男性下尿路症状和勃起功能障碍的相关性分析

目的:了解社区年龄≥50岁男性人群中有下尿路症状(LUTS)者ED的患病情况,评估LUTS(梗阻症状、刺激症状)和ED之间的相关性。方法:2006年10～11月对社区年龄≥50岁、有固定性伴侣的男性进行IPSS、IIEF-5调查,调查对象均签署知情同意书,完成规定问诊及相关检查,应用统计学方法对IPSS评分、梗阻症状评分以及刺激症状评分与勃起功能之间的相关性进行分析。结果:共调查245例,171例有LUTS患者中ED患病率为81.9%(140/171),无LUTS患者74例作为对照组,ED患病率为29.7%(22/74)。LUTS组中各年龄组ED的患病率分别为:50～59岁73.1%(38/52)、60～69岁82.1%(46/56)、≥70岁88.9%(56/63),各年龄组之间IPSS、IIEF-5比较差异有显著性(P<0.01),各年龄组之间轻、中、重度ED所占比例比较差异有显著性(P<0.01)。LUTS组中IPSS评分程度分布:轻度80例(46.8%)、中度67例(39.2%)、重度24例(14.0%),不同程度LUTS中ED者所占比例分别为:轻度LUTS71.3%(57/80)、中度LUTS89.6%(60/67)、重度LUTS95.8%(23/24),LUTS程度和ED患病率之间有显著相差性(r=0.52,P<0.01)。171例平均梗阻症状评分(3.1±3.6)分,梗阻症状与IIEF-5评分相关系数r=-0.41(P<0.01),平均刺激症状评分(6.8±4.9)分,刺激症状与IIEF-5评分相关系数r=-0.59(P<0.01)。结论:社区LUTS人群中ED有较高的患病率,LUTS程度和ED患病率显著性正相关,与梗阻症状相比刺激症状对中老年男性性生活的影响更大。在治疗LUTS的同时应该考虑ED问题,以求更有效改善患者生活质量。     

下尿路症状男性人群勃起功能调查

目的:了解下尿路症状(LUTS)男性人群的勃起功能障碍(ED)患病情况,探讨LUTS与ED之间的相关性。方法:2011年11月~2012年8月,抽取1 000例40~80岁、有固定性伴侣的男性人群,采用国际前列腺症状评分(IPSS)及国际勃起功能指数(IIEF-5)评估LUTS和ED的严重程度,单因素Logistic回归分析LUTS与ED的相关性。结果:40~80岁男性人群的LUTS患病率为42.81%(426/995),ED患病率为76.18%(758/995)。其中426例有LUTS症状患者的ED患病率为82.16%(350/426),569例无LUTS症状的ED患病率为71.70%(408/569)。随着LUTS严重程度的增高,ED的患病率明显升高。Logistic回归分析显示,年龄、LUTS严重程度与ED的关联存在统计学显著意义(P0.01)。结论:LUTS患者存在很高的ED发生率。年龄越大,LUTS症状愈严重者患ED的风险更高。     

681例中老年男性下尿路症状与勃起功能障碍调查

目的 了解中老年男性人群中下尿路症状(LUTS)与勃起功能障碍(ED)的患病率，并且从流行病学角度评估年龄、下尿路症状严重度及ED严重度之间相关性。方法 在2002年9—10月对定点本院的高干高知年度体检中，对50岁以上中老年男性人群作国际前列腺症状评分(IPSS)，生活质量评分(QoL)，国际勃起功能指数评分(IIEF-5)调查。另外，对每个调查对象必须完成直肠指检，对资料完整的681例所有资料做统计学分析。结果 在681名调查对象中，50～59岁，60～69岁，70岁以上3个年龄组中，中重度LUTS(IPSS≥8)发病率分别为19．0％，32．2％，39.8％；而ED患病率分别为82．6％，87．9％，96.6％：ED在轻度LUTS(IPSS为0～7)，中度LUTS(IPSS为8～19)，重度LUTS(IPSS为20～35)3组中患病率分别为71．8％，92，4％，96，4％，3组之间有显著性差异。结论 本研究结果表明，LUTS与ED在上海市高于高知老年男性中有很高的患病率，并随年龄增长而上升，LUTS严重程度会影响ED的患病率。     

