Lower urinary tract symptoms (LUTSs) and ED are clearly correlated, but to date no correlation with ejaculatory dysfunction (EjD) has been identified. Therefore, this study evaluated the impact of erectile function in men with LUTS on EjD and premature ejaculation (PE). Erectile function, PE and EjD of 239 men (mean age, 53.0±10.65 years), International Prostate Symptom Score (IPSS), International Index of Erection Function (IIEF), intravaginal ejaculatory latency time (IELT) and the seven-item Male Sexual Health questionnaire (MSHQ)-EjD were used to compare with the degree of LUTS. Ages were divided into five groups (o40, 40 --49, 50 --59, 60--69 and 470 years). The IPSS categorized patients into three symptom groups: mild, 1 --7; moderate, 8 --19; and severe, 419. ED was classified into five categories based on IIEF-EF scores: severe (0 --6), moderate (7 --12), mild-to-moderate (13--18), mild (19 --24) and normal (25 --30). The correlations among age, IIEF-EF, IELT and the MSHQ-EjD domain were studied through regression and cross-tabulation analyses. The results revealed that aging significantly affected each item of the MSHQ-EjD (Po0.05). The IIEF-EF domain was also correlated with each question on the MSHQ-EjD (Po0.05). PE (IELT o1 min) increased in incidence as patients got older but was not linked to IIEF-EF (P40.05). These results indicate that EjD is closely related to age and erectile function, and that PE is closely related to age, although PE is not related to erectile function.
INTRODUCTIONRepresentative symptoms that may develop with aging include lower urinary tract symptoms (LUTSs) and ED. These two symptoms are not simply the result of aging, and they have a common pathophysiology. Thus, by treating one disease, a synergistic effect of treating the other disease may occur simultaneously. 1,2 A multinational questionnaire survey involving 12 815 men older than 50 years revealed that the two diseases are associated, and for those with ED, age and LUTS were more potent risk factors than diabetes, hypertension or hyperlipidemia. 3 Ejaculation is the process of sperm transport from the epididymis to the urethral meatus, resulting in the expulsion of semen. Ejaculation occurs in two phases: seminal emission and ejaculation proper, and they are mediated by sympathetic and parasympathetic inputs, respectively. When sexual stimulation is extremely intense, the autonomic impulses responsible for the emission phase exit the spinal cord at the T10 --L2 level via sympathetic chains, course into the pelvis as hypogastric outflow and onto the genital structures involved in ejaculation. Parasympathetic and somatic inputs from S2 to S4 then cause ejaculation proper, and antegrade ejaculation occurs. 4,5 If the ejaculation reflex takes place too quickly, it may induce premature ejaculation (PE). In contrast, if it is late, delayed ejaculation may occur. Abnormalities in the sympathetic nerves or deterioration in male hormone levels because of aging may reduce semen volume or ejaculation force and decrease the fre...