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

Yohei Matsuda; Ko Kobayashi; Fumimasa Fukuta; Akio Takayanagi; Kohei Hashimoto; Toshiaki Tanaka; Naoya Masumori

doi:10.1016/j.esxm.2020.10.003

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

Sex Med. 2021 Apr;9(2):100275. doi: 10.1016/j.esxm.2020.10.003. Epub 2021 Feb 1.

Authors

Yohei Matsuda¹, Ko Kobayashi², Fumimasa Fukuta¹, Akio Takayanagi¹, Kohei Hashimoto¹, Toshiaki Tanaka¹, Naoya Masumori¹

Affiliations

¹ Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan.
² Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan. Electronic address: kou@sapmed.ac.jp.

Abstract

Introduction: Although an association between erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) has been suggested, it was not clarified whether LUTS developed before ED or vice versa.

Aim: To clarify whether LUTS develop before ED or vice versa and which symptoms predicted the onset of the other condition in a longitudinal community-based study.

Methods: We conducted a longitudinal community-based study on LUTS and ED in aged Japanese men. A follow-up study was conducted to determine their longitudinal changes of LUTS and ED after 15 years. Erectile function was evaluated using a validated questionnaire. LUTS were evaluated based on the International Prostate Symptom Score, quality of life index, and prostate volume.

Main outcome measure: We evaluated the baseline symptoms among the participants who had LUTS and ED in the follow-up survey and what prior symptoms could predict the onset of the other condition using the data from a long-term longitudinal survey.

Results: A total of 108 men were enrolled in this study. Of the 47 men having both LUTS and ED in the follow-up study, men having only LUTS (n = 16) were more frequent than those having only ED (n = 6) in the initial study. Likewise, of the 38 men having both nocturia and ED at the time of the follow-up study, those having only nocturia (n = 12) were more frequent than those having only ED (n = 5) in the initial study. In multivariable analysis, age 60 years or older (odds ratio: 7.10, 95% CI: 2.09-24.13) and nocturia (odds ratio: 15.83, 95% CI: 3.05-82.15) were independent predictors for the onset of ED.

Conclusion: There were more men with prior onset of LUTS, especially nocturia, than men with prior onset of ED among those with both ED and LUTS in this long-term longitudinal study. Nocturia may be a predictor of subsequent ED. Matsuda Y, Kobayashi K, Fukuta F, et al. Which Happens Earlier, Lower Urinary Tract Symptoms or Erectile Dysfunction?. J Sex Med 2021;9:100275.

Keywords: Benign Prostatic Hyperplasia; Community-Based Study; Longitudinal Study; Nocturia; Sexual Dysfunction.