Common approach to managing lower urinary tract symptoms and erectile dysfunction

Taylor, Jennifer; DeSouza, Rowena; Wang, Run

doi:10.1111/j.1745-7262.2008.00355.x

Cited by 16 publications

(18 citation statements)

References 60 publications

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“…[53] There are growing evidences that LUTS/BPH and ED are frequently co-associated. [9,10,54,55] Indeed, the mean IIEF-5 score of 2433 participants in the current review is less than 19, suggesting they had moderate to severe ED, which is consistent with the results reported by Miner et al [12] .…”

Section: Discussionmentioning

confidence: 99%

The impact of surgical treatments for lower urinary tract symptoms/benign prostatic hyperplasia on male erectile function

Chen

Wang

et al. 2016

Medicine

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Lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) is common in adult men and can impair erectile function (EF). It was believed surgical treatments for this illness can improve EF due to the relief of LUTS while they were also reported harmed EF as heating or injury effect. Current network meta-analysis aimed to elucidate this discrepancy.Randomized controlled trials (RCTs) were identified. Direct comparisons were conducted by STATA and network meta-analysis was conducted by Generate Mixed Treatment Comparison. Random-effects models were used to calculate pooled standard mean difference and 95% confidence intervals and to incorporate variation between studies.Eighteen RCTs with 2433 participants were analyzed. Nine approaches were studied as transurethral resection of the prostate (TURP), plasmakinetic resection of the prostate (PKRP), plasmakinetic enucleation of the prostate (PKEP), Holmium laser enucleation of the prostate (HoLEP), Holmium laser resection of the prostate (HoLRP), photoselective vaporization of the prostate (PVP), Thulium laser, open prostatectomy (OP), and laparoscopic simple prostatectomy (LSP). In direct comparisons, all surgical treatments did not decrease postoperative International Index of Erectile Function (IIEF)-5 score except PVP. Moreover, patients who underwent HoLEP, PKEP, Thulium laser, and TURP had their postoperative EF significantly increased. Network analysis including direct and indirect comparisons ranked LSP at the highest position on the variation of postoperative IIEF-5 score, followed by PKRP, HoLEP, TURP, Thulium laser, PKEP, PVP, HoLRP, and OP. In subgroup analysis, only PVP was found lower postoperative EF in the short term and decreased baseline group, whereas TURP increased postoperative IIEF-5 score only for patients with normal baseline EF. However, HoLEP and PKEP showed pro-erectile effect even for patients with decreased baseline EF and short-term follow-up. Our novel data demonstrating surgical treatments for LUTS/BPH showed no negative impact on postoperative EF except PVP. Moreover, HoLEP and PKEP were found pro-erectile effect for all subgroups. New technologies, such as LSP, PKRP, and Thulium laser, were ranked at top positions in the network analysis, although they had no pro-erectile effect in direct comparison due to limited original studies or poor baseline EF. Therefore, further studies and longer follow-up are required to substantiate our findings.

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Section: Discussionmentioning

confidence: 99%

The impact of surgical treatments for lower urinary tract symptoms/benign prostatic hyperplasia on male erectile function

Chen

Wang

et al. 2016

Medicine

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“…The pathophysiological mechanism of the correlations among LUTS, ED, and PE remains unclear, although several hypotheses have been proposed [18-21]. One possible cause is overactivation of the autonomic nervous system and increased sympathetic nervous system activity.…”

Section: Discussionmentioning

confidence: 99%

“…ED occurs as a result of smooth muscle contraction in the corpus cavernosum. PE occurs as a result of smooth muscle contraction in the prostate, seminal vesicle, vas deferens, and epididymis [18-21]. …”

Section: Discussionmentioning

confidence: 99%

Assessing Quality of Life Related to Voiding Symptoms and Sexual Function in Menopausal Women

