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Erectile dysfunction and lower urinary tract symptoms secondary to BPH

McVary KT; Eur Urol 2005;47:838-845

KEY WORDS: BPH; LUTS; Erectile dysfunction; ED; Prostate; Penis; Autonomic hyperactivity

The relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) have received increased attention recently because both diseases are highly prevalent, frequently co-associate in the same aging male group, and contribute significantly to the overall quality of life. The association between these two diseases has also garnered attention in order to verify the hypotesis of a common pathophysiology.

• Causal association between LUTS and ED cannot be established on the basis of the ever-increasing number of epidemiological studies. Attempting to explain a causal relationship between ED and LUTS needs to be examined using Hill's criterion, which is used by many epidemiologists to separate causal from non-causal explanations
• The link between ED and LUTS has biologic plausibility given the four leading theories of how these diseases interrelate. These explanations fall into four theories each with a variable amount of supporting data.
• Several studies have attempted to assess the relationship between ED and LUTS by treating one symptom (i.e. ED) and measuring the impact on the other disease (i.e. LUTS). This positive effect appears to affect outcomes regardless of which disease is treated primarily, thus suggesting a common etiology or mechanism. But the patient bother attributable to this effect is less clear.

See the abstract

http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15925081&dopt=Abstract