title: The Correlation Between Prostate Volume in Patients with Benign Prostatic Hyperplasia in Relation to Erectile Dysfunction.
abstract: BACKGROUND
  The exact etiology of lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH) has not yet been determined, and the etiology of erectile dysfunction (ED) is often multicausal and includes organic and/or psychogenic causes, as well as their combinations. Although the relation of BPH, and thus the volume of the prostate (VP) with ED is indisputable, precise mechanisms of integration are still under examination.
  
  
  OBJECTIVE
  The objective was to evaluate the correlation between prostate volume and degree of erectile dysfunction in patients with symptoms of lower urinary tract caused by benign prostatic hyperplasia. Material and Methods. 150 subjects with BPH, and before starting the BPH treatment, which can affect the sexual function, were divided into three groups: 50 patients with prostate volume of 30 to 40 ml (group A), 50 patients with a volume of 40 to 60 ml (group B) and 50 patients with prostate volume above 60 ml (group C). Quantification of erectile function is performed in all respondents by International Index of Erectile Function with five questions (IIEF-5).
  
  
  RESULTS
  The mean IIEF-5 in group A was 20.52 points with a standard deviation of 3.22, in group B 17.08 points with a standard deviation of 4.10, while in group C 10.78 points, with a standard deviation of 3.29. Comparing the results of a statistical analysis from all three groups of patients with the degree of ED, Group A had the highest value of IIEF-5, group C the lowest mean value of IIEF-5. The results of ANOVA (F=96.375, p=0.000) indicated that there was a statistically significant difference (p<0.05) between groups at high values of IIEF-5. Additional analysis by Turkey test revealed that there was a statistically significant difference between the first and second groups (p=0.000 <0.05), the first and third groups (p=0.000 <0.05) and the second and third groups (p=0.000 <0.05). Results of Fisher's exact test (p=0.000) confirmed that there was a statistically significant relationship (p<0.05) between prostate volume and the degree of erectile function. Results of Spearman correlation (ρ=-0.720; p=0.000) showed that prostate volume is negatively correlated with IIEF-5 score with a reliability of 99% (p<0.05), or that increase in the volume of the prostate reduces the IIEF score.
  
  
  CONCLUSIONS
  Results of IIEF-5 score are inversely proportional to the volume of the prostate or the prostate volume increase, the more severe erectile dysfunction, because the increase in prostate volume leads to a decline in IIEF score.
authors.affiliation: Department of Urology. Cantonal Hospital "dr Irfan Ljubijankic" Bihac, Bosna and Hercegovina.
authors.forename: Amel
authors.initials: A
authors.lastname: Kardasevic
authors.affiliation: Urology Clinic. University Clinical Center of the RS, Banja Luka, Bosnia and Herzegovina.
authors.forename: Snjezana
authors.initials: S
authors.lastname: Milicevic
mesh_terms: D000328:Adult; D017677:Age Distribution; D015415:Biomarkers / Q000097:blood; D017522:Bosnia and Herzegovina / Q000453:epidemiology; D018450:Disease Progression; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D059411:Lower Urinary Tract Symptoms; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D017430:Prostate-Specific Antigen
keywords: benign prostatic hyperplasia; erectile dysfunction; prostate volume; symptoms of the lower urinary tract