Body Mass Index and its Association with Genitourinary Disorders in Men Undergoing Prostate Cancer Screening

Abstract

Introduction Elevated body mass index (BMI) may predispose to several pelvic pathologies. Aims We tested the association between BMI and five end points, namely, (i) erectile dysfunction (ED); (ii) lower urinary tract symptoms (LUTS); (iii) chronic prostatitis-associated pain (CPP); and ejaculatory dysfunction that is subdivided between (iv) pain/discomfort on ejaculation; and (v) subjectively decreased ejaculate volume. Methods Age, height, and weight were prospectively recorded in a cohort of 590 consecutive healthy men undergoing prostate cancer screening. Continuously coded and categorized BMI (World Health Organization classification) were studied. Main Outcome Measures Age-adjusted analyses relied on logistic and linear regression models, according to data type. Results The average age was 54.1 years (range 30–83). Of all, 296 were overweight (50.2%, BMI 25–29.9 kg/m2) and 85 were obese (14.4%, BMI ≥ 30 kg/m2). After age adjustment, elevated continuously coded BMI (P < 0.001) and elevated categorized BMI (P = 0.01) were associated with worse erectile function. Conversely, after age adjustment, elevated continuously coded BMI (P = 0.02) and elevated categorized BMI (P = 0.05) were associated with a lower rate of subjectively decreased ejaculate volume. Finally, after age adjustment, elevated categorically coded BMI was related to lower rates of CPP (P < 0.001) and to a lower rate of pain/discomfort on ejaculation (P = 0.03). Conclusions In men undergoing prostate cancer screening, the effect of BMI on the five end points is not invariably detrimental. Elevated BMI may predispose to ED, but may also decrease the rate of pain/discomfort on ejaculation and may lower the reported rate of subjectively decreased ejaculate volume. Finally, it appeared to have no effect on LUTS.

Importance of Baseline Potency Rate Assessment of Men Diagnosed with Clinically Localized Prostate Cancer Prior to Radical Prostatectomy

“…Likewise, it was a significant (P < 0.019) independent risk factor for ED. These findings could have been confirmed by Bhojani et al who reported that men with major depression were 5.8 times more likely to report poor or very poor erections [28]. If ED is responsible for depression or the other way around remains unclear.…”

Lifestyle and Risk of Chronic Prostatitis/Chronic Pelvic Pain Syndrome in a Cohort of United States Male Health Professionals

“…12–14 However, studies that investigated categories of overweight and obesity in relation to self-reported history of prostatitis showed protective findings 7,9 and those that examined overweight/obesity in relation to CP/CPPS or pain/discomfort with ejaculation showed mixed findings. 10,11,15 While reasons for these conflicting results are unclear, each of these studies was cross-sectional and several were small with minimal to no adjustment for covariates associated with metabolism or weight, such as physical activity, diet and smoking. In our large cohort study we observed no association between obesity and CP/CPPS risk before and after adjusting for other lifestyle factors.…”

Erectile dysfunction and hormonal imbalance in morbidly obese male is reversed after gastric bypass surgery: a prospective randomized controlled trial

“…Camps et al (1996) revealed that weight loss, that is attained through bariatric surgery, improves body image and sexuality, which are directly related to mood stability and inversely connected to depression. Bhojani et al (2008) reported that men with major depression were 5.8 times more likely to report poor or very poor erections. If ED is responsible for depression or the other way around remains unclear.…”