Sexual Side Effects of Medical and Surgical Benign Prostatic Hyperplasia Treatments

Welliver, Robert C.; Essa, Ahmed

doi:10.1016/j.ucl.2016.04.010

Cited by 15 publications

(13 citation statements)

References 66 publications

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“…Traditional therapy for BPH involves administration of 5α-reductase inhibitors and α blockers, which can shrink the prostate gland or alleviate bladder outlet obstruction (BOO). However, these treatments have many side effects, such as gynecomastia and sexual dysfunction, and is not effective in all patients [7]. Therefore, there is a need for more efficient drugs with less side effects to treat BPH.…”

Section: Introductionmentioning

confidence: 99%

Resveratrol induces apoptosis of benign prostatic hyperplasia epithelial cell line (BPH-1) through p38 MAPK-FOXO3a pathway

Lü

et al. 2019

BMC Complement Altern Med

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Background Resveratrol is reported to inhibit the growth of prostate, which is characteristic of benign prostatic hyperplasia (BPH) condition. However, the mechanism remains unclear. This study aimed to identify the effects and probable mechanism of resveratrol on BPH. Methods We used the BPH epithelial cell line BPH-1 to investigate the effect of resveratrol. Cells were treated with various concentrations of resveratrol, and its effects on cells viability, apoptosis, ROS accumulation, and cell cycle were assessed. Western blot was used to examine activation of p38 MAPK and protein levels of FOXO3a, Bcl2, Bcl-XL, and caspase3. Cells were also co-treated with the p38 MAPK inhibitor SB203580 or ROS scavenger N-Acetyl-L-cysteine (NAC) to further investigate the mechanism. Results Resveratrol treatment inhibited the growth of BPH-1 and increased apoptosis of cells. In addition, levels of phosphorylated p38 MAPK level was elevated and FOXO3a repression was observed. Concomitantly, ROS was accumulated. All of these resveratrol-mediated effects were suppressed by additional treatment with SB203580 or NAC. Resveratrol was also found to induce cell cycle arrest at S phase. Conclusions Resveratrol can activate p38 MAPK and repress FOXO3a, thereby causing repression of SOD2, catalase, and increase of ROS accumulation, leading to apoptosis in BPH-1 cells.

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Section: Introductionmentioning

confidence: 99%

Resveratrol induces apoptosis of benign prostatic hyperplasia epithelial cell line (BPH-1) through p38 MAPK-FOXO3a pathway

Lü

et al. 2019

BMC Complement Altern Med

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“…38 Besides this, EJD is also the most common side effect complained by patients who undergo surgical treatment for LUTS/BPH, primarily in the form of RE. 39 In a systematic review based on 30 RCTs, the incidence of RE in patients after TURP was 66.1%, and there was no significant difference in EJD rates between standard monopolar resection and bipolar techniques. 40 Although a few reports found an overall ejaculatory improvement, 41,42 RE can make a substantial deleterious influence on the quality of life by reducing orgasmic intensity and inducing anxiety and depression.…”

Section: Discussionmentioning

confidence: 98%

Impact on Sexual Function of Endoscopic Enucleation vs Transurethral Resection of the Prostate for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

Liu

Cheng

Zhuo

et al. 2020

Journal of Endourology

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Introduction: Although the transurethral resection of the prostate (TURP) has been regarded as the gold standard surgical option for lower urinary tract symptoms due to benign prostatic hyperplasia, the endoscopic enucleation of the prostate (EEP) with novel techniques is also recommended. However, whether there are differences on male sexual functions after these two procedures is still controversial. We performed this metaanalysis to investigate the impact on erectile function (EF) and ejaculation of EEP and TURP, and to explore the potential superiority between these two approaches. Materials and Methods: Literature search was conducted on Medline, Embase, and the Cochrane library, to obtain all relevant randomized controlled trials published before December 13, 2018. Outcome data were pooled and analyzed with Review Manager 5.3 to compare the International Index of Erectile Function 5 (IIEF-5) scores and retrograde ejaculation (RE) rates from short-to long-term follow-ups. Results: Ten articles with 1435 patients were included. EEP group showed higher IIEF-5 scores than TURP group with mean difference (MD) = 1.00, confidence interval (95% CI): 0.95-1.05 at 48 months and MD = 1.08, 95% CI: 1.03-1.13 at ‡60 months, respectively. In subgroup analysis, the holmium laser enucleation of the prostate showed significantly better IIEF scores than TURP group at 48 months (MD = 1.00, 95% CI: 0.95-1.05) and ‡72 months (MD = 1.08, 95% CI: 1.03-1.13). Additionally, no significant difference in RE rate was found between EEP and TURP (risk ratio = 1.02, 95% CI: 0.85-1.23). Conclusions: Compared with TURP, EEP may produce a more durable benefit for postoperative preservation of EF at long-term stage.

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“…Whereas 4–26% of men treated medically with tamsulosin and up to 28% of men treated with silodosin report retrograde ejaculation [ 58 ], a much higher proportion of patients treated surgically have the same complaint, up to 65% after monopolar TURP [ 59 ]. Similarly, rates of erectile dysfunction post TURP have been reported to vary between 3.4–32% in the literature [ 57 ] as the neurovascular bundle can be damaged by transmitted electrocautery energy resulting from resection close to the prostatic capsule [ 60 ]. This compares to a more predictable rate of 8.1% of erectile dysfunction for patients treated with 5ARIs and that can be potentially reversed by the discontinuation of medication.…”

Section: Con Sidementioning

confidence: 99%

Is Early Surgical Treatment for Benign Prostatic Hyperplasia Preferable to Prolonged Medical Therapy: Pros and Cons

et al. 2021

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Background and objectives: Treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH) has shifted over the last decades, with medical therapy becoming the primary treatment modality while surgery is being reserved mostly to patients who are not responding to medical treatment or presenting with complications from BPH. Here, we aim to explore the evidence supporting or not early surgical treatment of BPH as opposed to prolonged medical therapy course. Materials and Methods: The debate was presented with a “pro and con” structure. The “pro” side supported the early surgical management of BPH. The “con” side successively refuted the “pro” side arguments. Results: The “pro” side highlighted the superior efficacy and cost-effectiveness of surgery over medical treatment for BPH, as well as the possibility of worse postoperative outcomes for delayed surgical treatment. The “con” side considered that medical therapy is efficient in well selected patients and can avoid the serious risks inherent to surgical treatment of BPH including important sexual side effects. Conclusions: Randomized clinical trials comparing the outcomes for prolonged medical therapy versus early surgical treatment could determine which approach is more beneficial in the long-term in context of the aging population. Until then, both approaches have their advantages and patients should be involve in the treatment decision.

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Sexual Side Effects of Medical and Surgical Benign Prostatic Hyperplasia Treatments

Cited by 15 publications

References 66 publications

Resveratrol induces apoptosis of benign prostatic hyperplasia epithelial cell line (BPH-1) through p38 MAPK-FOXO3a pathway

Resveratrol induces apoptosis of benign prostatic hyperplasia epithelial cell line (BPH-1) through p38 MAPK-FOXO3a pathway

Impact on Sexual Function of Endoscopic Enucleation vs Transurethral Resection of the Prostate for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

Is Early Surgical Treatment for Benign Prostatic Hyperplasia Preferable to Prolonged Medical Therapy: Pros and Cons

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