Abstract

Introduction: Lower urinary tract symptoms (LUTS) associated with BPH and erectile dysfunction (ED)

are common problems in aging male. In this study, we aimed to determine the causes of the relationship

between LUTS and ED, and the possible effects of body mass index (BMI), serum leptin, free testosterone (fT)

and lipid levels on LUTS and ED etiology.

Materials and Methods: Between June 2003 and February 2004, 46 patients were recruited in this study.

All patients underwent physical examination including digital rectal examination, urine analysis,

uroflowmetry and residual urine volume assessment. Serum leptin, lipid and free testosterone levels were

analyzed. All patients’ BMI were determined. Thirty-three patients received alpha blocker treatment and 13

patients were in the watchful waiting group. Erectile capacity and voiding symptoms of the patients were

analyzed with International Index of Erectile Function (IIEF-5), International Prostate Symptom Score

(IPSS), respectively before and after alpha blocker treatments. Ejaculatory function was assessed with Danish

Prostate Symptom Score sexual-function questionnaire (DAN-PSSsex). Data were analyzed using the Pearson

correlation test, Mann-Whitney test and Kruskal-Wallis test.

Results: There was a negative correlation between IPSS and IIEF (p<0.05). The incidences of ED in

patients with LUTS were 50%, 81.8% and 69.2% in patients with mild, moderate and severe symptom,

respectively. The frequency of erectile dysfunction was very high in patients especially with moderate

symptoms. After alpha blocker treatment the percentage of patients with mild symptoms decreased, but those

with moderate and severe symptoms increased. In our study there was no significant correlation between IIEF

and fT levels but the mean level of fT in patients with ED was under 15 ng/ml. There was no correlation

between serum lipid levels and the other parameters.

Conclusion: There is a strong correlation between LUTS and ED. As the severity of LUTS increases the

incidence of ED increases. Alpha blocker treatment seems to slightly increase the incidence of ED and

ejaculatory problems. Patients with LUTS and ED have lower levels of fT, but this is not statistically

significant. There is no correlation between serum lipids and other parameters. Leptin levels might be

important in predicting LUTS and ED relationship for future research.