良性前列腺增生症与勃起功能障碍的相关性研究

目的 研究中老年男性的下尿路症状(LUTS)与良性前列腺增生(BPH)及勃起功能障碍(ED)的相关性.方法 收集2006年1月至2008年2月在我院治疗的良性前列腺增生患者86例.对所有病例进行病史采集并进行统计学分析.结果 86例患者的ED患病率为68.60%.三个年龄组中ED的患病牢随着年龄的增加而升高.ED患病率随着LUTS程度的加重而逐渐升高.IPSS评分和残余尿量相关性良好(r=0.818,P<0.001);年龄和IIEF-5评分之间相关性良好(r=-0.688,P<0.001);IPSS评分和IIEF-5评分之间相关性良好(r=-0.686,P<0.001).控制年龄后进行统计分析,发现IPSS评分和IIEF-5评分之间仍然有相关性(r=-0.428,P<0.001).结论 前列腺体积和IPSS评分之间有弱相关性.残余尿量和IPSS评分之间相关性良好,说明残余尿量可以作为评价LUTS严重程度的一个重要指标.年龄、IPSS评分和IIEF-5评分的相关性良好,说明年龄和LUTS是ED的影响因素,其中LUTS是BPH引起ED的独立危险因素.     

良性前列腺增生患者下尿路症状与勃起功能障碍的相关性研究

目的 了解中老年男性良性前列腺增生(BPH)患者的下尿路症状(LUTS)与勃起功能障碍(ED)患病率的相关性.方法 选取BPH患者作一般情况问卷调查,对资料完整病例的所有资料均采用SPSS13.0进行相应的统计分析.结果 BPH伴有LUTS患者ED的患病率为92.9％ (260/280).相关性分析表明:年龄、病程、最大尿流率(Qmax)与国际勃起功能障碍问卷表-5(IIEF-5)评分有显著相关性.总国际前列腺症状评分(IPSS)、生活质量评分(QOL)与IIEF-5评分无显著相关性.IPSS评分中的第2个症状、第5个症状和第7个症状与IIEF-5评分有显著相关性,其余症状均无显著相关性.结论 年龄、病程以及IPSS评分中的症状2、症状5、症状7与IIEF-5评分结果有显著相关性；Qmax与IIEF-5评分结果有弱相关性；总IPSS评分、QOL评分与IIEF-5评分结果无相关性.     

中老年男性下尿路症状与良性前列腺增生及勃起功能障碍的相关性研究

目的 了解中老年男性下尿路症状(LUTS)与良性前列腺增生(BPH)及勃起功能障碍(ED)之间的相关性.方法 268例50岁以上被调查者行国际前列腺症状评分(IPSS)、生活质量评分(QOL)、国际勃起功能指数评分(IIEF-5),B超测量前列腺体积及残余尿量.并进行统计学分析.结果 IPSS与残余尿量呈高度相关(r＝0.78,P<0.001),IPSS和前列腺体积无相关性(r=0.15,P>0.05).IPSS评分和QOL评分呈高度相关(r=0.88,P<0.001).IIEF-5评分和IPSS评分呈负中度相关(r=-0.62,P<0.001),和前列腺体积无相关性(r=-0.11,P>0.05),年龄呈负弱相关(r=-0.42,P<0.001),IIEF-5评分和残余尿量呈负弱相关(r＝-0.53,P<0.001).三个年龄组(50～59岁,60～69岁,70岁以上)ED发病率分别为40.0%、66.67%、90.08%,不同程度LUTS患者ED发病率分别为37.5%、62.02%、91.48%.三组之间差异有统计学意义(P<0.05).控制年龄因素后仍发现IPSS评分和IIEF-5评分负相关(r=-0.53,P＜0.0001).结论 LUTS与前列腺体积无相关性,与QOL呈高度相关.IIEF-5和年龄及LUTS呈负相关,说明年龄、LUTS是ED的危险因素.且LUTS的严重程度和ED的发展密切相关.     

