The evolving relationship of erectile dysfunction and lower urinary tract symptoms

Abstract

Previously viewed as independent processes, erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) frequently co-associate and significantly influence the overall quality of life of men. Analysis of historical and emerging literature, using some of the Bradford Hill criteria, argues for a causal link between the two disease processes. Four mechanisms are proposed to explain the relationship between ED and LUTS. Understanding this relationship is crucial for several reasons: 1) additional information on risk factors for either disease could be important for patient screening; 2) the pool of affected men is increasing, given the age demographics in many societies; 3) sexual problems related to LUTS are not necessarily limited to ED; and 4) many medical or surgical treatments for one disorder affect the other.