Correlation between lower urinary tract symptoms and erectile dysfunction in men presenting for prostate cancer screening

Abstract

Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are age-related conditions that may have a profound impact on the quality of life. The relationship between LUTS and ED is not completely understood. In this study, we assessed this relationship in men over 45 years of age during a prostate cancer screening program. LUTS and ED were evaluated in 1267 men aged 45-75 years (mean 58.278.2 years). Patients completed the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function-5 (IIEF-5). The association between LUTS and ED was analyzed and the influence of age in the results was tested. We also evaluated the influence of the intensity of LUTS in the ED severity. A total of 514 (40.6%) patients were considered symptomatic of LUTS (24.8% with mild, 11.8% with moderate and 4% with severe LUTS). ED was present in 758 (59.9%) men and was considered mild in 25.0%, moderate in 18.3% and severe in 16.7%. The IIEF-5 score had a negative correlation with both the IPSS score (r ¼ À0.33, Po0.001) and age (r ¼ À0.31 and Po0.001). Age was positively associated with the IPSS score (r ¼ 0.14 and Po0.001). A significant correlation was observed between LUTS and ED, with 57.6% of the men with LUTS presenting ED as opposed to 29.7% of the asymptomatic population (odds ratio ¼ 3.32; 95% CI ¼ 2.57-4.29, Po0.001). Age-adjusted univariate analysis revealed a significant and independent influence of LUTS on the incidence of ED (odds ratio ¼ 2.72; 95% CI ¼ 2.08-3.57, Po0.001). IIEF scores varied significantly according to the severity of the urinary symptoms. Our findings in a prostate cancer screening population confirm that LUTS is an age-independent predictor of ED. Furthermore, they demonstrate that not only the presence of LUTS increases the likelihood of developing ED, but the severity of LUTS is associated with the intensity of ED.

Voiding dysfunction in patients with Parkinson's disease: Impact of neurological impairment and clinical parameters

“…However, it is well known that among the overall population a positive association exists between age and the presence of ICSV. 15,16 The fact that we did not find such an association in PD patients most probably reflects the impact of two factors. First, the relatively restricted age bracket of the patients, as the disease affects mainly individuals above 55-60 years of age.…”

Coexisting lower urinary tract symptoms and erectile dysfunction: a systematic review of epidemiological data

“…Although not all studies across the continuum from the general population to treatment‐seeking men reported the severity of LUTS and ED concomitantly, an overall increase in disease severity of both LUTS and ED can be seen by the increasing percentage of moderate to severe LUTS and/or ED as men progress through the healthcare system. Approximately 30% of men in primary care reported moderate to severe LUTS (15–17) and 19–66% reported moderate to severe ED (15–17), depending on age, whereas 54–86% of men in urology clinics reported moderate to severe LUTS (18,21,22) and 47–79% reported moderate to severe ED (19,21). Among treatment‐seeking men, 67–100% reported moderate to severe LUTS (23,24,35) and 43–59% reported moderate to severe ED (23,24,35) (Table 3).…”

“…Currently published literature is limited, but does support the fact that LUTS and ED commonly coexist. Based on the present review, the prevalence of coexisting LUTS and ED increases with age (1,2,15,16,26,29,31), the severity of one condition typically correlates to the severity of the other (1,17–19,26), and increasing severity of the conditions typically leads to reduced QoL and increased bothersomeness (1,20,21,30,35). The prevalence and severity of coexisting LUTS and ED increase as men move across the healthcare system from being in the general population to being treatment seeking for LUTS or ED.…”

“…articles (23 from PubMed, 0 from EMBASE and 0 from Cochrane) that reported on the prevalence of both male-LUTS and ED were identified for data extraction and are the focus of this review. Twelve studies used both the IPSS and IIEF as assessment tools (1,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24), whereas 11 used alternative approaches (1,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Eleven studies were cross-sectional (1,(14)(15)(16)(17)(18)20,(22)(23)(24)(25), seven were reported as prospective (19,21,(30)(31)(32)(33)(34), two studies reported retrospectively from BPH registries (24,35) and three reported retrospectively using medical record or prescription claims databases (27)(28)(29).…”

Is there a difference between Parkinson disease patients and a control group in terms of urinary symptoms and quality of life?

“…The total score varies from 0 to 35. According to the total score, urinary complaints are classified as mild (0-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), and severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Quality of life (QoL) is evaluated by the last question and severity of disruption of QoL is determined according to points from 0 to 5 (no disruption to severe) (11).…”