title: The role of BPH, lower urinary tract symptoms, and PSA levels on erectile function of Brazilian men who undergo prostate cancer screening.
abstract: BACKGROUND
  Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are common problems in middle-aged and older men. Recently, epidemiologic studies have shown significant associations between severity of LUTS and male sexual dysfunction.
  
  
  OBJECTIVE
  We analyzed the role of prostate enlargement, LUTS, and prostate specific antigen (PSA) levels in the erectile function of Brazilian men who underwent prostate cancer (PCa) screening.
  
  
  METHODS
  We analyzed data from 1,008 consecutive patients enrolled in a PCa screening program. Benign prostatic hyperplasia (BPH) was defined as a prostate weight greater than 30 g as defined by digital rectal examination. For statistical analysis, we used the chi-squared and analysis of variance tests. The odds ratios (OR) for correlation of ED with prostate volume LUTS and PSA were estimated using logistic regression models.
  
  
  METHODS
  The American Urological Association (AUA) symptom score for LUTS and the International Index of Erectile Function.
  
  
  RESULTS
  Mean patient age was 61.2 years (45-87) and median PSA value was 1.9 ng/mL. BPH was identified in 48.5% of patients. Mild, moderate, and severe LUTS were found in 52.3%, 30.9%, and 16.8% of cases, respectively. ED was classified as absent, mild, mild to moderate, moderate, and severe in 18.6%, 23.1%, 18.6%, 15.2%, and 24.5%, respectively. While only 5.4% of the patients with no ED presented severe LUTS, this finding was observed in 27.1% of patients with severe ED (P < 0.001). Univariate logistic regression analysis demonstrated that age, prostate volume, AUA symptom score, and PSA levels were significant predictors of ED. However, when controlled for patient age, only LUTS remained as an independent predictor of ED.
  
  
  CONCLUSIONS
  Controlling for patient age, LUTS are independent risk factors for the development of ED among Brazilian men who undergo PCa screening. Antunes AA, Srougi M, Dall'Oglio MF, Vicentini F, Paranhos M, and Freire GC. The role of BPH, lower urinary tract symptoms, and PSA levels on erectile function of Brazilian men who undergo prostate cancer screening.
authors.affiliation: University of Sao Paulo Medical School-Urology, Sao Paulo, Brazil.
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Antunes
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
authors.forename: Marcos F
authors.initials: MF
authors.lastname: Dall'oglio
authors.forename: Fabio
authors.initials: F
authors.lastname: Vicentini
authors.forename: Mario
authors.initials: M
authors.lastname: Paranhos
authors.forename: Geraldo C
authors.initials: GC
authors.lastname: Freire
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010410:Penile Erection; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D012307:Risk Factors; D014555:Urination Disorders / Q000175:diagnosis* / Q000503:physiopathology; D014563:Urodynamics
chemical_list: D017430:Prostate-Specific Antigen