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Der Urologe

, Volume 57, Issue 12, pp 1464–1471 | Cite as

Einfluss medikamentöser BPS-Therapie auf die sexuelle Funktion

  • T. Bschleipfer
  • M. Burkart
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Zusammenfassung

Hintergrund

Das benigne Prostatasyndrom (BPS) ist oft mit sexuellen Funktionsstörungen assoziiert. Die in der S2e-Leitlinie beschriebenen medikamentösen Therapieoptionen können vorbestehende Störungen der Sexualfunktion bessern, aber auch bestehende Störungen verstärken oder neue auslösen.

Fragestellung

Wie wirken sich die in der S2e-Leitlinie genannten medikamentösen Therapieoptionen auf die Sexualfunktion aus?

Material und Methode

Mittels selektiver Literaturrecherche zum Thema benignes Prostatasyndrom und sexuelle Funktionsstörungen wurden die Auswirkungen der in der S2e-Leitlinie genannten Medikamente ausgewertet.

Ergebnisse

Extrakte aus Serenoa repens verschlechtern nicht die Sexualfunktion, gleiches gilt für Muskarinrezeptorantagonisten. 5α-Reduktasehemmer verschlechtern häufig Erektionsfähigkeit, Libido und Ejakulation, selektive α1-Blocker die Ejakulation. Phosphodiesterase- (PDE-)5-Inhibitoren können die erektile Funktion verbessern. Eine Kombination aus α1-Blocker und 5α-Reduktasehemmer führt zu deutlich erhöhten sexuellen Funktionseinschränkungen.

Schlussfolgerungen

Die geeignete Therapie des benignen Prostatasyndroms sollte gemeinsam von Patient und Arzt gewählt werden und ist den individuellen Bedürfnissen anzupassen. Auswirkungen auf die Sexualität müssen bei der Therapiewahl berücksichtigt werden.

Schlüsselwörter

Benignes Prostatasyndrom Medikamentöse Therapie Erektile Dysfunktion Libido Ejakulation 

Abkürzungen

BPS

Benignes Prostatasyndrom

ED

Erektile Dysfunktion

IIEF

„International Index of Erectile Dysfunction“

LUTS

„Lower urinary tract symptoms“

PDE

Phosphodiesterase

Influence of medical BPS treatment on sexual function

Abstract

Background

Benign prostate syndrome is frequently associated with sexual dysfunction. The therapeutic options discussed in the S2e guideline may be able to improve existing sexual dysfunctions but can also worsen disorders or even trigger new ones.

Objectives

What are the effects of therapeutic options as described in the S2e guideline on sexual function?

Methods

By selective literature search related to benign prostate syndrome and sexual dysfunction adverse effects of drugs mentioned in the S2e guideline have been evaluated.

Results

Serenoa repens extracts do not have adverse effects on sexual function; this is also true for muscarine receptor antagonists. 5α-Reductase inhibitors frequently worsen erectile function, libido and ejaculation; selective α1-blockers have an adverse effect on ejaculation. Phosphodiesterase (PDE)-5 inhibitors can improve sexual function. A combination of α1-blockers and 5α-reductase inhibitors worsens sexual functions significantly.

Conclusions

A suitable therapy for benign prostate syndrome should be chosen jointly by the patient and the treating physician and should be adapted to personal needs. Effects on sexual functions have to be taken into consideration when choosing a therapy.

Keywords

Benign prostate syndrome Drug therapy Erectile dysfunction Libido Ejaculation 

Notes

Danksagung

Die Autoren danken Frau Dr. Isabell Karl für Ihre große Unterstützung bei der Erstellung des Manuskripts.

Einhaltung ethischer Richtlinien

Interessenkonflikt

T. Bschleipfer gibt an, Referent, Berater und/oder Studienteilnehmer für folgende Firmen zu sein: Allergan, Apogepha, Astellas, Bayer HealthCare, bene, Bionorica, Dr. R. Pfleger GmbH, GlaxoSmithKline, medac, Pfizer, Serag Wiessner, Speciality European Pharma GmbH, Laborie & Medi Tate, tic Medizintechnik GmbH & Co. KG, wellspect HealthCare, rollactiv, Grünenthal. M. Burkart gibt an, Mitarbeiter der Dr. Willmar Schwabe GmbH & Co. KG zu sein.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für Urologie, Andrologie und KinderurologieKlinikum Weiden/Kliniken Nordoberpfalz AGWeiden i.d.OPf.Deutschland
  2. 2.Dr. Willmar Schwabe GmbH & Co. KG, Betriebsstätte EttlingenEttlingenDeutschland

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