What is the relationship between male sexual function and lower urinary tract symptoms (LUTS)?

There is considerable current interest in the relationship between LUTS and sexual function in men, and in particular whether there is a causative relationship between them. This observational study, performed in a single centre, seeks to explore this area further.

1,420 patients attending a prostate assessment clinic were assessed by International Prostate Symptoms Score (IPSS), BPH impact index (BPH-II), Urinary flow rate (Q(max)), post-void residual volume (PVR) and the O'Leary sexual questionnaire (which assesses erectile, ejaculatory and sexual drive). The results were analyzed using univariate and multivariate techniques.

Following exclusion of those with incomplete data, those who were not sexually active, those with PSA >20 ng/ml and those who refused to fill in the questionnaire, there were 696 evaluable patients. Using univariate techniques, age, IPSS, Quality of life (QOL), BPH-II, Q(max) and PVR all correlated with differing domains of sexual function including erectile and ejaculatory function. Multiple regression analysis demonstrated that age was overwhelmingly the most important predictor of sexual function, but that BPH-II and QOL were also predictive for some domains, while the IPSS score was not.

This study confirms that a significant proportion of men with LUTS have sexual dysfunction. The relationship is complex and differs according to the type of sexual dysfunction.