Association between Nocturnal Frequency and Erectile Function in Eugonadal Men with Benign Prostatic Obstruction: A...

Area of Science:

• Urology
• Andrology
• Sleep Medicine

Background:

• Benign prostatic obstruction (BPO) is common in aging men.
• Nocturnal voiding (nocturia) is a significant lower urinary tract symptom associated with BPO.
• Erectile dysfunction (ED) is a prevalent condition affecting quality of life.

Purpose of the Study:

• To investigate the association between nocturnal voiding frequency and erectile dysfunction in men with BPO.
• To explore the relationship between nocturia, sleep-related erections (SRE), and objective measures of erectile function.

Main Methods:

• Simultaneous evaluation of urodynamic studies, prostate ultrasound, nocturnal penile tumescence testing (NPT), International Prostate Symptom Score (IPSS), and the 5-item International Index of Erectile Function (IIEF-5).
• Exclusion of patients with hypogonadism or nocturnal polyuria.
• Analysis of correlations between nocturia, SRE parameters (frequency, duration, rigidity activity units [RAU], tumescence activity units [TAU]), and IIEF-5 scores.

Main Results:

• Nocturia severity was significantly correlated with lower total IIEF-5 scores (p<0.001).
• Increased nocturia was associated with reduced SRE frequency (p=0.003) and duration (p=0.002).
• Nocturia and reduced bladder compliance correlated with objective SRE measures (RAU and TAU), which also related to subjective erectile function (IIEF-5).

Conclusions:

• Sleep fragmentation caused by BPO-related nocturia can impair SRE.
• Reduced frequency and duration of SRE, linked to nocturia and decreased bladder compliance, negatively impact erectile function.
• Nocturia is a significant factor contributing to erectile dysfunction in men with BPO.