Correlations between lower urinary tract symptoms, erectile dysfunction, and cardiovascular diseases: are there differences between male populations from primary healthcare and urology clinics? A review of the current knowledge.
OBJECTIVE
To evaluate the correlation between lower urinary tract symptoms, erectile dysfunction, and cardiovascular diseases in different male populations.


METHODS



METHODS
PubMed (Medline), clinical evidence, Embase, Cochrane reviews, and articles from reference lists.


METHODS
SELECTION CRITERIA in search databases were lower urinary tract symptoms, LUTS, comorbidity (MeSH), impotence (MeSH), sexual dysfunction, aging, primary care (MeSH), and male. Studies on these subjects, and concerning men aged 40 years or older, were eligible for inclusion in this review. Both community-based and clinical-based studies were included.


RESULTS
20 studies were eligible for inclusion, representing 71,322 men. These studies showed a significant positive correlation between lower urinary tract symptoms and erectile dysfunction. The odds ratios varied from 1.4 to 9.74. All studies were community or clinical based. Just one study based on a primary care population was described. The association between erectile dysfunction and cardiovascular diseases is not proven in primary care.


CONCLUSIONS
The evidence of a positive correlation between lower urinary tract symptoms and erectile dysfunction is significant in community- and clinical-based studies. It is at present unknown whether these correlations are significant in the patient population of primary healthcare. We need more evidence to prompt the general practitioner to screen every man with initial presentation of erectile dysfunction for standard cardiovascular risk factors and, as appropriate, start initial cardioprotective interventions.
Bouwman
Inge I
II
Department of General Practice, University Medical Centre Groningen, Groningen, the Netherlands. i.i.bouwman@med.umcg.nl
Van Der Heide
Wouter K
WK
Van Der Meer
Klaas
K
Nijman
Rien
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases; D007172:Erectile Dysfunction; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D014552:Urinary Tract Infections / Q000503:physiopathology*; D055815:Young Adult