Abdullah AÇIKGÖZ, Fikret ERDEMİR, Ekrem AKDENİZ

Prostatitlerde cinsel işlev bozuklukları yönetimi

Prostatit, önemli sayıda erkeği etkileyen bir hastalık yelpazesidir. Akut formunda basit bir klinik durumdan kronik olduğunda karmaşık, güçten düşüren bir duruma kadar değişmektedir. Kronik prostatit/kronik pelvik ağrı sendromu (KP/KPAS) veya NIH kategori III prostatit, idrar yolu enfeksiyonu yokluğunda genital/pelvik ağrı ve alt idrar yolu semptomları ile karakterize yaygın bir klinik sendromdur. Üroloji kliniklerine başvuran erkeklerde en yaygın teşhis edilen durumlardan biridir. Erektil disfonksiyon, ejakülatuar ağrı ve erken boşalma dahil olmak üzere cinsel işlev bozukluğunun KP/KPAS ile ilişkisi giderek artan bir şekilde kabul görmektedir. Prostat hastalıkları ile cinsellik üzerindeki etkiler arasındaki bağlantıları araştıran çok sayıda çalışmaya rağmen, prostatit ve cinsel işlev bozukluğu arasındaki ilişki tam olarak araştırılmamıştır. Bir dizi araştırma, prostatitin yaşam kalitesi üzerindeki olumsuz etkilerine ve bunun sonucunda cinsellik üzerinde dolaylı etkilerine odaklanmıştır. Ejakülasyon ile kronik prostatit/kronik pelvik ağrı sendromu prostatit alt grubu arasındaki bağlantılar hakkında daha ayrıntılı çalışmalar mevcuttur. Birkaç çalışmada, prostatit tedavisini takiben cinsel işlev bozukluğunun düzeldiği, özellikle de alfa bloker tedavisi ile ilişkili olduğu bildirilmiştir. Bu derlemede, KP/KPAS ile cinsel işlev bozukluğu arasındaki ilişkiyi, cinsel işlev bozukluğu için potansiyel mekanizmaları ve KP/KPAS’da erektil disfonksiyon için tedavi stratejilerini tartışıyoruz.

Management of sexual dysfunctions in prostatitis

Prostatitis is a spectrum of disorders that impacts a significant number of men. It ranges from a straightforward clinical entity in its acute form to a complex, debilitating condition when chronic. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), or NIH category III prostatitis, is a common clinical syndrome characterized by genital/ pelvic pain and lower urinary tract symptoms in the absence of urinary tract infection. It is one of the most widely diagnosed conditions in men attending urologic clinics. There is also growing recognition of the association of sexual dysfunction with CP/CPPS including erectile dysfunction, ejaculatory pain, and premature ejaculation. Despite a large number of reports exploring the links between diseases of the prostate and effects on sexuality, the relationship between prostatitis and sexual dysfunction has not been as thoroughly investigated. A number of reports have focused on the adverse effects of prostatitis on quality of life, with resultant indirect effects on sexuality. More detailed studies are available on the links between ejaculation and the chronic prostatitis/chronic pelvic pain syndrome subgroup of prostatitis. Moreover, improvement of sexual dysfunction following treatment of prostatitis has been reported in a few studies, most notably in association with alpha-blocker therapy. In this review, we discuss the association between CP/CPPS and sexual dysfunction, potential mechanisms for sexual dysfunction, and treatment strategies for erectile dysfunction in CP/CPPS.

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