探討Mirabegron對於男性膀胱過動症患者勃起功能的影響
吳宗憲、李偉嘉、沈元琦、王弘仁、莊燿吉
高雄長庚紀念醫院泌尿科
The impact of erectile function in male overactive bladder patients treated with Mirabegron
Tsung-Hsien Wu, Wei-Chia Lee, Yuan-Chi Shen, Hung-Jen Wang, Yao-Chi Chuang
Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
Purpose: Mirabegron, a selective b3 adrenoceptor agonist, is widely used for treatment of overactive bladder (OAB). Mirabegron has been demonstrated to relax human and rat corpus cavernosum. We aimed to evaluate the erectile function in male OAB patients treated with Mirabegron (50 mg) in daily urological practice.
Materials and Methods: The evaluation of ED and OAB was based on a self-administered questionnaire containing International Index of Erectile Function (IIEF-5) and OAB symptom score (OABSS), respectively. In the present study, the patients with an OABSS urgency score of ≥2 and sum score of ≥3 were considered to have OAB. The study was a consecutive cohort of 128 male LUTS patients ≥ 50 years in a tertiary referral center. Among the 128 patients, 59 has sexual activity and responded to both OABSS and IIEF-5, and 34 OAB patients treated with mirabegron. The therapeutic outcomes were assessed at baseline, 4, and 12 weeks.
Results: Mirabegron usage was associated with a statistically significant decrease in OABSS at 4-week (30.8% decrease) and 12-week follow-up (26.0% decrease), however, IIEF-5 was also decreased at 4-week (5.4% decrease, p=0.077) and 12-week follow-up (14.0% decrease, p=0.021). The patients with higher IIEF-5 (≥17) had lower OABSS (7.00±2.56) than the lower IIEF-5 (<17) group (8.73±3.24; p=0.0907), however, both groups reduced OABSS (improved OAB symptoms) and IIEF-5 (impaired erectile function) after mirabegron treatment.
Conclusion: Mirabegron (25 mg) improves OAB symptoms, but may decrease the erectile function. We need to discuss potential impact of erectile function in male OAB patients treated with mirabegron.