西地那非改善ED合并BPH患者勃起功能及下尿路症状

为评价枸橼酸西地那非对同时存在勃起功能障碍（ED）和良性前列腺增生症（BPH）相关性下尿路症状（LUTS）患者的临床疗效，Mc Vary KT等人进行了一项随机双盲研究[J Urol，2007，177（3）：1071—1077]，研究入选45岁及以上369例，IIEF评分≤25分和IPSS≥12分的男性患者，给予患者随机服用西地那非（n=189）或安慰剂（n=180），连续服用12周。评价患者的国际勃起功能评分（IIEF），国际前列腺症状评分（IPSS），良性前列腺增生症相关影响因子，性生活自信度／性关系问卷调查表和勃起功能障碍治疗满意指数评分。     

症状性良性前列腺增生患者的性功能调查

目的:调查伴有下尿路症状(LUTS)的良性前列腺增生(BPH)患者治疗前性功能障碍的程度,并分析性功能障碍与LUTS、年龄的相关性。方法:88例具有典型LUTS的BPH患者,年龄49~86(67.90±7.59)岁。所有患者均进行了国际前列腺症状评分(IPSS)、勃起功能障碍国际问卷-5(IIEF-5)、简明性功能问卷(BSFI)调查,并同时检测尿流率、前列腺总体积和血清睾酮。应用多元逐步回归分析方法和一元相关回归分析评价各检测变量间的相关性。结果:本组患者IPSS评分2~33(18.4±7.79)分。IIEF-5评分1~25(8.50±8.98)分,其中勃起功能障碍(ED)患者76例(86.36%)。BSFI中性欲部分评分0~8(1.92±2.21)分,其中性欲低下患者65例(72.86%);勃起功能部分评分0~16(4.18±4.96)分,其中ED患者70例(79.55%);射精部分评分0~8(2.55±3.57)分,其中射精障碍患者60例(68.18%);问题部分评分0~12(10.44±3.57)分;满意度部分评分0~4(1.90±1.37)分。统计学分析表明:年龄只与BSFI中勃起功能有显著的相关性(γ=-0.552,P=0.000),同样IIEF-5与年龄有显著的相关性(γ=-0.567,P=0.000),IPSS评分与年龄有显著的相关性(γ=0.213,P=0.047)。IPSS评分与BSFI中勃起功能和满意度有显著的相关性(γ=-0.332,P=0.002;γ=-0.302,P=0.005)。IIEF-5与BSFI中性欲、勃起功能和射精部分评分具有一致的相关性(P<0.05)。血清睾酮与年龄、IIEF-5和BSFI评分间无明显相关性(P>0.05),同样最大尿流率和前列腺总体积与IPSS、IIEF-5和BSFI评分间无明显相关性(P>0.05)。结论:年龄和LUTS是性功能障碍的危险因素,LUTS的严重程度与性功能障碍的发展密切相关。     

