PD21-01 EFFICACY OF TAMSULOSIN FOR THE MANAGEMENT OF PAINFUL ORGASM AFTER RADICAL PROSTATECTOMY: A PROSPECTIVE, NON-PLACEBO CONTROLLED STUDY

Abstract

INTRODUCTION AND OBJECTIVES:In contrast to the large number of studies on erectile dysfunction after prostatectomy, research on orgasmic dysfunction has been limited. Painful orgasm is a form of ejaculatory dysfunction that can occur after prostatectomy. Although the incidence is not high, it can affect quality of life. Furthermore, the causes of and treatments for painful orgasm have not been clarified. In this study, we evaluated the efficacy of a selective alpha-blockade, tamsulosin, on post-prostatectomy painful orgasm. METHOD(S): We studied 90 patients with painful orgasm who underwent nerve sparing radical prostatectomy with prostate cancer. Patients were prescribed tamsulosin 0.2 mg daily for a total of 8 weeks. Primary outcomes were changes in scores for pain after treatment using a visual analog scale (VAS) and Global Assessment Questionnaire (GAQ) scores. We also identified the pain site and the reported time between ejaculation and onset of pain. We compared the results between groups of patients who underwent one of two surgical methods (laparoscopic vs. robot-assisted prostatectomy). RESULT(S): In all, 56 of 90 (62.2%) patients reported significant improvement in pain (>=2 points on pain VAS) and 10 (11.1%) noted complete resolution of their pain. There was a statistically significant decrease in pain as measured by the VAS for both groups in response to tamsulosin treatment. The pain areas were penis (61.1%), testis (34.2%), perineum (33.3%), and lower abdomen (13.3%). Sixty-four (71.1%) patients reported pain within 3 min of orgasm. After treatment, the average VAS decreased by 2.8 points and there was a significant improvement in GAQ. However, we did not find any significant difference between the laparoscopic and robot-assisted prostatectomy groups. CONCLUSION(S): We detected a statistically significant, beneficial effect of tamsulosin on postprostaomy patients with painful orgasms. Because ejaculatory function is a significant contributor to quality of life after prostatectomy, further studies should be performed on this topic.