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Urologists’ attitudes to sexual complications of LUTS/BPH treatments

Abstract

Introduction

Many LUTS/BPH treatments currently available may affect sexual function (SD). We wished to assess urologists’ attitude and practice in this area.

Methods

Attendees of an international meeting were randomly selected, interviewed and stratified by professional status and LUTS/BPH cases seen per month. There were four questions: treatment options offered, frequency of discussing erectile dysfunction (ED) with each treatment, frequency of discussing ejaculatory dysfunction (EjD) with each treatment, and offering alternative treatment based on the risks of sexual dysfunction.

Results

199 of the 245 interviewed (81%) were urologists. The most common treatments offered were α-blockers (99.5%), 5-ARI (95.0%) and TURP (92.5%). About 70% of the specialists discuss ED before α-blockers (not known to cause ED). Regarding EjD, 70% discuss this prior to prescribing α-blockers, 60% before 5-ARI therapy, while 80% before TURP. A significant minority fails to discuss this complication in all areas. Many respondents do not routinely discuss alternative therapies on the risk of SD. The higher the caseload, the less likely was a urologist to offer alternative therapies, with 37% of urologists seeing over 30 LUTS/BPH patients per month stating they would “Not at all often” offer alternative therapies for this reason.

Conclusions

There is a significant discrepancy in attitudes to counselling patients on SD related to LUTS/BPH treatments. This may, in some cases, affect the validity of consent to the treatment. Most urologists do not discuss alternative treatments with patients based on the risks of different outcomes and complications, and this seems more marked in those with the busier practices. This may sit ill with the concept of personalised healthcare.

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Acknowledgements

We thank Jacqueline Welch for the support and the statistical analysis provided.

Funding

Study funded by unrestricted educational grant from Neotract inc. Gordon Muir has received funding as investigator, consultant and mentor for both BSCI and Neotract.

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Affiliations

Authors

Contributions

S Giona: Data collection and management, Data analysis, Manuscript writing. I Ganguly: Data collection. G Muir: Protocol development, Manuscript editing

Corresponding author

Correspondence to Simone Giona.

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Conflict of interest

Study funded by unrestricted educational grant from Neotract inc. Gordon Muir has received funding as investigator, consultant and mentor for both BSCI and Neotract.

Research involving Human Participants and/or Animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required

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Giona, S., Ganguly, I. & Muir, G. Urologists’ attitudes to sexual complications of LUTS/BPH treatments. World J Urol 36, 1449–1453 (2018). https://doi.org/10.1007/s00345-018-2283-x

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Keywords

  • LUTS treatment
  • BPH
  • Sexual function
  • Ejaculation
  • Urologist behaviours
  • Quality of life