良性前列腺增生症状参数与性功能关系的临床分析

目的 分析不同程度性功能情况下良性前列腺增生(BPH)症状参数的分布情况,并探讨两者间的相关性.方法 根据国际勃起功能问卷评分表(IIEF-5)和不同的射精功能情况,将BPH患者分为勃起功能正常、轻度、中度和重度障碍4组和射精正常、射精量减少、射精痛或射精不适和早泄4组,分析各组间的下尿路症状(LUTS)、前列腺总体积(TPV)、最大尿流率(Qmax)间的情况,应用方差分析研究各参数间的差异,并探讨两者间的关系.结果 BPH患者165例,年龄53～75岁.144例有勃起功能障碍(ED)(87.27%),140例有射精功能障碍(EjD)(84.85%).研究显示:年龄与性功能关系密切.TPV在IIEF-5评分正常组与重度ED组间比较,差异有统计学意义;IPSS评分在IIEF-5正常组与轻、中、重度ED组间比较,差异有统计学意义.IPSS评分在射精正常组与精液量减少、射精痛或射精不适的组间比较,差异有统计学意义.结论 年龄是性功能障碍的主要因素.BPH患者中ED和EjD的发生率较高.ED的程度与LUTS的严重程度和TPV大小之间有相关性,而不同的射精障碍与LUTS的严重程度也有相关性.     

ED与LUTS药物治疗的相关性研究

目的探索、研究勃起功能障碍(ED)和下尿路症状(LUTS)在药物治疗方面是否存在相关性。方法本组研究对象80例病人均患有ED和LUTS,分为3组,每例研究对象在初诊时,必须填写IIEF-5、IPSS评分表,作为研究开始的基线。A组服用两地那非,B组服用多沙唑嗪控释片,C组联合应用西地那非和多沙唑嗪控释片。用药6个月后再次填写IIEF-5和IPSS评分表以作对比。用方差分析检验方法,进行用药前后数据统计学分析。结果3组治疗前后IIEF-5、IPSS评分变化差异均有编者计学意义,C组(联合用药组)变化最大(P<0.001)。结论ED与LUTS相互影响,ED患者LUTS发生率明显升高,而LUTS患者的ED危险性亦显著增加。西地那非可显著改善ED患者合并的LUTS症状,多沙唑嗪可改善LUTS患者的性功能;西地那非联合多沙唑嗪治疗ED、LUTS患者具协同作用。     

Relationships between lower urinary tract symptoms, the bother they induce and erectile dysfunction

OBJECTIVE: To study the relationships between lower urinary tract symptoms (LUTS), LUTS-induced bother, age and erectile dysfunction. MATERIAL AND METHODS: A survey consisting of two questionnaires, the International Prostate Symptom Score (IPSS) (reflecting LUTS) and the International Index of Erectile Function (IIEF)-5 (reflecting erectile function), together with instructions on how to perform timed micturition, was sent to 2000 randomly selected men (age range 60-70 years) living in the five counties surrounding our hospital. The IPSS questionnaire included a question concerning the degree of bother induced by LUTS. RESULTS: The survey was answered by 1096 men; after the exclusion of incomplete answers, 924 surveys were evaluated. Of these 924 men, 725 (78%) were sexually active and included in the analyses. The prevalence of moderate-to-severe LUTS (IPSS>or=8) was 45%. The prevalence of erectile dysfunction (ED), defined as an IIEF-5 score of 相似文献   

Is there a relationship among age,international index of erectile function,international prostate symptom score,and aging males’ symptoms score?

Purpose To investigate the relationship among the International Index of Erectile Function (IIEF), International Prostate Symptom Score (IPSS), and Aging Males’ Symptoms (AMS) scale scores in various age groups of males. Patients and methods A total of 307 male patients enrolled in the study. Mean age was 52.3 (range 21–77) years. Group 1 consisted of 51 (≤39 years), Group 2 consisted of 160 (40–59 years), and Group 3 consisted of 96 (≥60 years) patients. First five and 15th questions of the IIEF, IPSS, and AMS scale were replied by all the patients. The patients were assessed based on the IIEF for erectile dysfunction (ED), IPSS for lower urinary tract symptoms (LUTS), and AMS scale for Symptomatic Late-Onset Hypogonadism (SLOH). Results ED, LUTS, and SLOH symptoms were detected in 236 (76.8%), 162 (52.8%), and 184 (59.9%) patients. Except for total AMS scores, IIEF and IPSS scores were significantly different among the groups (p _AMS = 0.320, p _IIEF = 0.000, p _IPSS = 0.000). In the comparisons of the IIEF scores between the each group, significant differences were observed (p _{Group1–Group2} = 0.000, p _{Group1–Group3} = 0.000, p _{Group2–Group3} = 0.000). Nevertheless, IPSS score was significantly lower in the patients with age ≤39 years than the other age groups (p = 0.000). Conclusions In the present study, ED ratio and LUTS severity significantly increased in older men. We did not find significant relationship between aging and SLOH symptoms. In the light of our results, LUTS seems to be an important risk factor on erectile function.     

