Review articleUrologic complications of nonurologic medications
Section snippets
Voiding dysfunction
The coordination of bladder filling, storage, and emptying, relies on intact sympathetic, parasympathetic, and somatic neural pathways [1]. The smooth muscle of the bladder body has the greatest density of muscarinic cholinergic receptors and β-adrenoceptors, whereas the bladder neck and proximal urethra contain a preponderance of α-adrenergic receptors [2], [3]. Neurologically, the micturition center is located in the midbrain and coordinates ascending input from the spinal cord and descending
Erectile dysfunction
All phases of sexual function in the male, including libido, penile erections, orgasm, and ejaculation are dependent on anatomic, physiologic, and psychologic factors. Thus, drugs that interfere with any of these processes can adversely affect sexual function in the male [11], [12]. Erectile dysfunction affects a significant proportion of men and in up to 25% of cases it can be attributed, to some degree, to drug therapy [13].
Drugs that interfere with central neuroendocrine or local
Infertility
Fertility in the male is dependent on the production of viable sperm by the testes and the successful delivery of the sperm in sufficient numbers to the female genital tract, and ultimately, the ovum. Infertility can result from disruption or alterations in spermatogenesis, or dysfunctions of penile erection, emission, or ejaculation. Drug effects on penile erection, emission, or ejaculation were discussed previously. Drug actions on the neuroendocrine relationship between the hypothalamus,
Urolithiasis
Medication-induced urolithiasis was first recognized during World War II when dehydrated patients were given sulfa medications and formed sulfa precipitates in ureters and developed uremia [52]. Sulfa drugs, including acetylsulfamethoxazole, acetylsulfasoxazole, acetylsulfaguanidine, and sulfadiazine may lead to precipitation of sulfa if the urine becomes oversaturated with the drug at a specific pH [52]. As with many cases of urolithiasis, sulfa stones can be avoided with adequate hydration.
Retroperitoneal fibrosis
Retroperitoneal fibrosis or Ormond's disease is an uncommon entity. While most cases are idiopathic, retroperitoneal fibrosis has been associated with the medication methysergide, used in the treatment of migrane headaches, in 12.4% of cases [62]. Other medications that have been implicated in the development of retroperitoneal fibrosis include methyldopa [63], amphetamines, beta-adrenergic blocking agents [64], and lysergic acid diethylamide (LSD) [65].
Epididymitis
Noninfectious epididymitis may result
Summary
A physician must be aware of common drug side effects and interactions before prescribing a certain agent. In addition to the drugs that we, as urologists, prescribe, we must also be aware of the urologic side effects of drugs that are commonly prescribed by nonurologists. The mechanisms of the pharmacologic causes for voiding dysfunction, erectile and sexual dysfunction, infertility, and urolithiasis are often mutifactorial and incompletely understood. The recognition and association of a
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Sexual Dysfunction After Abdominal Aortic Aneurysm Surgical Repair: Current Knowledge and Future Directions
2018, European Journal of Vascular and Endovascular SurgeryCitation Excerpt :Medication can also contribute to ED in patients with AAA. Indeed, patients with AAA often have comorbidities such as hypertension or dyslipidemia and treatments including anti-hypertensive drugs and statins have been identified as drugs that can cause ED.48,49 It is possible that medical treatment in patients who undergo AAA surgical repair could contribute to the occurrence of post-operative ED.
Ejaculatory disorders except premature ejaculation, orgasmic disorders
2013, Progres en UrologieErectile dysfunction
2013, The LancetCitation Excerpt :Antipsychotics such as risperidone and olanzapine have the highest likelihood of all psychotropic drugs of causing erectile dysfunction.54 Thiazides, followed by β blockers, are the most common groups of antihypertensive drugs that cause erectile dysfunction, whereas α blockers, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers are the least likely of these drugs to cause erectile dysfunction.55 Statins have also been implicated in the development of erectile dysfunction.56
Retroperitoneal fibrosis
2004, Annales d'UrologieErectile dysfunction
2007, New England Journal of Medicine