A case‐control study on the association between chronic prostatitis/chronic pelvic pain syndrome and erectile dysfunction

Abstract

Study Type – Symptom prevalence (case control) Level of Evidence 3a What's known on the subject? and What does the study add? In recent years, a number of studies have reported a high prevalence of erectile dysfunction (ED) among patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Several studies have reported that the prevalence of ED ranges from 15.0 to 40.5% in men in China with CP/CPPS; however, the previous studies focusing on the prevalence of ED among patients with CP/CPPS all neglected to explore the magnitude of this association. Our study found an association between ED and previously diagnosed CP/CPPS. The odds of previous CP/CPPS were 3.62 times greater for cases than for controls, after adjusting for patient socio‐demographic characteristics, comorbidities, obesity, and alcohol abuse/alcohol dependence syndrome. OBJECTIVE To examine the association between erectile dysfunction (ED) and a previous diagnosis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) using a population‐based dataset. PATIENTS AND METHODS The data for this case–control study was obtained from the National Health Insurance database. A total of 3194 males, who were ≥18 years of age when they first received a diagnosis of ED, were identified and 15 970 controls were randomly selected. The prevalence and risk of CP/CPPS among cases and controls were calculated by using conditional logistic regression analysis. RESULTS In total, 667 (3.5%) of the 19 164 sampled subjects had been diagnosed with CP/CPPS before the index date; CP/CPPS was found in 276 (8.6%) cases and in 391 (2.5%) controls (P < 0.001). Regression analysis indicated that cases were more likely to have had previous CP/CPPS (odd ratio 3.62, 95% confidence interval 3.07–4.26) after adjusting for patient monthly income, geographical location and urbanization level, as well as hypertension, diabetes, coronary heart disease, renal disease, obesity and alcohol abuse/alcohol dependence syndrome status, when compared with controls. CONCLUSIONS We conclude that there was an association between ED and having been previously diagnosed with CP/CPPS. Urologists should be alert to the association between CP/CPPS and ED, and assess the erectile function of patients suffering from CP/CPPS.

Asymptomatic prostatic inflammation in men with clinical BPH and erectile dysfunction affects the positive predictive value of prostate-specific antigen

“…This is consistent with the data on 918 Asian men with ED in the same age group, where 55% had moderate to severe ED [20]. Though ED has been associated with chronic prostatitis and chronic pelvic pain syndrome, the relationship of this association has not been well understood [21]. It is still not clear whether ED leads to chronic prostatitis/chronic pelvic pain syndrome or vice versa.…”

Clinical Utility of the UPOINT Phenotype System in Chinese Males with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS): A Prospective Study

“…In the absence of an appropriate LUT segmented test to obtain prostate-specific specimens, a diagnosis of prostatitis is only tentative, and nothing can be said about positivity or negativity of the “I” domain. ED is apparently quite common among men with CP/CPPS seeking medical care, and men with CP/CPPS are more likely to experience ED than age-matched controls [13], [22], [23]. Most recently, a case-control study by using a population-based dataset in Taiwan of China showed that cases with ED were more likely to have had a previous CP/CPPS (odd ratio: 3.62, 95% confidence interval: 3.07–4.26) after adjusting for the patients’ socio-demographic characteristics, comorbidities, obesity, and alcohol abuse/alcohol dependence syndrome status, when compared with controls [22].…”

“…Several studies have suggested that ED and CP/CPPS may be linked by a shared inflammatory process originating from a prostatic source [29]–[31]. It may be possible that such prostatic inflammation affects smooth muscle relaxation and impair microvascularization of the prostate [32], thus decreasing the ability of penile tissue to fill with blood and maintain an erection [22]. Also, inflammation of the prostate might impair chemokine, nitric oxide synthase and cyclooxygenase-2 production, and impaired nitric oxide disponibility has been associated with ED [33].…”

Age-Specific Clinical Features of Erectile Dysfunction

“…There was an association between ED and having been previously diagnosed with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Urologists should be alert to the association between CP/CPPS and ED, and assess the ED patients suffering from CP/CPPS [12]. But difference still existed between the two groups, for elderly ED group, it was benign prostatic hyperplasia and chronic prostatitis for young ED group as one of the top three complications.…”