The relationship between LUTS and sexual function

Lower urinary tract symptoms (LUTS) are common in middle-aged and elderly men and are frequently caused by an enlarged prostate. Increasing severity of LUTS may negatively affect patients' health-related quality of life (QoL) to varying degrees. Sexual function is an important aspect of QoL and studies show that sexual dissatisfaction increases with increased severity of LUTS. The ICS-BPH International Study of 1271 men aged 45 y and over who reported to one of 12 clinics examined the relationship between urodynamic parameters, LUTS, sexual dysfunction and QoL. Results showed that nearly 90% of men found that the effect of LUTS on their sex lives was a problem and 45% reported that their sex lives were spoilt by LUTS. Storage symptoms, in particular incontinence, had a greater association with sexual dysfunction than voiding symptoms. Similar results were reported in the ICS-BPH UK Community Study, which involved 423 men aged 40 y and over. In contrast, a French Community Study of 2011 men aged 50-80 y reported that symptoms of hesitancy, straining, reduced stream and wet underclothes were most strongly associated with sexual dysfunction. Sexuality is clearly of concern to men with LUTS and should be included in discussions on treatment decisions.