Which Happens Earlier, Lower Urinary Tract Symptoms or Erectile Dysfunction?

Area of Science:

• Urology
• Andrology
• Gerontology

Background:

• The relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) is recognized, but the temporal sequence of their onset remains unclear.
• Understanding the chronological order is crucial for effective clinical management and patient counseling.

Purpose of the Study:

• To determine whether LUTS precede ED or vice versa in a longitudinal study.
• To identify specific symptoms that predict the onset of the other condition.

Main Methods:

• A 15-year longitudinal, community-based study involving aged Japanese men.
• Assessment of LUTS using the International Prostate Symptom Score and prostate volume.
• Evaluation of erectile function via a validated questionnaire.

Main Results:

• Among men with both LUTS and ED at follow-up, LUTS were more frequent initially than ED.
• Nocturia was a significant independent predictor of the onset of ED (OR: 15.83).
• Older age (≥60 years) also predicted ED onset (OR: 7.10).

Conclusions:

• Lower urinary tract symptoms, especially nocturia, tend to occur before erectile dysfunction in older men.
• Nocturia emerges as a potential predictive biomarker for the subsequent development of ED.
• This finding has implications for early identification and intervention strategies.