Body mass index and its association with genitourinary disorders in men undergoing prostate cancer screening

Elevated body mass index (BMI) may predispose to several pelvic pathologies.

We tested the association between BMI and five end points, namely, (i) erectile dysfunction (ED); (ii) lower urinary tract symptoms (LUTS); (iii) chronic prostatitis-associated pain (CPP); and ejaculatory dysfunction that is subdivided between (iv) pain/discomfort on ejaculation; and (v) subjectively decreased ejaculate volume.

Age, height, and weight were prospectively recorded in a cohort of 590 consecutive healthy men undergoing prostate cancer screening. Continuously coded and categorized BMI (World Health Organization classification) were studied.

Age-adjusted analyses relied on logistic and linear regression models, according to data type.

The average age was 54.1 years (range 30-83). Of all, 296 were overweight (50.2%, BMI 25-29.9 kg/m(2)) and 85 were obese (14.4%, BMI > or = 30 kg/m(2)). After age adjustment, elevated continuously coded BMI (P < 0.001) and elevated categorized BMI (P = 0.01) were associated with worse erectile function. Conversely, after age adjustment, elevated continuously coded BMI (P = 0.02) and elevated categorized BMI (P = 0.05) were associated with a lower rate of subjectively decreased ejaculate volume. Finally, after age adjustment, elevated categorically coded BMI was related to lower rates of CPP (P < 0.001) and to a lower rate of pain/discomfort on ejaculation (P = 0.03).

In men undergoing prostate cancer screening, the effect of BMI on the five end points is not invariably detrimental. Elevated BMI may predispose to ED, but may also decrease the rate of pain/discomfort on ejaculation and may lower the reported rate of subjectively decreased ejaculate volume. Finally, it appeared to have no effect on LUTS.