Study documents effect of LUTS on erectile function

"The idea has been bantered about for years that the worse off your urinary symptom scores are, the more problems you're going to have with erectile function. We're the first to really put it down on paper to say, yes, there is a correlation," said presenter Jesse Mills, MD, a urology resident at the University of Colorado Health Sciences Center in Denver.

The researchers, including lead author E. David Crawford, MD, evaluated LUTS and sexual function in 6,078 men who were screened for prostate cancer in 2003 and who completed two different questionnaires-the American Urological Association Symptom Score and the Sexual Health Inventory for Men (SHIM). Age and race were assessed as independent factors affecting the SHIM score. The mean age of the patients was 60.2 years (±9.8 years); 4,938 were Caucasian (81%), and 1,140 were African-American (19%).

Age showed an inverse correlation with the SHIM score (p<.001). Men in their 40s had a mean SHIM score of 20, men in their 50s had a mean SHIM score of 18, and those in their 60s had a mean SHIM score of 15.

On average, African-American men had a .85 lower SHIM score than Caucasian men matched by age and a lower AUA Symptom Score (p<.001). African-American men had at least a 0.85 lower SHIM score than age-matched Caucasians.

Clinical usefulness

Data that point to a relationship between LUTS and sexual health have several uses.

"If somebody comes to you with obstructive voiding symptoms and their AUA symptoms scores are above 7, then they're already in a moderate risk group for erectile dysfunction," Dr. Mills said. "You can bring up the topic of erectile dysfunction, and then say by treating your lower urinary tract symptoms, we may have a positive effect on your erectile function, as well."

Having definitive evidence of the relationship between LUTS and ED can also be useful for future research on both conditions, according to Dr. Mills.

"The next step is going to the bench and developing an animal model where you simulate lower urinary tract symptoms and somehow intervene and see whether something measurable-like the cavernosal artery flow to the penis-will be affected by modulating your bladder outlet obstruction," he said.