Association between lower urinary tract symptoms and erectile dysfunction.

Objectives: To assess whether the association between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) is confounded by age or whether LUTS represent an independent risk factor for ED.

Methods: Men aged 20 to 80 years, who were participating in a health-screening project in the area of Vienna, completed the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function-5. In parallel, all men underwent a detailed health evaluation, including physical examination, evaluation of various lifestyle factors, and a blood laboratory study with 14 parameters.

Results: Within the total study population (n = 2858; mean age 45.8 years, range 20 to 80), the prevalence of LUTS and ED increased statistically significantly with age (P <0.0001). In multivariate analysis controlling for age, comorbidities, and lifestyle, the IPSS (P = 0.0001), the obstructive score of the IPSS (P = 0.0001), nocturia (P = 0.04), and the LUTS bother score (P = 0.002) correlated statistically significantly with the presence of ED (International Index of Erectile Function-5 score less than 22). The odds ratio for the presence of ED was 2.2 (95% confidence interval [CI] 1.8 to 2.8) for LUTS (IPSS greater than 7), 2.0 (95% CI 1.7 to 2.4) for voiding symptoms, 1.4 (95% CI 1.1 to 1.7) for nocturia (score greater than 2), and 2.5 (95% CI 2.0 to 3.1) for the LUTS bother score.

Conclusions: The presence of LUTS, in particular voiding symptoms, nocturia, and the quality-of-life impairment due to LUTS, is an independent risk factor for the presence of ED. These findings have implications for the treatment of elderly men with LUTS and open a new area for research.