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.
Nocturia is the most prevalent of the lower urinary tract symptoms (LUTS) and can cause a significant negative impact on an individual’s quality of life if left untreated.1,2 In a meeting held at University Malaya Medical Centre, Associate Professor Dr Ong Teng Aik shared his insights on the management of nocturia.
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
At a recent morning tea symposium held in conjunction with the Malaysian Urological Conference 2016, Dr Marie Carmela Lapitan discussed about the benefits of combination therapy with alpha-blockers and 5-alpha-reductase inhibitors (5-ARIs) for the management of benign prostatic hyperplasia (BPH).
The phosphodiesterase type 5 inhibitor tadalafil significantly improved the erectile function of patients receiving the 5-alpha reductase inhibitor (5-α RI) dutasteride for the management of bladder outlet obstruction, according to a Turkish study.