Association between erectile dysfunction and lower urinary tract symptoms due to benign prostatic hyperplasia in...

Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) are highly prevalent in aging men. It is also necessary to evaluate ED before and subsequent to treatment intervention, when a patient presents with BPH. Current evidence suggests that there is an association between these two clinical conditions independent of age and comorbidities. No study from our environment has looked at this possible association which is therefore the aim of this study.

132 patients who presented to our urology clinic for evaluation of LUTS/BPH were requested to complete the International Prostate Symptoms Score (IPSS) and International Index for Erectile Function-5 (IIEF-5) questionnaires. Their comorbidities were also noted. Data were evaluated with SPPS 14.0 software and a p value <0.05 was considered significant.

The mean age of the patients was 64.8 (range 46-84) years. ED and LUTS/BPH significantly correlated with the age of the patients. ED was present in 71% of the patients. The second question in the IIEF-5 questionnaire (How would you rate your ability to have an erection hard enough for penetration?) showed a significant correlation with total IPSS score (p = 0.022) while the total ED score and other questions showed only weak correlations that did not reach significant levels. However, the sum of the obstructive symptoms scores (p < 0.001), unlike the sum of the irritative symptoms scores (p = 0.202), showed a significant correlation with ED scores. In addition, there was a significant correlation between the quality of life (QOL) due to urinary symptoms and ED scores.

ED is highly prevalent and related to LUTS/BPH among our patients. The high prevalence may be due to the obstructive urinary symptoms therefore providing a possible link between BPH and ED through the increased alpha-adrenergic outflow from the pelvis. The poor QOL associated with LUTS/BPH may also result in ED. It is hoped that this study would form groundwork for further research in this area in our environment.