The Association Between Vascular Risk Factors and Lower Urinary Tract Symptoms in Both Sexes

Ponholzer, Anton; Temml, Christian; Wehrberger, Clemens; Marszalek, Martin; Madersbacher, Stephan

doi:10.1016/j.eururo.2006.01.031

Cited by 164 publications

(179 citation statements)

References 23 publications

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“…42 In a recent epidemiologic study that supports this notion, both men and women who had two risk factors of atherosclerosis (diabetes mellitus, hypertension, hyperlipidemia and nicotine use) had a statistically significant higher IPSS compared with subjects with one or no risk factors. 43 Another epidemiologic study showed that men with risk factors for vascular disease are more likely to have a higher IPSS and a lower IIEF score than men without risk factors. 44 In a prospective office-based study, a total of 374 male patients with ED were enrolled to assess if there is an underlying vascular association between LUTS and ED.…”

Section: Luts and Ed: Pathophysiological Correlationsmentioning

confidence: 99%

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

2011

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There is strong evidence from multiple epidemological studies that lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are correlated, independent of age or comorbidities as diabetes or hypertension. Although a direct causal relationship is not established yet, four pathophysio logical mechanisms can explain the relationship. These include alteration in nitric oxide bioavailability, a1-adrenergic receptor hyperactivity, pelvic atherosclerosis and sex hormones. This association has different clinical implications on the management of both disorders. Men seeking care for one condition should always be screened for complaints of the other condition. Sexual function should be assessed and discussed with the patient when choosing the appropriate management strategy for LUTS, as well as when evaluating the patient's response to treatment. Multiple large clinical trials have shown an improvement in LUTS after phosphodiesterase-5 (PDE5)-inhibitor treatment. PDE5 inhibitors show promise as a future treatment for LUTS, either in conjunction with existing therapies or as a primary treatment. There may be a potential therapeutic role for testosterone in LUTS treatment in cases of testosterone deficiency that needs to be investigated. Much further investigation is required, but it is evident that the association between LUTS and ED is fundamental for future therapies and possible preventative strategies.

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Section: Luts and Ed: Pathophysiological Correlationsmentioning

confidence: 99%

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

2011

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“…Recent studies imply an important role of bladder ischemia and change of bladder blood flow (BBF) in the development and severity of LUTS and lower urinary tract dysfunction. Recent animal studies suggest that arterial occlusive disease such as atherosclerosis may cause lower urinary tract dysfunction via bladder ischemia, hypoxia and oxidative stress in the bladder 5,[6][7][8][9][10] . These reports show the possibility that atherosclerosis has a pathophysiological role in the development of male LUTS.…”

Section: Introductionmentioning

confidence: 99%

The impact of abdominal aortic calcification and visceral fat obesity on lower urinary tract symptoms in patients with benign prostatic hyperplasia

Motoya

Matsumoto

Yamaguchi³

et al. 2014

Int Urol Nephrol

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“…In a recent analysis of 1724 men with a mean age of 52.3 years, those with more than one major vascular risk factor had a significantly increased IPSS ( þ 24.2%), suggesting an impact of predisposing factors of atherosclerosis on the bladder and lower urinary tract. 21 This theory was also tested in animal models mimicking hypercholesterinemia and pelvic arterial stenosis to induce increased bladder outlet resistance due to smooth muscle loss with loss of compliance. 22 Furthermore, noradrenaline is involved in the contraction of penile tissue via activation of a-adrenergic receptors.…”

Section: Luts and Ed Links For Diagnosis Management And Treatment A mentioning

confidence: 99%

Lower urinary tract symptoms and erectile dysfunction; links for diagnosis, management and treatment

Ponholzer

Madersbacher

2007

Int J Impot Res

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Recent large-scale epidemiological studies have documented a strong association between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). This observation has two important scientific and clinical aspects: (i) to reveal the pathomechanism linking LUTS and ED and (ii) to consider this fact in the individual approach for diagnosis and management of these two disorders. The following hypotheses are under investigation to explain the relation between LUTS and ED: (i) an increased Rho-kinase activation, (ii) an a-adrenergic receptor imbalance, (iii) a decrease of NOS/ NO in the endothelium, (iv) atherosclerosis affecting the small pelvis and (v) an autonomic hyperactivity, each affecting simultaneously bladder, prostate and penis. According to a recent randomized trial, sildenafil has a positive effect on LUTS yet not on uroflowmetry in men with LUTS and ED. Although further trials are mandatory, phosphodiesterase-5 inhibitors might play a role in the management of LUTS in the future. a-Blockers have no relevant effect on erectile function, tamsulosin leads to retrograde ejaculation in up to 10%. 5a-Reductase inhibitors are associated with ED, loss of libido and reduction of ejaculate volume in up to 10%. Transurethral and open prostatectomy induce retrograde ejaculation in up to 90% of patients while their impact on erectile function is still controversially discussed. Minimal invasive treatment options (laser prostatectomy, transurethral microwave thermotherapy) have a lower rate of retrograde ejaculation in the range of 20-70%. LUTS and ED are strongly linked although the exact mechanism is poorly understood. Men seeking for help for LUTS/benign prostatic hyperplasia should be assessed for different aspects of sexual dysfunction and informed regarding the impact of medication and surgery on sexual health.

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The Association Between Vascular Risk Factors and Lower Urinary Tract Symptoms in Both Sexes

Cited by 164 publications

References 23 publications

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

The impact of abdominal aortic calcification and visceral fat obesity on lower urinary tract symptoms in patients with benign prostatic hyperplasia

Lower urinary tract symptoms and erectile dysfunction; links for diagnosis, management and treatment

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