The relationship between lower urinary tract symptoms associated with benign prostatic hyperplasia and erectile dysfunction: the role of autonomic hyperactivity

To investigate whether autonomic nervous system (ANS) hyperactivity may be a potential cause for the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). Materials and methods: Twenty-four patients were recruited for this study. Complete physical examinations, urine analysis, uroflowmetry, and postvoid residual urine volume (PVRU) analysis were performed. The potential impact of some factors such as hyperglycemia, obesity, and hyperlipidemia were analyzed. These values were correlated with the various symptom scores. We performed an electromyographic and an electrocardiographic evaluation. The alterations after treatment with 2 different alpha-blockers were also analyzed. Results: The electromyographic and electrocardiographic assessments revealed a minimal increase in ANS activity and it did not change significantly after treatment (P > 0.05). After treatment, maximum flow rate increased and PVRU decreased significantly (P < 0.001 and P < 0.001, respectively); total and free testosterone levels increased significantly (P = 0.0068 and P = 0.0071, respectively). There was a statistically significant difference between the 2 treatment groups regarding the outcomes of the Danish Prostate Symptom Score questionnaire (P = 0.047). Conclusion: This current study suggested that the effect of ANS hyperactivity is not the fundamental factor underlying the relationship between LUTS and ED.

The relationship between lower urinary tract symptoms associated with benign prostatic hyperplasia and erectile dysfunction: the role of autonomic hyperactivity

To investigate whether autonomic nervous system (ANS) hyperactivity may be a potential cause for the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). Materials and methods: Twenty-four patients were recruited for this study. Complete physical examinations, urine analysis, uroflowmetry, and postvoid residual urine volume (PVRU) analysis were performed. The potential impact of some factors such as hyperglycemia, obesity, and hyperlipidemia were analyzed. These values were correlated with the various symptom scores. We performed an electromyographic and an electrocardiographic evaluation. The alterations after treatment with 2 different alpha-blockers were also analyzed. Results: The electromyographic and electrocardiographic assessments revealed a minimal increase in ANS activity and it did not change significantly after treatment (P > 0.05). After treatment, maximum flow rate increased and PVRU decreased significantly (P < 0.001 and P < 0.001, respectively); total and free testosterone levels increased significantly (P = 0.0068 and P = 0.0071, respectively). There was a statistically significant difference between the 2 treatment groups regarding the outcomes of the Danish Prostate Symptom Score questionnaire (P = 0.047). Conclusion: This current study suggested that the effect of ANS hyperactivity is not the fundamental factor underlying the relationship between LUTS and ED.

