclusion, apo SL is safe and efficacious in the treatment of ED in this patient population, irrespective of underlying diseases and concomitant medications.
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