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    Changing Aspects of Male Sexual Functions Accompanying Treatment of Benign Prostatic Hyperplasia With Silodosin 8 mg Per Day
    (Elsevier Sci Ltd, 2020) Cihan, Ahmet; Kazaz, Ilike Onur; Yildirim, Omer; Deliktas, Hasan; Ongun, Sakir; Gul, Umit; Sahin, Bahadir
    Background: Alpha-adrenergic antagonist treatment for benign prostatic hyperplasia (BPH) and drug-related sexual side effects are frequent in aging men. Aim: To investigate functional changes in erectile and ejaculatory aspects of male sexuality under Silodosin 8 mg per day treatment for BPH. Methods: Sexually active patients diagnosed with BPH and who initiated Silodosin treatment were the subjects of the study. The International Prostate Symptom Score, premature ejaculation patient profile (PEP-male) questionnaire, Sexual Health Inventory for Men (SHIM) questionnaire, and estimated intravaginal ejaculation latency time (IELT) values of the participants were used to evaluate sexual functions. Data evaluation was performed in 8 urology clinics retrospectively. Outcomes: Participant ratings for SHIM, PEP, and estimated IELT were the primary outcome measures in the study. Results: Among 187 recruited patients, data of 98 patients, who completed the trial period in the study, were eligible. The median age of the eligible participants who completed the trial period for 3 months was 59.5 years (range 45-82). 16 patients of 187 (8%) reported a desire for drug withdrawal for anejaculation during the recruitment period. 46 (46.9%) and 49 (50%) patients reported anejaculation in the first and third month of the treatment, respectively. De novo erectile dysfunction was noticed in 15 patients (15.3%). There was a significant increase in the estimated IELT of subjects in both the first (P = .01) and third ( P = .002) month. SHIM-1 (P = .008), SHIM-total (P = .009), and PEP scores (P = .008) were also improved in the third month of the treatment. Neither baseline patient characteristics nor changes in the International Prostate Symptom Score after treatment predicted final outcomes with multivariable analysis. The subgroup analysis of participants who reported anejaculation also revealed better outcomes compared with participants ejaculating naturally in the third month as per SHIM ratings. Clinical Implications: Despite several male patients having dry orgasms due to Silodosin-induced anejaculation, the majority experienced improved erectile function. Strengths & Limitations: The present study demonstrated pioneering results while investigating both erectile and ejaculatory dimensions of the male sexual function during Silodosin treatment for BPH. However, lack of partner evaluation, low follow-up rates, and lack of knowledge about reasons why subjects are lost to follow-up after drug initiation have limited our interpretation. Conclusion: Most patients using Silodosin 8 mg per day for BPH treatment experienced improvement in their erectile function, estimated IELT, and premature ejaculation profile in the third month of the treatment. Underlying mechanisms and reasons for individual differences necessitate further investigation. Copyright (C) 2020, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.
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    Effects of androgen deprivation therapy on cognitive functions in patients with metastatic prostate cancer: A multicentric, prospective study of the Society of Urological Surgery Andrology group
    (Wiley-Hindawi, 2021) Cinar, Onder; Turunc, Tahsin; Kazaz, Ilke Onur; Yildirim, Omer; Deliktas, Hasan; Cihan, Ahmet; Gudeloglu, Ahmet
    Aims of the study The aim of this study was to investigate the impact of testosterone deficiency on cognitive functions in metastatic prostate cancer patients receiving androgen deprivation therapy (ADT). Methods In this multicentric prospective study, 65 metastatic prostate cancer patients were evaluated. Demographic and clinical data were recorded. Cognitive functions were assessed using the Symbol Digit Modalities Test, the California Verbal Learning Test Second Edition, the Brief Visuospatial Memory Test-Revised, and the Trail Making Test. Depressive symptoms were assessed using the Beck Depression Inventory. Cognitive functions and depressive symptoms were recorded before the androgen deprivation therapy and at the 3- and 6-month follow-ups. Results At the basal cognitive assessment, the mean Symbol Digit Modalities Test, the California Verbal Learning Test Second Edition, the Brief Visuospatial Memory Test-Revised scores were 25.84 +/- 17.54, 32.68 +/- 10.60, and 17.63 +/- 11.23, respectively, and the mean time for the Trail Making Test was 221.56 +/- 92.44 seconds, and were similar at the 3-month, and 6-month controls (P > .05). The mean pretreatment, third and sixth month testosterone levels were 381.40 +/- 157.53 ng/dL, 21.61 +/- 9.09 ng/dL and 12.25 +/- 6.45 ng/dL (P < .05), and the total PSA levels were 46.46 +/- 37.83 ng/mL, 1.41 +/- 3.31 ng/mL and 0.08 +/- 0.14 ng/mL (P < .05), respectively. Conclusion The ADT in patients with metastatic prostate cancer does not affect patients' cognitive functions and depressive symptoms. However, further prospective randomised studies with higher cohorts and longer follow-up periods are needed.