___

  • 1. Ponholzer A, Temml C, Obermayr R, Madersbacher S. Association between lower urinary tract symptoms and erectile dysfunction. Urology 2004; 64: 772–776.
  • 2. McVary KT. Erectile dysfunction and lower urinary tract symptoms secondary to BPH. Eur Urol 2005; 47: 838–845.
  • 3. Sünter AT, Dündar C, Canbaz S, Dabak Ş, Pekşen Y. Prevalence of lower urinary tract symptoms in men over 40 years: a crosssectional study in Samsun. Turk J Med Sci 2007; 37: 297–301.
  • 4. Schulman CC. The aging male: a challenge for urologists. Curr Opin Urol 2000; 10: 337–342.
  • 5. McVary KT, McKenna KE. The relationship between erectile dysfunction and lower urinary tract symptoms: epidemiological, clinical and basic science evidence. Curr Urol Rep 2004; 5: 251–257.
  • 6. Bloch W, Klotz T, Loch C, Schmidt G, Engelmann U, Addicks K. Distribution of NOS implies a regulation of circulation, SM tone and secretory function in the human prostate by nitric oxide. Prostate 1997; 33: 1–8.
  • 7. Tarcan T, Azadzoi KM, Siroky MB, Goldstein I, Krane RJ. Age related erectile and voiding dysfunction: the role of arterial insufficiency. BJU 1998; 82 (Suppl. 1): 26–33.
  • 8. Golomb E, Rosenzweig N, Ellam R, Abramovici A. Spontaneous hyperplasia of the ventral lobe of the prostate in aging genetically hypertensive rats. J Androl 2000; 21: 58–64.
  • 9. McVary KT, Razzaq A, Lee C, Venegas MF, Rademaker A, McKenna KE. Growth of the rat prostate gland is facilitated by the autonomic nervous system. Biol Reprod 1994; 51: 99–107.
  • 10. Tong YC, Hung YC, Lin SN, Cheng JT. The norepinephrine tissue concentration and neuropeptide Y immunoreactivity in genitourinary organs of the spontaneously hypertensive rat. J Auton Nerv Syst 1996; 56: 215–218.
  • 11. Hale TM, Okabe H, Bushfield TL, Heaton JP, Adams MA. Recovery of erectile function after brief aggressive antihypertensive therapy. J Urol 2002;168: 348–354.
  • 12. Glynn RJ, Campion EW, Bouchard GR, Silbert JE. The development of benign prostatic hyperplasia among volunteers in the Normative Aging Study. Am J Epidemiol 1985; 121: 78– 90.
  • 13. Meigs JB, Mohr B, Barry MJ, Collins MM, McKinlay JB. Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men. J Clin Epidemiol 2001; 54: 935–944.
  • 14. Gökkaya CS, Öztekin ÇV, Özden C, Öztürk E, Aktaş BK, Memiş A. Insulin resistance impairs response to doxazosin therapy in men with benign prostatic hyperplasia. Turk J Med Sci 2013; 43: 1–5.
  • 15. Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, O’Leary MP, Puppo P, Robertson C, Giuliano F. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol 2003; 44: 637– 649.
  • 16. McVary KT, Rademaker A, Lloyd GL, Gann P. Autonomic nervous system overactivity in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol 2005; 174: 1327–33.
  • 17. Watahiki Y, Baba M, Matsunaga M, Takebe K, Onuma T. Sympathetic skin response in diabetic neuropathy. Electromyogr Clin Neurophysiol 1989; 29: 155–159.
  • 18. Seçil Y, Özdedeli K, Altay B, Aydoğdu İ, Yılmaz C, Ertekin C. Sympathetic skin response recorded from the genital region in normal and diabetic women. Neurophysiol Clin 2005; 35: 11–17.
  • 19. Uncini A, Pullman SL, Lovelace RE, Gambi D . The sympathetic skin response: normal values, elucidation of afferent components and application limits. J Neurol Sci 1988; 87: 299–306.
  • 20. Grubb BP, Kosinski DJ. Syncope resulting from autonomic insufficiency syndromes associated with orthostatic intolerance. Med Clin North Am 2001; 85: 457–472.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Comparison in clinical features and life impact between juvenile-onset and adult-onset ankylosing spondylitis

Mingqiang GUAN, Jian WANG, Zhigang ZHU, Jun XIAO, Liang ZHAO, Zhihan LI, Zhanjun SHI

Determining torsion angle of humerus head using MRI method

Ayfer Metin TELLİOĞLU, Sacide KARAKAŞ, Füsun TAŞKIN

Comparison of intraarticular bupivacaine and levobupivacaine injection in rat synovial inflammation

Bekir Suat KÜRKÇÜOĞLU, Melehat DÖNMEZ, Seher ALTINEL, Seda Banu AKINCI

Effects of osteocytes on vibration-induced reflex muscle activity in postmenopausal women

Şafak Sahir KARAMEHMETOĞLU, İlhan KARACAN, Muharrem ÇİDEM

Clonal comparison of Acinetobacter strains isolated from intensive care patients and the intensive care unit environment

Esra KIRKGÖZ, Yasemin ZER

Pharmacological profile of a nitric oxide donor spermine NONOate in the mouse corpus cavernosum

Fatma Peyman ERTUĞ, Erğin ŞİNGİRİK, Hacer Sinem BÜYÜKNACAR, Cemil GÖÇMEN, Mehmet Ata SEÇİLMİŞ

Hepatitis C virus genotypes in Adana and Antakya regions of Turkey

Agah Bahadır ÖZTÜRK, Ümit Bilge DOĞAN, Nevin Akçaer ÖZTÜRK

Evaluation of histopathologic and histomorphometric changes of testicular tissue and gonadotropin levels following consumption of methylphenidate in male mice

Simin FAZELIPOUR, Zahra TOOTIAN, Zahra GHAHRI SAREMI, Minoo SHAFII, Mohammad Taghi SHEIBANI, Seyed Babak KIAEI, Mehrnush KIUMARSI, Fardin ASSADI

Attitudes towards influenza vaccination in high socioeconomic status Turkish parents

Suzan GÜNDÜZ, Çiğdem Nüket YÜKSEL, Hale Bozkurt AKTOPRAK, Metin CANBAL, Mehmet KAYA

Early graft dysfunction and mortality rate in marginal donor liver transplantation

Pınar SARKUT, Barış GÜLCÜ, Remzi İŞÇİMEN, Murat KIYICI, Gürkan TÜRKER