Association between lower urinary tract symptoms and erectile dysfunction

• Published in: Urology (Ridgewood, N.J.) Vol. 64; no. 4; pp. 772 - 776
• Main Authors: Ponholzer, Anton, Temml, Christian, Obermayr, Rudolf, Madersbacher, Stephan
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2004; Elsevier Science
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Austria - epidemiology; Biological and medical sciences; Cohort Studies; Comorbidity; Confounding Factors (Epidemiology); Erectile Dysfunction - epidemiology; Humans; Life Style; Male; Mass Screening; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Physical Examination; Prevalence; Quality of Life; Risk Factors; Sleep Wake Disorders - epidemiology; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Urination Disorders - epidemiology; Urination Disorders - psychology; Austria; Urinary incontinence; Voiding dysfunction; Nephrology; Urinary system disease; Association; Erection disorders; Bladder disease; Urinary tract disease; Male genital diseases; Urology
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2004.05.025

To assess whether the association between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) is confounded by age or whether LUTS represent an independent risk factor for ED. Men aged 20 to 80 years, who were participating in a health-screening project in the area of Vienna, completed the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function-5. In parallel, all men underwent a detailed health evaluation, including physical examination, evaluation of various lifestyle factors, and a blood laboratory study with 14 parameters. Within the total study population (n = 2858; mean age 45.8 years, range 20 to 80), the prevalence of LUTS and ED increased statistically significantly with age ( P <0.0001). In multivariate analysis controlling for age, comorbidities, and lifestyle, the IPSS ( P = 0.0001), the obstructive score of the IPSS ( P = 0.0001), nocturia ( P = 0.04), and the LUTS bother score ( P = 0.002) correlated statistically significantly with the presence of ED (International Index of Erectile Function-5 score less than 22). The odds ratio for the presence of ED was 2.2 (95% confidence interval [CI] 1.8 to 2.8) for LUTS (IPSS greater than 7), 2.0 (95% CI 1.7 to 2.4) for voiding symptoms, 1.4 (95% CI 1.1 to 1.7) for nocturia (score greater than 2), and 2.5 (95% CI 2.0 to 3.1) for the LUTS bother score. The presence of LUTS, in particular voiding symptoms, nocturia, and the quality-of-life impairment due to LUTS, is an independent risk factor for the presence of ED. These findings have implications for the treatment of elderly men with LUTS and open a new area for research.