Vpliv medikamentozne terapije simptomov spodnjih sečil zaradi benigno povečane prostate na erektilno funkcijo : magistrsko delo

Štraus, Anja (avtor), Starc, Andrej (mentor), Poteko, Sandi (komentor)

Uvod: Benigno povečana prostata je najpogostejša benigna bolezen pri moških. Bistveno vlogo pri nastanku benigno povečane prostate ima spolni hormon testosteron. Testosteron se v prostati pod vplivom encima 5-alfa reduktaze spremeni v aktivni dihidrotestosteron, ki se veže na receptorje in ima glavno vlogo pri rasti prostate. Benigno povečana prostata lahko povzroča simptome spodnjih sečil. Ena izmed možnosti zdravljenja simptomov spodnji sečil zaradi benigno povečane prostate je zdravljenje z zdravili – z inhibitorji 5-alfa reduktaze. Kot vsako zdravilo imajo tudi ta neprijetne stranske učinke, med katerimi so tudi slabša erektilna funkcija in zmanjšan libido. Namen: Namen raziskave je ugotoviti povezavo med medikamentoznim zdravljenjem simptomov spodnjih sečil zaradi benigno povečane prostate in erektilno funkcijo ter s tem vpliv na kakovost življenja. Raziskovali bomo vpliv medikamentozne terapije z inhibitorji 5-alfa reduktaze na erektilno funkcijo, in sicer 6 mesecev po prejemanju le-te. Metode dela: Uporabili smo opisno raziskovalno metodo z zbiranjem, kritično presojo in analizo domače ter tuje literature. Uporabljeni so bili viri iz spletnih baz CINAHL, Medline in kataloga COBIB.SI ter iz knjižnice Zdravstvene fakultete v Ljubljani in Medobčinske splošne knjižnice v Žalcu. V drugem delu magistrskega dela smo izvedli presečno študijo s pomočjo anketnega vprašalnika, ki je bil sestavljen iz mednarodnega vprašalnika IIEF-5, mednarodnega vprašalnika QEQ in demografskih podatkov. Rezultati: Moški z benigno povečano prostato pred jemanjem medikamentozne terapije težko obdržijo erekcijo. Po prejeti terapiji z inhibitorji 5-alfa reduktaze na lestvici kakovosti erektilne funkcionalnosti ne prihaja do pomembnih razlik med merjenjema, na lestvici erektilne disfunkcionalnosti se pa pojavijo pričakovane razlike; funkcionalnost se pomembno poslabša. Ugotovili smo tudi, da imata neodvisni sprejemljivki starost in zaposlitveni status vpliv na izid medikamentoznega zdravljenja, in sicer starejši kot so moški, več težav imajo z erektilno funkcijo, kar je tudi povezano z zaposlitvenim statusom. Upokojeni imajo več težav v primerjavi s še vedno zaposlenimi. Med doseženo izobrazbo in poklicem pa ni bilo pomembne povezave. Razprava in zaključek: Rezultati raziskave so bili pričakovani, glede na prej prebrano literaturo, ki je navajala negativne učinke medikamentoznega zdravljenja z inhibitorji 5-alfa reduktaze. Zdravljenje negativno vpliva na erektilno funkcijo, tako da stanje še poslabša, zato je pomembno, da se pri nastanku bolezni čim prej poišče zdravniško pomoč. Bolezen se praviloma pojavi pri starejši populaciji moških in ima že pred zdravljenjem negativni vpliv na erektilno funkcijo. Pred zdravljenjem bi bilo potrebno moške ozaveščati o negativnih vplivih medikamentoznega zdravljenja ter še o drugih možnostih, ki vplivov na erektilno funkcijo nimajo.

• Jezik: Slovenski jezik
• Ključne besede: benigno povečana prostata, erektilna funkcija, medikamentozno zdravljenje, simptomi spodnjih sečil
• Vrsta gradiva: Magistrsko delo/naloga
• Organizacija: ZF - Zdravstvena fakulteta
• Leto izida: 2019
• PID: 20.500.12556/RUL-107584
• COBISS.SI-ID: 5613163
• Datum objave v RUL: 27.04.2019

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: The effect of medicinal therapy of the lower urinary tract symptoms due to prostatic benign enlargement on erectile function : master thesis

Izvleček

Introduction: Benign prostatic enlargement is the most common benign disease in men. The main cause for emergence of benign prostatic enlargement is sexual hormone testosterone. Under the influence of enzyme 5 alfa reductase testosterone turns into active dihydro testosterone, which is then combined with receptors and causes the growth of prostate. Benign prostatic enlargement can cause the lower urinary tract symptoms. One of the treatment options of lower urinary tract symptoms due to benign prostatic enlargement is treatment with medicaments – inhibitors 5 alfa reductase. Like any other medicament, this one can also have unpleasant side effects, between others reduced erectile function and smaller libido. Purpose: The purpose of this research is to find the correlation between medicament treatment of lower urinary tract symptoms due to benign prostatic enlargement and erectile function and consequently influence on the quality of life. We will research the influence of treatment with medicaments inhibitors 5-alfa reductase on the erectile function six months after the treatment. Work methods: We used descriptive research method with collecting, critical judgment and analysis of domestic and foreign literature. We used resources from Internet databases like CINAHL, Medline, catalogue COBIB.SI and from libraries of Health faculty in Ljubljana and intermunicipal library of Žalec. In the second part of the work a cross study was made, with help of a questionnaire. Results: Men with benign prostatic enlargement have problems with holding an erection already before starting the therapy with medicaments. After the therapy with inhibitors 5-alfa reductase the results of the research show that on the erectile function scale, there are no significant differences between first and second measurement, but on the erectile dysfunction scale expected differences occur – the functionality decreases. We also noticed that the independent variables of age and employment status have influence on the result of treatment with medicaments in the way that older participants in the study have more issues with erectile function than younger ones. Secondly, the men in retirement have more problem than employed men. There were no noticeable connections between the finished education and the profession of the participants. Discussion and conclusion: The results of the research were expected, according to the before consulted literature, where the side effects of treatment with medicaments inhibitors 5-alfa reductase were already mentioned. The effects that the treatment has on erectile function are that the function deteriorates, that is why it is important that we seek doctor assistance immediately after it occurs. The disease mainly manifests itself at older generation of men and it has a negative effect on erectile function already at the very beginning. Before starting the treatment the patients would need to be informed about the side effects of the medicamental treatment and they should be presented about other possibilities of treatment without side effects to erectile function.

• Ključne besede: benign prostatic enlargement, erectile function, treatment with medicaments, lower urinary tract symptoms