Lower urinary tract symptoms in patients with erectile dysfunction: is there a vascular association?

To assess if there is an underlying vascular association between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED).

A total of 374 male patients with ED were enrolled in this study. Patients were interviewed for ED using the International Index of Erectile Function. Assessments for penile vasculature using color Doppler ultrasonography and rigidometer were performed. All patients were also screened for LUTS using the International Prostate Symptoms Score. All patients underwent routine laboratory investigation, plus total testosterone and prolactin assessment.

Mean age+/-SD was 54.4+/-8.9 years with an age range of 28-84 years. Eighty-five percent of the patients had organic causes of ED. Of the patients, 80.7% had different degrees of LUTS. There was a significant association between presence of LUTS and: arteriogenic and neurogenic causes of ED, poor response to intracorporeal injection, poor rigidity in the rigidometer, and low peak systolic velocity of the cavernosal arteries (p < 0.05 for each). No significant association was found between presence of LUTS and increasing values of end diastolic velocity or decreasing values of resistive index of the cavernosal arteries (p > 0.05 for each). There was a significant association between the higher degrees of LUTS and the decreasing values of peak systolic velocity (p < 0.05).

This study demonstrated that reduced peak systolic velocity of the cavernous artery does associate with LUTS in patients with erectile dysfunction. Further studies are warranted to address the underlying vascular mechanisms of ED in patients with LUTS.