Introduction: Alpha-adrenergic blockers are now the cornerstone medication in management of lower urinary tract symptom (LUTS); however, the associated treatment-related abnormal ejaculation could be a bothersome event. This is a comparative study among different methods of tamsulosin administration in terms of efficacy, recoverability of ejaculatory function, and quality of life (QoL) in men with tamsulosin-related abnormal ejaculation. Patients and Methods: Sexually active men receiving tamsulosin for LUTS who were bothered by treatment-related abnormal ejaculation following initiation of tamsulosin were randomized into 3 groups; group A received intermittent-full-standard-dose, group B received low-dose-tamsulosin, and group C received full-standard-dose tamsulosin The status of ejaculatory function, IPSS, QoL score, and Q-Max were measured at baseline and 3 months later. Results: A total of 93 men with mean age of 53.1 years were included in the study, 3-months after randomization, statistically significant improvements in IPSS, QoL index, and Q-Max in comparison to pre-treatment levels were noted. Restoration of normal ejaculation was reported by 74.1 and 90.3% of patients in group A and B, respectively, versus none in group C. The QoL score was significant when comparing group A to the other groups; finally, the Q-Max was significant when comparing group C to the other groups. Conclusion: For patients bothered by tamsulosin-related abnormal ejaculation, a significant improvement in the QoL, without deviation from the therapeutic purpose of treatment, can be achieved by administration of 0.4 mg tamsulosin every other day.

1.
Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7).
Eur Urol
. 2003 Dec; 44(6): 637–49.
2.
Gravas S, Bachmann A, Descazeaud A, Drake M, Gratzke C, Madersbacher S, et al. Guidelines on the Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO) – Update April 2014. Available from: https://uroweb.org/wp-content/uploads/Non-Neurogenic-Male-LUTS_2705.pdf.
3.
Gravas S, Bach T, Bachmann A, Drake M, Gacci M, Gratzke C, et al. K.A.O. Tikkinen Guidelines Associates: M. Karavitakis, S. Malde, V. Sakkalis, R. Umbach: EAU Guidelines On Non-neurogenic Male LUTS Including Benign Prostatic Obstruction. Available from: https://uroweb.org/wp-content/uploads/EAU-Guidelines-Management-of-non-neurogenic-male-LUTS-2016-Pocket-1.pdf.
4.
van Dijk MM, de la Rosette JJ, Michel MC. Effects of alpha(1)-adrenoceptor antagonists on male sexual function.
Drugs
. 2006; 66(3): 287–301.
5.
McVary KT, Roehrborn CG, Avins AL, Barry MJ, Bruskewitz RC, Donnell RF, et al. Update on AUA guideline on the management of benign prostatic hyperplasia.
J Urol
. 2011 May; 185(5): 1793–803.
6.
Hellstrom WJ, Sikka SC. Effects of acute treatment with tamsulosin versus alfuzosin on ejaculatory function in normal volunteers.
J Urol
. 2006 Oct; 176(4 Pt 1): 1529–33.
7.
Lepor H; Tamsulosin Investigator Group. Phase III multicenter placebo-controlled study of tamsulosin in benign prostatic hyperplasia.
Urology
. 1998 Jun; 51(6): 892–900.
8.
Kawabe K, Yoshida M, Homma Y; Silodosin Clinical Study Group. Silodosin, a new alpha1A-adrenoceptor-selective antagonist for treating benign prostatic hyperplasia: results of a phase III randomized, placebo-controlled, double-blind study in Japanese men.
BJU Int
. 2006 Nov; 98(5): 1019–24.
9.
Park CH, Chang HS, Oh BR, Kim HJ, Sul CK, Chung SK, et al. Efficacy of low-dose tamsulosin on lower urinary tract symptoms suggestive of benign prostatic hyperplasia : a nonblind multicentre korean study.
Clin Drug Investig
. 2004; 24(1): 41–7.
10.
Kim JH, Park JY, Oh MM, Lee JG, Kwon SS, Bae JH. Treatment satisfaction with low-dose tamsulosin for symptomatic benign prostatic hyperplasia: results from a multicentre cross-sectional survey.
Int J Clin Pract
. 2012 Dec; 66(12): 1209–15.
11.
Kim SW, Lee WC, Kim MT, Ko K, Lee WK, Lee CH, et al. Effects of low-dose tamsulosin on sexual function in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
Korean J Urol
. 2013 Oct; 54(10): 697–702.
12.
Yanardag H, Goktas S, Kibar Y, Kilic S, Erduran D. Intermittent tamsulosin therapy in men with lower urinary tract symptoms.
J Urol
. 2005 Jan; 173(1): 155–7.
13.
Goktas S, Kibar Y, Kilic S, Topac H, Coban H, Seckin B. Recovery of abnormal ejaculation by intermittent tamsulosin treatment.
J Urol
. 2006 Feb; 175(2): 650–2.
14.
Höfner K, Claes H, De Reijke TM, Folkestad B, Speakman MJ. Tamsulosin 0.4 mg once daily: effect on sexual function in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction.
Eur Urol
. 1999 Oct; 36(4): 335–41.
15.
van Moorselaar RJ, Hartung R, Emberton M, Harving N, Matzkin H, Elhilali M, et al.; ALF-ONE Study Group. Alfuzosin 10 mg once daily improves sexual function in men with lower urinary tract symptoms and concomitant sexual dysfunction.
BJU Int
. 2005 Mar; 95(4): 603–8.
16.
Nickel JC, Narayan P, McKay J, Doyle C. Treatment of chronic prostatitis/chronic pelvic pain syndrome with tamsulosin: a randomized double blind trial.
J Urol
. 2004 Apr; 171(4): 1594–7.
17.
Magistro G, Wagenlehner FM, Grabe M, Weidner W, Stief CG, Nickel JC. Contemporary Management of Chronic Prostatitis/Chronic Pelvic Pain Syndrome.
Eur Urol
. 2016 Feb; 69(2): 286–97.
18.
Kaplan SA, Reis RB, Cologna A, Suaid HJ, Martins AC, Kohn IJ, et al. Intermittent alpha-blocker therapy in the treatment of men with lower urinary tract symptoms.
Urology
. 1998 Jul; 52(1): 12–6.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.