Sexologies.book Page 102 Mercredi, 2.
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Material and Methods: 86 patients with BPH and co-mor-
bidity chronic prostatitis were enrolled in study. Control
group (39 patients) received Tamsulosin during 3 months and
doxiciclinum for 10 days. Experience group (47 patients)
received also laser therapy. Efficiency was assessed using I-
PSS, uroflowmetry, prostate secretion analysis and bacteri-
ological tests. The first examination was before the treat-
ment, and the final estimation was in 3 months.
Results: In control group symptom scores reduced by 38%
and flow rates improved by 24%. In experience group
improvement in symptom score and flow rates was 54% and
32% accordingly. In control group 58% patients had signs of
prostate inflammation, growth of microbial flora and there
were only 16% such patients in experience group. No adverse
effects were marked.
Conclusions: Simultaneous application of laser therapy,
doxiciclinum and Tamsulosin in patients with co-morbidity
BPH and prostatitis resulted in cumulation of antibacterial
in a prostate tissue, removal of spasm, facilitation of outflow
of a prostate secret and an inflammatory exudate, cupping
of dysuria. All the I-PSS scores decreased significantly during
the treatment.
T07-O-04
Sildenafil for erectile dysfunction in Spinal
Cord Injury (SCI) patients
M. Marzotto Caotorta, D. Molho, C. Martina, A. Tagliabue,
S. Sandri. Spinal cord Unit and Urology division - Magenta
Hospital Magenta, MI, Italy
Objectives: To provide a comprehensive insight into sexu-
ality after spinal cord injury, the patients received a ques-
tionnaire to assess their sexual activities, abilities, desires,
satisfaction and sexual adjustment before and after injury.
Relationship to partner, social life, bladder management
and physical well-being had a significant impact on quality
of life.
Methods: We studied 34 pts. with the following spinal
cord lesions: 6 cervical lesions; 6 upper thoracic lesions; 17
thoraco-lumbar (D11-L2), 4 lower thoracic, sacral or cauda
equina lesions; 1 transverse myelitis; 1 multiple sclerosis;
23(67%) pts. with complete lesions and 11 (33%) with incom-
plete lesions. The average is 41 ys. (range: 25-54 ys.)
Results: The median f-up was 5 months (range 1-11) in 27
pts. with this results: 13 are very satisfied; 5 with partial
response; 9 were unsatisfied unable to have a sexual inter-
course. 19 pts. choose the 100 mg dose to have the best
response; side effects were reported only in 3 cases: 3 pts.
respectively with cephalalgia, severe hypotension and dys-
reflessia, interrupted the therapy.
Conclusions: In the upper motoneuron lesions (LMNS) we
had positive and negative response respectively in 77% and
23%. of the cases, but in the lower motoneuron lesions (LMNI)
the results were positive and negative respectively in 44%
and 56% of the pts.
Topic 7: Pharmacology
T07-O-05
Finasteride 5 mg and sexual side effects.
How many of these are related to a nocebo
phenomenon?
N. Mondaini1, P. Gontero2, E. Sarti1, G. Giubilei1, T. Cai1, A.
Gavazzi1, E. Meliani1, M. Pallanti3, V. Boncinelli3, R.
Bartoletti1. 1UO Urology, S Maria Annunziata Hospital,
University of Florence, Florence, Italy; 2Department of
Urology, University of Torino, Torino, Italy; 3Clinical
Psicology, University of Siena, Siena, Italy
Introduction: Sexual adverse experiences such as erectile dys-
function, loss of libido, and ejaculation disorders have been
consistent side effects of Finasteride in a maximum percent-
age of 15% after one year of therapy as reported in the PLESS-
Study.Such data could be seen as far from reality, if compared
to a higher percentage that may be found in any common clin-
ical practice.This study wishes to explain the dichotomy
between literature's data and clinical practice data.
Materials and methods: 120 patients with diagnosis of
Benign Prostatic Hyperplasia (prostate volume >40 ml), age
ranging between 45 and 65, sexually active (IIEF question-
nairie > 25) in a stable relationship for at least 6 months; tes-
tosterone level in the normal range; never on previous BPH
medication were randomized to receive finasteride 5 mg per
day for one year with (group 2) or without (group 1) counsel-
ling on the drug sexual side effect.The phrase used to inform
group 2 patients was "….it may cause erectile dysfunction,
decreased libido, problems of ejaculation but these are
uncommon ".The estimation of side effect was conducted at
6 months and 12 months with MSF 4 Questionarie and the
information reported by patients diary.
Results: Data are referred to 107 patients who completed
the study.Group 2 patients (N= 55) reported a significant
higher proportion of sexual side effects as compared to
group 1 (N °=52) (43.6 vs 15.3%).The incidence of erectile
dysfunction; decrease libido.; ejaculation disorders were
9.6%, 7.7%,5.7% for group 1 and 30,9%; 23,6%; 16,3% for
group 2 respectively.
Conclusions: In the current study Finasteride showed a
significantly higher proportion of sexual dysfunction in
patients informed on side effects (group 2) as compared to
those in which information on side effects was blinded
(group 1) (p=0,03). A scenario similar to group 2 of the cur-
rent study is likely to occur in clinical practice, where the
patient has access to the drug information sheet. The burden
of this nocebo effect has to be taken into account when man-
aging finasteride sexual side effects.
T07-O-06
The benefit of testosterone administration to
men not responding to PDE-5 inhibitors: state
of the art
A. Yassin1, F. Saad2. 1GUlF Medical College, Ajman/Uae &
Segeberger Kliniken, Norderstedt, Germany; 2Gulf Medical