Factors associated with erectile dysfunction in men with lower urinary tract symptoms (LUTS): a Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) study

Background: Erectile function (EF) and its associated covariates have not been extensively studied in a large covariate of patients seeking treatment for lower urinary tract symptoms (LUTS). Our objective is to determine the relationship between urinary symptoms and comorbidities with erectile dysfunction (ED) in 447 treatment-seeking men with LUTS. Methods: Data from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) observational cohort study were analyzed using multivariable logistic regression models to quantify the relationship between LUTS and ED. Models also included anxiety, depression, obesity, cardiovascular disease (CVD), diabetes, and medication use. Results: Men reporting sexual activity were younger (median age 61 vs. 69 years) and had lower prevalence of diabetes and CVD (13% and 15%, respectively) compared with men reporting no sexual activity (24% for diabetes and 27% for CVD). Among sexually-active participants, higher odds of ED were associated with diabetes [odds ratio (OR) =2.4; 95% confidence interval (CI): 1.1–5.0], age (per 5 years, OR =1.4; 95% CI: 1.2–1.6), urinary incontinence (UI) (OR =1.2; 95% CI: 1.0–1.4), and anxiety (per 10 T-score units, OR =1.4; 95% CI: 1.0–2.1). Low erectile confidence was related to older age in non-sexually-active men (per 5 years, OR =1.5; 95% CI: 1.2–1.8). In sexually-active men, anxiety (per 10 T-score units, OR =1.6; 95% CI: 1.1–2.4), age (OR =1.3; 95% CI: 1.2–1.5), PDE5-inhibitor use (OR =2.1, 95% CI: 1.0–4.3), and diabetes (OR =2.2; 95% CI: 1.1–4.7) were also associated with low erectile confidence. Conclusions: The association of UI with ED highlights the importance of screening men with UI for ED. Modifiable health variables, such as anxiety and diabetes, were related to ED and erectile confidence in treatment-seeking men with LUTS.