Sexual Dysfunction in Men with Lower Urinary Tract Symptoms

Frankel, Stephen; Donovan, Jenny; Tim, Peters; Abrams, Paul; Dabhoiwala, N.F.; Osawa, D.; Lin, Alex T.L.

doi:10.1016/s0895-4356(98)00044-4

Cited by 209 publications

(225 citation statements)

References 20 publications

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“…Frankel et al 58 reported that urinary incontinence or painful urination could decrease social and sexual confidence and thus lead to ED. Elliott et al 10 suggested that depression could reduce sexual function.…”

Section: Psychological Factorsmentioning

confidence: 99%

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

2011

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There is strong evidence from multiple epidemological studies that lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are correlated, independent of age or comorbidities as diabetes or hypertension. Although a direct causal relationship is not established yet, four pathophysio logical mechanisms can explain the relationship. These include alteration in nitric oxide bioavailability, a1-adrenergic receptor hyperactivity, pelvic atherosclerosis and sex hormones. This association has different clinical implications on the management of both disorders. Men seeking care for one condition should always be screened for complaints of the other condition. Sexual function should be assessed and discussed with the patient when choosing the appropriate management strategy for LUTS, as well as when evaluating the patient's response to treatment. Multiple large clinical trials have shown an improvement in LUTS after phosphodiesterase-5 (PDE5)-inhibitor treatment. PDE5 inhibitors show promise as a future treatment for LUTS, either in conjunction with existing therapies or as a primary treatment. There may be a potential therapeutic role for testosterone in LUTS treatment in cases of testosterone deficiency that needs to be investigated. Much further investigation is required, but it is evident that the association between LUTS and ED is fundamental for future therapies and possible preventative strategies.

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Section: Psychological Factorsmentioning

confidence: 99%

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

2011

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“…Thus, it is difficult to compare our results with the results of other studies. Tubaroa et al 22 and Frankel et al 23 assessed the reduction in semen volume using a questionnaire survey, and Blanker et al 6 investigated reduction in semen volume and pain during ejaculation. Rosen et al 24 reported that EjD is highly prevalent and bothersome in sexually active men with LUTS.…”

Section: Discussionmentioning

confidence: 99%

Impact of erectile function and age in men with lower urinary tract symptoms on ejaculatory dysfunction and premature ejaculation

et al. 2012

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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...

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“…Several studies have tried to define whether storage or voiding symptoms have a stronger relationship with the incidence of ED. Frankle et al 12 thought that storage symptoms were more predictive of the presence of ED than obstructive symptoms. A prospective and multicenter study from the Netherlands showed that severe irritative voiding symptoms were much more closely related to ED than obstructive symptoms.…”

Section: Discussionmentioning

confidence: 99%

Association between ED and LUTS in Japanese motorcyclists

et al. 2008

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Recently, the association between motorcycling and erectile dysfunction (ED) has been reported. Also, lower urinary tract symptoms (LUTS) were reported to be associated with ED. The aim of this study is to evaluate the association of ED with LUTS in motorcyclists. We investigated the prevalence and the status of ED using a 5-item version of the International Index of Erectile Function (IIEF-5) in 150 motorcyclists. ED was diagnosed when the IIEF-5 score was less than 17. The International Prostate Symptom Score (IPSS) was also applied, and the relationship between IIEF-5 and IPSS was evaluated. Of the 150 motorcyclists, 37 (25%) had ED, and 31 (21%) had moderate or severe symptoms of LUTS (IPSS X8). The IIEF-5 was significantly associated with the severity of IPSS (P ¼ 0.002) and age (Po0.0001). The IIEF-5 was also significantly associated with the scores of both voiding (Po0.0001) and storage symptoms (P ¼ 0.001). On stepwise logistic regression analysis, age and storage symptoms are independent risk factors for ED in motorcyclists. LUTS seemed to be associated with ED in motorcyclists.

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Sexual Dysfunction in Men with Lower Urinary Tract Symptoms

Cited by 209 publications

References 20 publications

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

Impact of erectile function and age in men with lower urinary tract symptoms on ejaculatory dysfunction and premature ejaculation

Association between ED and LUTS in Japanese motorcyclists

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