Effects of components of metabolic syndrome on sexual function in Korean BPH/LUTS patients.

Introduction: There are limited data concerning the association between components of metabolic syndrome and sexual function in men aged 40 years and older in Korean benign prostatic hyperplasia (BPH) patients.

Aim: To examine the effects of metabolic markers on sexual function in Korean BPH patients and to evaluate obesity as a causal factor for the development of BPH and sexual dysfunction in a large population of Korean men.

Methods: This is a multicenter, cross-sectional, prospective study conducted at four centers in Korea. A total 602 men with LUTS secondary to BPH were included. BPH/LUTS cases were men with international prostate symptom scores (IPSS) >or=8 points and prostate volume >or=20 cc by transrectal ultrasound of the prostate. Height, weight, and waist circumference were measured. Trained interviewers using the structured Male Sexual Health Questionnaire (MSHQ) and International Index of Erectile Function (IIEF-15) collected information on sexual function.

Main Outcome Measures: Sexual function using IIEF-15 and MSHQ was assessed according to presence of diabetes mellitus (DM) or hypertension, waist circumference and BMI.

Results: BPH patients with DM or hypertension had significantly lower sexual function, and satisfaction scores on the MSHQ were significantly lower in BPH patients with hypertension. In the central obesity group, prostate volume was significantly greater compared to the normal waist group (P = 0.01). Moreover, in Korean BPH/LUTS patients, central obesity was significantly related to sexual function. BPH/LUTS represented by IPSS was significantly correlated with prostate volume and MSHQ and IIEF-15 scores. In addition, severe LUTS was significantly related to all domains of the MSHQ.

Conclusions: This study provides evidence that in the Korean population, sexual function is more closely associated to central obesity than general obesity. The relationship of comorbidities such as diabetes, hypertension, and sexual dysfunction determined by the MSHQ correlated with that determined by the IIEF-15.