title: Overactive bladder is associated with erectile dysfunction and reduced sexual quality of life in men.
abstract: BACKGROUND
  The prevalence of sexual dysfunction, including erectile dysfunction (ED), is greater in men with lower urinary tract symptoms (LUTS), including overactive bladder (OAB), than in men without LUTS.
  
  
  OBJECTIVE
  To evaluate the prevalence of ED, the impact of urinary symptoms on sexual activity and sexual enjoyment, and sexual satisfaction in men with OAB.
  
  
  METHODS
  A nested case-control analysis was performed on data from a subset of men with (cases) and without (controls) OAB frequency-matched for age (5-year age strata) and country from the EPIC study. Respondents were asked about OAB symptoms (using the 2002 International Continence Society [ICS] definitions) and sexual activity. Sexually active respondents were asked about ED, sexual enjoyment, and overall satisfaction with their sex lives. Conditional logistic regression was used to assess factors associated with ED.
  
  
  METHODS
  The percentage of cases and controls reporting ED, a reduction in the frequency of sexual activity or enjoyment of sexual activity because of urinary symptoms, and overall satisfaction with their sex lives was determined for cases and controls.
  
  
  RESULTS
  A total of 502 cases and 502 controls were matched for age strata and country. Significantly more cases (14%) reported reduced sexual activity because of urinary symptoms compared with controls (4%; P <or= 0.05). Among sexually active respondents, cases were significantly more likely to have ED than were controls (prevalence odds ratio, 1.5; 95% confidence interval, 1.1-2.2); the prevalence of ED was similar to that for men with hypertension or diabetes. Significantly more cases (15%) reported decreased enjoyment of sexual activity because of urinary symptoms relative to controls (2%; P <or= 0.05), and significantly fewer cases were satisfied with their sex lives (81% vs. 90%; P <or= 0.05).
  
  
  CONCLUSIONS
  OAB, as defined by the ICS, was significantly associated with increased prevalence of ED, reduced sexual activity and sexual enjoyment because of urinary symptoms, and reduced sexual satisfaction.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599, USA. dirwin@email.unc.edu
authors.forename: Debra E
authors.initials: DE
authors.lastname: Irwin
authors.forename: Ian
authors.initials: I
authors.lastname: Milsom
authors.forename: Kate
authors.initials: K
authors.lastname: Reilly
authors.forename: Steinar
authors.initials: S
authors.lastname: Hunskaar
authors.forename: Zoe
authors.initials: Z
authors.lastname: Kopp
authors.forename: Sender
authors.initials: S
authors.lastname: Herschorn
authors.forename: Karin S
authors.initials: KS
authors.lastname: Coyne
authors.forename: Con J
authors.initials: CJ
authors.lastname: Kelleher
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
authors.forename: Paul
authors.initials: P
authors.lastname: Abrams
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000523:psychology; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000523:psychology; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D012725:Sexual Behavior; D053201:Urinary Bladder, Overactive / Q000453:epidemiology* / Q000523:psychology; D014549:Urinary Incontinence / Q000453:epidemiology / Q000523:psychology