title: Association between severity of lower urinary tract symptoms, erectile dysfunction and metabolic syndrome.
abstract: BACKGROUND
  The purpose of this study was to investigate the association between severity of lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and metabolic syndrome.
  
  
  METHODS
  Our study population included a consecutive series of 190 patients with LUTS (International Prostate Symptom Score-IPSS >7) with or without manifestations of the metabolic syndrome. The diagnoses of diabetes mellitus and hypertension were obtained from the patient's medical history. Data on blood pressure, waist measure, body height and weight were collected and body mass index were calculated. Patients were assessed based on the International Index of Erectile Function (IIEF) for ED and IPSS and IPSS-Quality of Life for LUTS. Blood samples were drawn from fasting patients to determine, fasting blood glucose (FBG), triglycerides, HDL-cholesterol and serum total testosterone levels.
  
  
  RESULTS
  In severe LUTS patient group, IIEF erectile function domain scores were significantly lower than moderate LUTS patient group (p < 0.05). Multiple logistic regression analysis confirmed that presence of ED was the most predictor of severe LUTS. The prevalence of metabolic syndrome was higher in patients with severe LUTS (26%vs. 46%, p = 0.009). The severe form of the LUTS was significantly correlated with waist circumference >102 cm (p < 0.05), blood pressure > or =130/85 mmHg (p < 0.05) and FBG >110 mg/dl (p < 0.01).
  
  
  CONCLUSIONS
  Obesity, high plasma level of FBG and hypertension constitute risk factors for the development of severe LUTS. Metabolic syndrome may play a key role in the pathogenesis in both ED and LUTS. Presence of ED is the most predictor of severe LUTS.
authors.affiliation: Department of Urology, Dokuz Eylul University, School of Medicine, Inciralti, Izmir, Turkey. omer.demir@deu.edu.tr
authors.forename: Omer
authors.initials: O
authors.lastname: Demir
authors.forename: Korhan
authors.initials: K
authors.lastname: Akgul
authors.forename: Zafer
authors.initials: Z
authors.lastname: Akar
authors.forename: Ozgur
authors.initials: O
authors.lastname: Cakmak
authors.forename: Ismail
authors.initials: I
authors.lastname: Ozdemir
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bolukbasi
authors.forename: Ertan
authors.initials: E
authors.lastname: Can
authors.forename: Bilal H
authors.initials: BH
authors.lastname: Gumus