The Effects Of Different α1-adrenoceptor Antagonists On Ejaculation Function In Men With Benign Prostatic Hyperplasia Or Prostatitis

ObjectivesTo investigate the effects of doxazosin,tamsulosin and silodosin on ejaculation in patients with benign prostatic hyperplasia（BPH）or prostatitis.MethodsPatients with benign prostatic hyperplasia or prostatitis,who age 20-60 years old,erect and ejaculate normally and have sex regularly,were included in the clinical study.According to theα₁-Adrenoceptor Antagonists（also alpha-blockers or ABs）they used for treatment,they were divided into three groups.Patients of group doxazosin would take Cardura 4mg once every night,the ones of group tamsulosin would take Harnal0.2mg once every night and the others of group silodosin would take Rapaflo 4mg twice daily for two weeks.The ejaculatory function including premature ejaculation（PE）,anejaculation（AE）and retrograde ejaculation（RE）,of those patients was assessed before they took the medicines,after two-weeks treatment and after two-weeks withdrawl.ResultsThe number of patients in group doxazosin,group tamsulosin and group silodosin was 35,42 and 40 respectively.And the average age of those three groups was 45.00±9.27,48.00±9.44 and 47.00±8.11 years old respectively（P>0.05）.All the IIEF-5scores of those patients were higher than 22 before treatment and after two-weeks treatment（P>0.05）.The number of cases of PE in group doxazosin,group tamsulosin and group silodosin was 3,7 and 5,respectively.The number of cases whose PEDT（Premature Ejaculation Diagnostic Tool）≥9 was 3,6 and 5,respectively,after two-weeks of treatment（P>0.05）and there was no change on IELT（Intravaginal Ejaculatory Latency Time）of those 13 cases.All of the patients can ejaculate normally before treatment.After two-weeks treatment,the number of cases of AE was 0,1 and 3,respectively（compared with the number of cases of AE before treatment,P>0.05）,and the number of cases of RE was 0,2 and 9,respectively（compared with the number of cases of RE before treatment,P<0.05）.After two weeks of treatment,there were 12cases of ejaculation disorder（EjD）in group silodosin（P<0.05 compared with number of cases of EjD before treatment）,which was higher than that in group tamsulosin（3 cases,P<0.05）.After the occurrence of EjD,all the patients stopped taking ABs for two weeks and then they could ejaculate normally again.ConclusionsThe effects of ABs on the ejaculatory function in patients with BPH and prostatitis should be taken into consideration when the patients get treated with AB.Silodosin has the most severe impact on the ejaculatory function,which could lead to AE or RE.Tamsulosin is secondary to Silodosin and doxazosin almost has nothing to do with EjD.