Kang

Yoon

et al. 2012

Korean J Urol

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Purpose To evaluate the correlation between lower urinary tract symptoms (LUTS) and premature ejaculation (PE) in Korean men older than 40 years. Materials and Methods In total, 258 men older than 40 years completed the International Prostate Symptom Score (IPSS; total score, storage symptoms [ST], and voiding symptoms [VD]), a 5-item version of the International Index of Erectile Function (IIEF-5), and the Premature Ejaculation Diagnostic Tool (PEDT). The study examined the relationship between LUTS and PE. In the PEDT, PE is defined as a score ≥11. Results The prevalence of PE was 29.1% with the PEDT versus a self-reported value of 49.5%. The prevalence of PE was 30.9% in 40 to 59-year-old men (21.3%) and 28.1% in 60 to 79 year-old men (78.7%). In men 40 to 59 and 60 to 79 years old, the mean PEDT, IPSS, and IIEF-5 scores were 8.65 and 7.88, 13.5 and 12.38, and 15.83 and 13.69, respectively. No significant correlations were observed between the total and subscale scores of the IPSS (p=0.204) and the PEDT (p=0.309) with increasing age, whereas a significant negative correlation was detected between the IIEF-5 and age (p=0.002). The PEDT score was significantly correlated with the IPSS-ST (r=0.326, p<0.001), IPSS-VD (r=0.183, p=0.005), IPSS-total (r=0.310, p<0.001), and IIEF-5 total (r=-0.248, p<0.001). Conclusions LUTS, especially storage symptoms, were related to PE. In elderly men, control of both erectile dysfunction and LUTS may play an important role in managing PE.

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“…In addition to improving sexual satisfaction, treating ED with PDE5-I can partially relieve symptoms of benign prostatic hyperplasia,20 which is highly prevalent in aging males. This outcome will undoubtedly prompt more aging males to receive ED treatment because of the advantages of simultaneously treating frustrating lower urinary tract symptoms and ED.…”

Section: Discussionmentioning

confidence: 99%

Medical management of erectile dysfunction in aging males: is it too late to treat?

Zhang

Liu

et al. 2014

Asian J Androl

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Erectile dysfunction (ED) is a common disorder among aging males. However, most aging males refuse to seek medical help and believe that ED is an irreversible event in the aging process. The purpose of this study was to describe the current medical management of ED in aging males and to examine whether it is too late to treat this disorder in these elderly men. From 2007 to 2008, 4507 patients diagnosed with ED were gathered from 46 centers in China; 4241 completed the study, 3837 of whom were treated with sildenafil. The 3837 patients were divided into five groups based on age (group A: 20–30 years; group B: 31–40 years; group C: 41–50 years; group D: 51–60 years; and group E: >60 years). After comparing pre- and posttreatment International Index of Erectile Function-Erectile Function domain (IIEF-EF) questionnaires, Erection Hardness Scale (EHS), and IIEF Q13 (“How satisfied have you been with your overall sex life?”), we discovered that the aging males had worse erectile function, erection hardness, and sexual satisfaction than the younger males (P < 0.001). After treatment, the improvement rates in the IIEF-EF, EHS, and IIEF Q13 scores were 107.0%, 83.1%, and 116.5%, respectively. The magnitude of these changes demonstrated significant differences among groups (P < 0.001). Accordingly, aging males are likely to benefit more from medical treatment. We propose that aging males should be informed that age is not a limiting factor for medical ED management, and it is never too late to treat.

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Common approach to managing lower urinary tract symptoms and erectile dysfunction

Cited by 16 publications

References 60 publications

The impact of surgical treatments for lower urinary tract symptoms/benign prostatic hyperplasia on male erectile function

The impact of surgical treatments for lower urinary tract symptoms/benign prostatic hyperplasia on male erectile function

Assessing Quality of Life Related to Voiding Symptoms and Sexual Function in Menopausal Women

Medical management of erectile dysfunction in aging males: is it too late to treat?

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