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

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 58.2+/-8.2 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=-0.33, P<0.001) and age (r=-0.31 and P<0.001). Age was positively associated with the IPSS score (r=0.14 and P<0.001). 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=3.32; 95% CI =2.57-4.29, P<0.001). Age-adjusted univariate analysis revealed a significant and independent influence of LUTS on the incidence of ED (odds ratio=2.72; 95% CI=2.08-3.57, P<0.001). 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.     

The effectiveness of sildenafil citrate in patients with erectile dysfunction and lower urinary system symptoms and the significance of asymptomatic inflammatory prostatitis

We evaluated the effectiveness of sildenafil citrate on lower urinary system symptoms (LUTS) by using symptom score scales. We also evaluated whether or not the presence of asymptomatic inflammatory prostatitis had an effect on the alteration in the symptom scores. A total of 36 male patients were included in the study. For all the cases, 'International Prostate Symptom Score' (IPSS), 'National Health Institute Chronic Prostatitis Symptom Index' (NIH-CPSI) and 'International Index of Erectile Function' (IIEF-5) were investigated and the scores were calculated in the first visit. Sildenafil citrate was given for 30 days and at the second visit IPSS, NIH-CPSI and IIEF-5 scores were once more analyzed. Afterwards, the alterations of the scores between visits were statistically compared. Mean age of the 36 cases included in the study was 59.03±1.35. When the alterations in parameters of first visit and second visit were evaluated, we found a statistically significant increase in IIEF-5 and a statistically significant decrease in IPSS, IPSS-QOL (Quality of Life). In addition, when the cases were divided into two groups with and without asymptomatic inflammatory prostatitis, in the cases with asymptomatic inflammatory prostatitis, sildenafil citrate caused improvement only in ED, but had no effect on LUTS. Sildenafil citrate use in cases with LUTS and ED has an improving effect on LUTS as well as ED. However, in cases with asymptomatic inflammatory prostatitis, sildenafil citrate did not lead to an improvement in LUTS.     

Type 2 diabetes but not metabolic syndrome is associated with an increased risk of lower urinary tract symptoms and erectile dysfunction in men aged <45 years

Study Type – Prognosis (case series)
Level of Evidence 4

OBJECTIVE

To investigate the association of type 2 diabetes mellitus (T2DM) and metabolic syndrome with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in Taiwanese men aged <45 years.

PATIENTS, SUBJECTS AND METHODS

Voiding and erectile function in 226 men with T2DM, at one diabetes clinic, and 183 healthy men with normal fasting blood glucose levels, were compared. Participants were evaluated using the International Prostate Symptom Score (IPSS), the five‐item version of the International Index of Erectile Function questionnaire (IIEF‐5), and measurements of flow rate and postvoid residual urine volume. The association of metabolic syndrome with LUTS and ED was also evaluated.

