Anxiety and erectile function in men with urological disease: a cross-sectional couple-based study

This study examined psychological and clinical predictors of erectile function in men with urological conditions using a cross-sectional couple-based framework.

This cross-sectional secondary analysis included 109 men presenting with varicocele, erectile dysfunction as primary complaint, chronic prostatitis, or urinary stone disease, together with their partners. Male participants completed the International Index of Erectile Function-5 (IIEF-5), whereas both members of each couple completed the Hospital Anxiety and Depression Scale. They were classified using an IIEF-5 cut-off score of 17. Group comparisons were conducted using chi-square tests and t-tests. Patient-related and partner-related psychological variables were assessed using a couple-based multiple linear regression model controlling for diagnosis and demographic variables.

Patient anxiety scores differed significantly between the lower and higher erectile function groups and showed a negative correlation with IIEF-5 scores. In the regression model, patient anxiety remained independently associated with lower erectile function. No significant partner-related psychological associations were observed. The proportion of men with lower erectile function differed across the four diagnostic groups. Primary presenting urological diagnosis was also associated with IIEF-5 score, although this finding should be interpreted cautiously because erectile dysfunction itself was a diagnostic category.

Erectile function severity in this sample was mainly associated with patient anxiety and clinical characteristics, whereas partner psychological variables were not independently associated with IIEF-5 scores. Because of the cross-sectional design and the partial overlap between erectile dysfunction diagnosis and the IIEF-5 outcome, these findings should be interpreted as associative rather than causal.