Side Effects of α-Blocker Archives

Side Effects of α-Blocker Use: Retrograde Ejaculation

December 17, 2018August 26, 2017 by admin

Abstract

There are currently 5 α-blockers that are approved by the US Food and Drug Administration to treat lower urinary tract symptoms (LUTS). The American Urological Association guidelines committee believes that all α-blockers are equally effective. However, α-blockers differ in their likelihood of causing abnormal ejaculation. This article discusses the effects on ejaculatory function, and specifically retrograde ejaculation, of the currently available α-blockers being used to treat men with LUTS due to benign prostatic hyperplasia.

In the 1980s, the recognition by Lepor and colleagues that prostatic smooth muscle tension was mediated by α1-adrenoceptors led to the development of α-blockade as a treatment of lower urinary tract symptoms (LUTS).1 This dynamic component of prostatic obstruction accounts for approximately 40% of outflow obstruction due to benign prostatic hyperplasia (BPH).2 There are currently 5 α-blockers that are US Food and Drug Administration (FDA) approved to treat LUTS: doxazosin, terazosin, tamsulosin, alfuzosin, and silodosin. The American Urological Association...

The Management Of Retrograde Ejaculation: A Systematic Review And Update.

December 16, 2018August 31, 2017 by admin

Abstract

OBJECTIVE: To determine the best management of retrograde ejaculation to optimize the chance of conception.

DESIGN: Systematic review.

SETTING: Tertiary reproductive medicine center.

PATIENT(S): Subfertile men with retrograde ejaculation.

METHOD(S): Systematic search of studies using search terms "management" or "therapy" or "treatment" and "retrograde ejaculation." We excluded case reports and papers not in English.

MAIN OUTCOME MEASURE(S): Pregnancy and live birth rates and rates of achievement of antegrade ejaculation.

RESULT(S): Thirty-four studies met our criteria. Studies were mostly observational. Descriptions of predictive and confounding variables were often insufficient. The treatment options included urinary sperm retrieval and medical management with anticholinergics and sympathomimetics. Successful pregnancies and live births were also achieved using surgical techniques and electroejaculation; however, numbers were small.

CONCLUSION(S): Many treatment options exist in the management of retrograde ejaculation; however, current literature is insufficient to allow firm...