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A 70-year-old male with a history of diabetes, hyperlipidaemia and hypertension managed with atenolol presented to his family physician with lower urinary tract symptoms (LUTS). He was prescribed terazosin. Over the course of a year he noticed worsening erectile dysfunction (ED) with difficulty maintaining a hard erection until orgasm.
Erectile dysfunction (ED) is a common condition defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance.1 It is one of the most common complaints in men’s sexual medicine, affecting both physical and psychosocial health and having a significant impact on the patient and partner’s quality of life.1 Moreover, ED is commonly associated with other comorbid conditions, including hypertension, dyslipidaemia and diabetes mellitus.1
Evaluation of ED should include a detailed medical and sexual history of the patient. 1 A discussion of the patient and partner’s preference and treatment goals is essential to better tailor treatment and improve patient satisfaction and adherence to treatment.2 Lifestyle modification and management of risk factors should precede pharmacotherapy, while first-line treatment with oral phosphodiesterase type 5 inhibitors (PDE5i) is well established for the management of patients with ED.1
Benign prostatic hyperplasia (BPH) is characterized by an enlargement of the prostate gland that can lead to compression of the urethra.1 Patients often experience lower urinary tract symptoms (LUTS), which are typically classified as either voiding or storage symptoms.1
Over 60% of men will experience any LUTS.2 Although Asian men typically have smaller prostates compared with Western men, Asians experience similar or higher rates of LUTS that can impact sexual function and quality of life (QoL).1,3
Targeted antibiotic prophylaxis – after a rectal swab to identify specific intestinal flora – does not appear to significantly impact the risk of urinary sepsis following a transrectal ultrasound (TRUS)-guided prostate biopsy, according to a recent study.
Conservative management appears to be the favoured option in managing non-penetrating renal trauma with urinary extravasation, according to a study presented at EAU 2018.
MRI, with or without targeted biopsy, detects more clinically significant prostate cancer and less clinically insignificant prostate cancer than the standard transrectal ultrasonography (TRUS)-guided approach, enabling more than one-quarter of patients to safely avoid a biopsy altogether.
Men with nonmetastatic castration-resistant prostate cancer (CRPC) have similar health-related quality of life (HRQoL) with apalutamide given on top of androgen deprivation therapy (ADT) vs ADT alone, according to new data from the SPARTAN (Prostate Androgen Receptor Targeting with ARN-509) trial presented at the European Association of Urology (EAU) 2018 Congress.
Patients with urologic cancers are more likely to attempt suicide, highlighting the need for increased psychiatric intervention for these patients at an earlier stage, according to findings presented at the European Association of Urology (EAU) 2018 Congress.