RESULTS

The mean (sd , range) age of the patients was 38.9 (6.1, 20–45) years and the mean duration of diabetes was 2.8 (3.1, 0.5–20) years. Compared with controls, men with T2DM had a significantly mean (sd ) higher IPSS, of 6.1 (5.8) vs 4.1 (4.6) (P < 0.001), an increased of odds ratio (95% confidence interval) of having moderate to severe LUTS of 1.78 (1.12–2.84) (P = 0.01), greater voiding volume of 376 (177) vs 326 (102) mL (P = 0.04), a worse IIEF‐5 score of 17.3 (6.4) vs 20.0 (3.8) (P < 0.001), an increased of odds ratio of having moderate to severe ED of 3.5 (2.1–5.8) (P < 0.001) but a similar maximum flow rate and postvoid residual. The IIEF‐5 score was negatively correlated with the IPSS (P < 0.0001, coefficient = ?0.23, 0.35–0.11) and glycosylated haemoglobin (P = 0.02, coefficient = ?0.14, 0.26–0.01). In all, 156 (69%) patients met the criteria for metabolic syndrome. The mean age, duration of diabetes, glycosylated haemoglobin, IPSS, voided volume, maximum urinary flow rate and IIEF‐5 score were similar between patients with and without metabolic syndrome.

CONCLUSIONS

Men with T2DM and aged <45 years had more LUTS but a similar bladder emptying function than the controls. ED was highly prevalent and was associated with the severity of LUTS. Metabolic syndrome did not aggravate the severity of LUTS, emptying function or ED in the early stage of DM.     

Association between ED and LUTS in Japanese motorcyclists

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 >or=8). The IIEF-5 was significantly associated with the severity of IPSS (P=0.002) and age (P<0.0001). The IIEF-5 was also significantly associated with the scores of both voiding (P<0.0001) and storage symptoms (P=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.     

The relationship between lower urinary tract symptoms (LUTS), diagnostic indicators of benign prostatic hyperplasia (BPH), and erectile dysfunction in patients with moderate to severely symptomatic BPH

Purpose  To evaluate the relationship between lower urinary tract symptoms (LUTS), different diagnostic indicators of benign prostatic hyperplasia (BPH), and erectile dysfunction (ED) in a selected group of BPH patients with moderate-or-severe symptoms, for whom either transurethral or open prostatectomy was planned. Materials and methods  Between 2003 and 2006, 453 patients were included in this study. LUTS and ED were assessed by validated symptom scales. Maximum and average urine flow rates and post-void residual urine volumes (PVRU) of all patients were measured. Additionally, prostate volumes for all patients were detected with transrectal ultrasound (TRUS). Results  The incidence of LUTS and ED increased significantly with aging (P < 0.001). ED was reported to be 36% in men with moderate LUTS and 94% in men with severe LUTS (P < 0.001). The odds ratio for ED was 28.7 for severe LUTS. When age, IPSS, and IIEF scores were analyzed we observed that the occurrence of LUTS is an age-independent risk factor for the development of ED (P < 0.001). There was a positive correlation between IIEF score, Q _max (r = 0.441, P < 0.001), and Q _ave (r = 0.326, P < 0.001), and a negative correlation was found between IIEF score, prostate volume (r = -0.299, P < 0.001), and PVRU (r = -0.486, P < 0.001). Conclusions  The presence of LUTS, particularly severe LUTS, is an independent risk factor for ED. It is crucial to assess ED of the patient before BPH surgery, otherwise ED may be regarded as an outcome of the surgery rather than a preoperative, already existing condition.     

Are lower urinary tract symptoms associated with erectile dysfunction in aging males of Taiwan?

INTRODUCTION: This study was conducted to evaluate the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in aging males of Taiwan. PATIENTS AND METHODS: A free health screening for aging males (>or=45 years old) was conducted in Kaohsiung Medical University Chung-Ho Memorial Hospital in August 2004. LUTS and ED were assessed by validated symptom scales: the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function-5 (IIEF-5). The subjects also completed a health and demographics questionnaire and underwent detailed physical examination, serum prostate-specific antigen level determination, and transrectal ultrasonography. RESULTS: The final study population consisted of 141 patients with a mean age of 59.8 years. The severity of LUTS and ED increased with age. After controlling for comorbidities, age (p<0.001) and IPSS score (p<0.001) were significantly associated with the IIEF-5 score. Furthermore, men with moderate to high IPSS scores were more likely to have ED as compared with those with mild symptoms after age adjustment (age-adjusted odds ratio 3.27, p=0.002). CONCLUSIONS: ED and LUTS are highly prevalent in our study population, and this prevalence increases with age. ED is significantly associated with the severity of LUTS after controlling for age and comorbidities. These results highlight the clinical importance of evaluating LUTS in patients with ED and the need to consider sexual issues in the management of patients with benign prostatic hyperplasia.     

