INTRODUCTION: An epidemiological association between Lower Urinary Tract Symptoms (LUTS) and Erectile Dysfunction (ED) is well established.
However, interactions between multiple risk factors and the role of each one in pathological mechanisms are not fully elucidated.
METHODS: We enrolled 898 men undergoing prostate cancer screening for evaluation with the IPSS and IIEF-5 questionnaires. Age, race, hypertension, diabetes, dyslipidemia, metabolic syndrome, cardiovascular disease, serum hormones and anthropometric parameters were also evaluated. Risk factors for ED were identified on logistic regression. Men with at least mild-to-moderate ED (IIEF≤ 16; n=333) were included in a Latent Class Model to identify relationships between risk factors for ED.
RESULTS: Age, hypertension, diabetes, LUTS and cardiovascular event were independent predictors of ED(p< 0.05). Three latent classes (LC) of patients with ED were identified(Entropy=0.82). LC1 had younger subjects, with low cardiovascular risk and moderate/high prevalence of LUTS. LC2 had the oldest patients, with moderate cardiovascular risk and elevated prevalence of LUTS. LC3 included subjects with intermediate age and the highest prevalence of cardiovascular risk factors and LUTS. LUTS and ED severity increased from LC1 to LC3.
CONCLUSION: Risk factor interactions determined different severities of LUTS and ED. The effect of LUTS and cardiovascular risk outweighed that of age. While for youngest patients LUTS acted as a lone risk factor for ED, the contribution of vascular disease resulted in significantly more severe dysfunction. The application of a risk factor interaction model to prospective trials could reveal distinct classes of response to drugs and help define optimal treatment strategies for specific groups.
Written by:
Barbosa JA, Muracca E, Nakano E, Assalin AR, Cordeiro P, Paranhos M, Cury J, Srougi M, Antunes AA. Are you the author?
University of Sao Paulo Medical School, Division of Urology.
Reference: J Urol. 2013 May 28. pii: S0022-5347(13)04413-3.
doi: 10.1016/j.juro.2013.05.048
PubMed Abstract
PMID: 23727187
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