title: Erectile dysfunction (ED) is prevalent, bothersome and underdiagnosed in patients consulting urologists for benign prostatic syndrome (BPS).
abstract: OBJECTIVE
  The aim of the present study was to determine the prevalence of erectile dysfunction (ED) in patients visiting office-based urologists in Germany because of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH), and to evaluate the impact of ED on quality of life (QoL) in these patients.
  
  
  METHODS
  500 office-based urologists in Germany were invited to evaluate 20 consecutive patients for erectile dysfunction, who presented because of BPH-related LUTS. Physicians provided information on demographic factors, duration and treatment history of BPH, severity of LUTS, ED risk factors, and assessed the patient for the clinical diagnosis of ED. Patients were asked to complete the German version of the IPSS to measure LUTS severity. ED-patients quantified erectile dysfunction and impact on quality of life with validated German questionnaires (Cologne assessment of male erectile dysfunction KEED, and Qol-Med).
  
  
  RESULTS
  Office-based urologists were aware of ED in 37.3% of 8768 patients presenting for LUTS before the study, 14.7% of patients were treated for ED. After the study-related assessment, physicians diagnosed ED in 62.1% of these patients and planned treatment in 46.9%. Severity of LUTS and ED prevalence correlated significantly after age-stratification. The incidence of ED was increased in patients with established ED risk factors. Mean QoL-Med score (best QoL: 100, worst QoL: 0) was 53.8 in patients with ED and 50.1 in ED-patients considering treatment.
  
  
  CONCLUSIONS
  ED is highly prevalent in LUTS patients visiting an office-based urologist and is accompanied by a profound impact on the quality of life. Apparently, even during an urological consultation many ED-patients are hesitant to actively ask for treatment. Sexual issues should become key considerations for physicians managing patients with LUTS, especially since effective and well established oral treatment for ED is available.
authors.affiliation: Department of Urology, Hospital Barmherzige Brüder, Technical University Munich, Romanstr. 93, 80639 München, Germany.
authors.forename: C E
authors.initials: CE
authors.lastname: Hoesl
authors.forename: E M
authors.initials: EM
authors.lastname: Woll
authors.forename: M
authors.initials: M
authors.lastname: Burkart
authors.forename: J E
authors.initials: JE
authors.lastname: Altwein
mesh_terms: D007172:Erectile Dysfunction / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011470:Prostatic Hyperplasia / Q000150:complications*; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires