Correlation between Lower Urinary Tract Symptoms (LUTS) and sexual function in benign prostatic hyperplasia: impact of treatment of LUTS on sexual function.

INTRODUCTION: Although many reports have shown a relationship between lower urinary tract symptoms (LUTS) and sexual function (SF), it is not known which symptom(s) among LUTS should be treated to improve SF. AIM: Thus, the aim of this study was to investigate correlations between LUTS and SF and to determine which symptom(s) should be improved to increase SF. MAIN OUTCOME MEASURE: The correlation between the severity of LUTS and erectile dysfunction (ED) was investigated, and changes in LUTS were compared and analyzed to determine which symptom(s) should be eliminated to improve SF. METHODS: The correlation between LUTS and SF was investigated in 365 men (62.04 +/- 8.26) with benign prostatic hyperplasia. To measure the severity of the LUTS and ED, the International Prostate Symptom Score (IPSS), frequency of nocturia, uroflowmetry, residual urine, transrectal ultrasonography, and the International Index of Erectile Function (IIEF)-5 were performed at the first visit. After 3 months of treatment with alpha-blockers (n = 304), they were assessed again to evaluate the effectiveness of the treatment. RESULTS: All parameters of LUTS (IPSS, age, residual urine, uroflow rate, and nocturia) except prostate volume correlated significantly with the total and each domain of IIEF-5 (P < 0.01). After 3 months, the changed scores in the IPSS-VD domain and IPSS-quality of life (QoL) correlated significantly with the improvement in total IIEF-5 and the domains of IIEF-5 (P < 0.05). The changed rates of the mean uroflow correlated significantly with the improvement in total IIEF-5 and the EF domain (P < 0.05). CONCLUSION: Among the LUTS parameters, improvement in the IPSS-VD domain, IPSS-QoL, and mean uroflow significantly correlated with an increased score in the IIEF-5 EF domain. Thus, it is expected that the improvement of voiding symptoms and uroflow will be associated with the improvement in erectile function.

Sexual dysfunction in male stroke patients: correlation between brain lesions and sexual function.

OBJECTIVES: To identify the sexual function of, and effect of the location of brain lesions on sexual function in, stroke patients. METHODS: We conducted a survey on 109 stroke patients (64.93 +/- 8.81 years) and 109 age-matched controls (64.69 +/- 8.85 years). We used a questionnaire that included the five-item version of the International Index of Erectile Function (IIEF-5) and questions about changes in sexual desire, ejaculatory function, and sexual satisfaction after a stroke. We analyzed the correlation between the results of the questionnaire and the locations of brain lesions. RESULTS: Erectile function was significantly decreased in the stroke patient group (IIEF-5, 5.89 +/- 7.08) compared with the control group (IIEF-5, 10.67 +/- 7.10). In most patients, the frequency of intercourse and sexual desire decreased after stroke, and an ejaculation disorder accompanied intercourse, but fear regarding intercourse was not severe. A lack of sexual desire was the largest cause (59.4%) of an absence of sexual intercourse. In cases with lesions in the right cerebellum and the left basal ganglia, a significant ejaculation disorder and decrease of sexual desire were more likely to occur, respectively. CONCLUSIONS: The sexual desire, erectile function, and ejaculatory function were impaired after stroke. A lack of sexual desire was the major cause of an absence of sexual intercourse. The specific locations of the stroke lesions, such as the left basal ganglia and right cerebellum, might be associated with sexual desire and ejaculation disorder, respectively.