The association between lower urinary tract symptoms and erectile dysfunction in four centres: the UrEpik study

Abstract

population registers to provide representative samples of the population of men aged 40-79 years (and their partners) in each community. Direct interviews were held in Seoul and postal questionnaires used in the three European centres. The samples were selected randomly, providing representative samples in each community. RESULTSIn all, 4800 men and 3674 women responded; the response rates among men were 77% in Boxmeer, 21% in Auxerre, 42% in Birmingham and 65% in Seoul. The overall prevalence of ED for men aged 40-79, estimated as an ED score of 0-4, was 21.1%. There was evidence of a linear increase with age ( P < 0.001) and the pattern was very similar in the four centres. From the weighted logistic model, there was evidence of an association between sexual dysfunction, other self-reported diseases and lifestyle. From the ED score, after adjusting for age and country, men with diabetes were more likely to score of 0-4 (odds ratio 1.57, 95% confidence interval 1.09-2.25), as were those with high blood pressure (1.38, 1.09-1.75) and with an IPSS of 8-35 (1.39, 1.10-1.74). For lifestyle, smokers were more likely to score 0-4 (1.54, 1.23-1.92), while physical activity during leisure time was slightly associated with a reduction in the chance of scoring 0-4 (0.87, 0.77-0.99). The analysis gave the same results when repeated using self-reported ED instead of the dichotomised score. CONCLUSIONSED is clearly age-related and a problem for a large proportion of men in the community. It can have a profound impact on the quality of life of the man and on his partner. Were all men with this problem to seek medical help there would be a large burden on healthcare systems. There are cultural and age effects on the assessment of this problem.

Effect of transurethral resection of the prostate on erectile function: a prospective comparative study

“…28,[30][31][32] In the Multinational Survey of the Aging Male, LUTS were an independent risk factor for ED after controlling for age and comorbidities. 28 We presume that the improvement observed in erectile function in the TURP group in our study was caused by relief of obstructive urinary symptoms.…”

Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men

“…The International Prostate Symptom Scale (IPSS) is a series of questions used to assess the severity of irritative (frequency, urgency, nocturia) and obstructive LUTSs (incomplete emptying, intermittency, weak stream, straining), attributable to bladder outlet obstruction caused by prostatic enlargement. 19 Symptoms are classified as mild (score 0-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) or severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35).…”

“…The severity of urinary symptoms is correlated with the degree of erectile impairment. 11,12 Moreover, pharmacological treatment of LUTS has been shown to decrease the severity of ED, and vice versa. 13 Therefore, it is highly likely that cardiovascular disease, insulin resistance, ED and LUTS share common pathogenetic pathways in obese men, and will, accordingly, respond to a common intervention.…”

Efficacy and safety of combination therapy with mirodenafil and α1-blocker for benign prostatic hyperplasia-induced lower urinary tract symptoms accompanied by erectile dysfunction: a multicenter, open-label, prospective study

“…[1][2][3][4] Other studies have also suggested that the same pathophysiological mechanisms may underlie both ED and BPH-induced LUTS (LUTS/BPH): these mechanisms may involve nitric oxide synthase/ nitric oxide pathways, endothelin-1, autonomic overactivity, rhokinase activity and a 1 -adrenergic receptors. [5][6][7] With regard to the latter, as a 1 -adrenergic blockers (a 1 -blockers) inhibit the a 1 -adrenergic receptors of smooth muscles of the prostate and bladder neck, and induce the relaxation of these muscles, these blockers alleviate LUTS.…”