Erectile dysfunction (ED) is prevalent, bothersome and underdiagnosed in patients consulting urologists for benign prostatic syndrome (BPS)

OBJECTIVES: The aim of the present study was to determine the prevalence of erectile dysfunction (ED) in patients visiting office-based urologists in Germany because of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH), and to evaluate the impact of ED on quality of life (QoL) in these patients. METHODS: 500 office-based urologists in Germany were invited to evaluate 20 consecutive patients for erectile dysfunction, who presented because of BPH-related LUTS. Physicians provided information on demographic factors, duration and treatment history of BPH, severity of LUTS, ED risk factors, and assessed the patient for the clinical diagnosis of ED. Patients were asked to complete the German version of the IPSS to measure LUTS severity. ED-patients quantified erectile dysfunction and impact on quality of life with validated German questionnaires (Cologne assessment of male erectile dysfunction KEED, and Qol-Med). RESULTS: Office-based urologists were aware of ED in 37.3% of 8768 patients presenting for LUTS before the study, 14.7% of patients were treated for ED. After the study-related assessment, physicians diagnosed ED in 62.1% of these patients and planned treatment in 46.9%. Severity of LUTS and ED prevalence correlated significantly after age-stratification. The incidence of ED was increased in patients with established ED risk factors. Mean QoL-Med score (best QoL: 100, worst QoL: 0) was 53.8 in patients with ED and 50.1 in ED-patients considering treatment. CONCLUSION: ED is highly prevalent in LUTS patients visiting an office-based urologist and is accompanied by a profound impact on the quality of life. Apparently, even during an urological consultation many ED-patients are hesitant to actively ask for treatment. Sexual issues should become key considerations for physicians managing patients with LUTS, especially since effective and well established oral treatment for ED is available.     

Effects of three types of alpha‐1 adrenoceptor blocker on lower urinary tract symptoms and sexual function in males with benign prostatic hyperplasia

Objectives: The aim of the present study was to explore the effects of three different types of alpha‐1 adrenoceptor blockers (α1‐blocker) on lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and ejaculatory dysfunction (EjD) in patients with benign prostatic hyperplasia. Methods: A total of 136 male LUTS patients aged 50–80 years with International Prostate Symptom Score (IPSS) ≥8 were enrolled. They were divided into three groups. Group S received silodosin at 4 mg twice a day; group T received tamsulosin at 0.2 mg once a day; and group N received naftopidil at 50 mg once a day. Assessment included IPSS, quality of life indexes (QOL), International Index of Erectile Function (IIEF‐5), an ejaculation questionnaire, Qmax and post‐void residual urine volume (PVR). These parameters were recorded at baseline, and at 1 and 3 months after treatment had ended. Results: Mean IPSS and Qmax significantly improved after treatment in all groups without any significant difference among them. As for the IIEF‐5 score, only group N significantly improved at 1 and 3 months. After treatment, 2.6 and 2.4% of patients complained of a de novo reduced volume of ejaculation in both groups T and N, respectively. Ten out of 41 patients (24.4%) complained of a total absence of antegrade ejaculation in group S after treatment. Conclusions: All three types of α1‐blockers provided an objective and subjective improvement of LUTS in the present study population. However, erectile function only improved in patients treated with naftopidil and a higher rate of EjD was observed in those receiving silodosin. Because of their variable effects, we should consider the sexual dimension when prescribing α1‐blockers for LUTS.