title: A prospective study on association of prostatic calcifications with sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
abstract: BACKGROUND
  Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common debilitating condition of unclear etiology. Sexual dysfunction is an important component of the clinical phenotype of CP/CPPS. Patients often have prostatic calcifications, but a link to sexual dysfunction is unknown.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the association of prostatic calcifications with sexual dysfunction in this condition.
  
  
  METHODS
  A total of 358 males with CP/CPPS were consecutively enrolled, and a prospectively maintained database of these patients was analyzed. Calcifications were diagnosed using ultrasound imaging of the prostate. Symptom severity was measured using the National Institutes of Health Chronic Prostatitis Symptom Index (CPSI). Sexual dysfunction was evaluated using the validated 15-item International Index of Erectile Function (IIEF-15) questionnaire and 5-item Premature Ejaculation Diagnostic Tool scales. The variables were compared between patients with prostatic calcifications and those without using the Student's t-test, Wilcoxon unpaired test, or chi-square test.
  
  
  METHODS
  Logistic regression models were developed to explore a possible association between prostatic calcifications and sexual dysfunction.
  
  
  RESULTS
  Measurable calcifications in the prostate were found in 175 (48.9%) of the 358 patients. Patients with calcifications were more likely to have higher white blood cell counts or positive bacteria cultures in their prostatic fluid, longer symptoms duration, and lower scores for the total IIEF-15, IIEF-erectile function, and IIEF-intercourse satisfaction domains (P < 0.001 for each). However, the scores for CPSI, premature ejaculation, and IIEF-orgasmic function, IIEF-sexual desire, and IIEF-overall satisfaction domains were identical between men with and without calcifications (P > 0.05 for each). Furthermore, logistic regression analyses revealed that intraprostatic calcification is significantly associated with self-assessed erectile dysfunction (ED) (odds ratio:3.632, 95% confidence interval: 2.405-5.822, P < 0.001).
  
  
  CONCLUSIONS
  Our results showed that prostatic calcifications are significantly associated with the presence of ED in CP/CPPS males.
authors.affiliation: Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Zhao
authors.forename: Xujun
authors.initials: X
authors.lastname: Xuan
authors.forename: Jingwei
authors.initials: J
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: He
authors.forename: Guohua
authors.initials: G
authors.lastname: Zeng
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D002908:Chronic Disease; D059350:Chronic Pain / Q000209:etiology*; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017699:Pelvic Pain / Q000209:etiology*; D061686:Premature Ejaculation / Q000209:etiology; D011446:Prospective Studies; D011472:Prostatitis / Q000150:complications* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013577:Syndrome; D055815:Young Adult
keywords: Chronic Pelvic Pain Syndrome; Prostatic Calcifications; Prostatitis; Sexual Dysfunction