LUTS and Sexual Function
LUTS associated with BPH are often
accompanied by sexual dysfunction,
including erectile dysfunction (ED)
and ejaculatory problems. Interest in
sexual intercourse declines with severity
of LUTS. Men with more severe
LUTS have significantly lower libido,
greater difficulty maintaining an
erection, and lower levels of sexual
satisfaction than men with less severe
LUTS. O’Leary showed that, in men
with LUTS, the severity of urinary
symptoms appears to exert the greatest
influence on the degree of sexual
dysfunction.4 Burger and colleagues
found evidence of a correlation
between sexual desire, erectile reliability,
and sexual satisfaction and the
degree of baseline symptoms.5
According to the U.S. National
Health and Social Life Survey, both
premature ejaculation difficulties and
ED are associated with LUTS.6 Frankel
and colleagues reported that men
with storage-related complications
from LUTS, particularly incontinence,
had approximately twice the
probability of experiencing sexual
dysfunction, especially impotence, as
men without such complications.7 It is
unclear whether the sexual dysfunction
that occurs with LUTS is due to
sleep disturbance, anxiety, or a physiologic
effect.8 The impact of ED the
emotional distress that often accompanies
it must be differentiated from
LUTS, highlighting the need for several
different diagnostic tools when
evaluating a patient.