Association of lower urinary tract symptoms with erectile dysfunction in Japanese men

Terai, Akito; Ichioka, Kentaro; Matsui, Yoshiyuki; Yoshimura, Koji

doi:10.1016/j.urology.2004.02.019

Cited by 67 publications

(79 citation statements)

References 16 publications

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“…Our initial search identified 221 articles, but only 11 cross-sectional studies [13][14][15][16][17][18][19][20][21][22] documented the adjusted OR for alcohol, another cross-sectional study 23 and a prospective cohort 24 from the same study population provided adjusted relative risks (RR), one cohort study 25 provided adjusted OR. Only the 11 cross-sectional studies that provided adjusted ORs will be included in the meta-analysis, since the other two cohort studies were of different study design, and the RR reported by the cross-sectional and cohort studies were derived with a different statistical method (Mantel-Haenszel rather than logistic regression).…”

Section: Resultsmentioning

confidence: 99%

“…Alcohol consumption and erectile dysfunction JYW Cheng et al (95% CI, 12-22), 16% (11-23) and 15% (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) in those with o1 drink/day, 1-3 drinks/day and X4 drinks/day of alcohol consumption respectively. This incidence figure was adjusted for age, active and passive smoking, overweight, hypertension, physical activity, cholesterol, fat intake, testosterone, depression and antihypertensive medication intake.…”

Section: Cohort Study (Mmas)mentioning

confidence: 99%

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Alcohol consumption and erectile dysfunction: meta-analysis of population-based studies

et al. 2007

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Alcohol is long regarded as a risk factor for erectile dysfunction (ED), but epidemiological evidence has been equivocal. We aimed to investigate the ED risk associated with various levels of alcohol consumption by meta-analysis. We searched for population-based studies on ED through Medline, PubMed, PsychInfo, and scanned through reference lists. Eleven cross-sectional studies were included and analyzed with random effects model. We reviewed the results from one crosssectional study and two cohort studies. Regular alcohol consumption was negatively associated with ED (odds ratio (OR) ¼ 0.79; 99% confidence interval (CI), 0.67-0.92; Po0.001). Consumption of 8 or more drinks/week significantly reduced the risk of ED (OR ¼ 0.85; 99% CI, 0.73-0.99; P ¼ 0.007), but consumption of less alcohol (1-7 drinks/week) was not significant (OR ¼ 0.73; 99% CI, 0.44, 1.20; P ¼ 0.101). Begg's test and Egger's test detected no significant publication bias. Our estimates (in sensitivity analyses) were rendered nonsignificant when International Index of Erectile Function definition was used and when statistical adjustment was made only for age. Meta-analysis of crosssectional studies yielded a protective association of alcohol on ED, but the two cohort studies did not demonstrate any significant findings for alcohol consumption. More research is needed to confirm whether alcohol is protective or is unrelated to ED development.

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Section: Resultsmentioning

confidence: 99%

Section: Cohort Study (Mmas)mentioning

confidence: 99%

Alcohol consumption and erectile dysfunction: meta-analysis of population-based studies

et al. 2007

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“…Both ED and LUTS are associated with decreased quality of life. 3,4 Many studies have found a positive association between LUTS and ED 2,[5][6][7][8][9][10][11][12][13][14][15][16] ; all but one 16 were cross-sectional. Because the cross-sectional design cannot address the temporal relationship between LUTS and ED it remains unclear whether this association is causal.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study of Lower Urinary Tract Symptoms and Erectile Dysfunction

et al. 2008

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Purpose-Several studies have reported that men with lower urinary tract symptoms (LUTS) are more likely to experience erectile dysfunction (ED). All but one of these studies was crosssectional, limiting inferences about whether LUTS precipitate ED.Materials and Methods-The association between LUTS and incident ED was examined prospectively in the Health Professionals Follow-up Study. LUTS were assessed biennially by the American Urological Association Symptom Index, which captures symptoms of frequency, urgency and force of urinary stream. Severe LUTS was defined as a symptom score of ≥ 20 points and no LUTS was defined as a score of ≤ 7 points, both among men not treated for LUTS. In 2000, the men were asked to rate their erectile function for several time periods. ED was defined as "poor" or "very poor" function or use of ED medications and no ED was defined as "very good" or "good" function and no use of ED medications. We estimated risk ratios using Poisson regression adjusting for age and other potentially confounding factors.Results-We observed 3,953 incident ED cases among 17,086 men. Men with severe LUTS in 1994 or earlier had a statistically significant 40% higher risk of ED subsequently than men without LUTS. The risk of ED increased with increasing LUTS severity (p trend < 0.0001). The positive association between LUTS and ED was stronger among younger than older men (p interaction = 0.03).Conclusions-This study provides evidence that men with LUTS are more likely to develop ED subsequently.

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“…1,2 In fact, both entities belong to the most frequent urologic disorders 3,4 and a variety of recent large-scale epidemiological studies analysing 1200-12 000 men have convincingly documented an age-independent relationship between LUTS and ED leading to a new paradigm in the fields of research, diagnosis and treatment. [5][6][7][8][9][10][11][12][13] Despite the fact that the underlying pathophysiology is still poorly understood, several theories have been elaborated to link both disorders, such as the Rho-kinase pathway, a-adrenergic receptor imbalance, a decrease of NOS/NO in the endothelium, atherosclerosis and an autonomic hyperactivity. From the clinical standpoint the most important issue is the impact of surgical and medical treatment for LUTS on male sexual function.…”

Section: Introductionmentioning

confidence: 99%

Lower urinary tract symptoms and erectile dysfunction; links for diagnosis, management and treatment

Ponholzer

Madersbacher

2007

Int J Impot Res

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Recent large-scale epidemiological studies have documented a strong association between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). This observation has two important scientific and clinical aspects: (i) to reveal the pathomechanism linking LUTS and ED and (ii) to consider this fact in the individual approach for diagnosis and management of these two disorders. The following hypotheses are under investigation to explain the relation between LUTS and ED: (i) an increased Rho-kinase activation, (ii) an a-adrenergic receptor imbalance, (iii) a decrease of NOS/ NO in the endothelium, (iv) atherosclerosis affecting the small pelvis and (v) an autonomic hyperactivity, each affecting simultaneously bladder, prostate and penis. According to a recent randomized trial, sildenafil has a positive effect on LUTS yet not on uroflowmetry in men with LUTS and ED. Although further trials are mandatory, phosphodiesterase-5 inhibitors might play a role in the management of LUTS in the future. a-Blockers have no relevant effect on erectile function, tamsulosin leads to retrograde ejaculation in up to 10%. 5a-Reductase inhibitors are associated with ED, loss of libido and reduction of ejaculate volume in up to 10%. Transurethral and open prostatectomy induce retrograde ejaculation in up to 90% of patients while their impact on erectile function is still controversially discussed. Minimal invasive treatment options (laser prostatectomy, transurethral microwave thermotherapy) have a lower rate of retrograde ejaculation in the range of 20-70%. LUTS and ED are strongly linked although the exact mechanism is poorly understood. Men seeking for help for LUTS/benign prostatic hyperplasia should be assessed for different aspects of sexual dysfunction and informed regarding the impact of medication and surgery on sexual health.

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Association of lower urinary tract symptoms with erectile dysfunction in Japanese men

Cited by 67 publications

References 16 publications

Alcohol consumption and erectile dysfunction: meta-analysis of population-based studies

Alcohol consumption and erectile dysfunction: meta-analysis of population-based studies

A Prospective Study of Lower Urinary Tract Symptoms and Erectile Dysfunction

Lower urinary tract symptoms and erectile dysfunction; links for diagnosis, management and treatment

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