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

• Published in: Turkish journal of medical sciences Vol. 44; no. 4; pp. 681 - 686
• Main Authors: Umul, Mehmet, Altay, Ahmet Bariş, Bademkiran, Fikret, Turna, Burak, Semerci, Mehmet Bülent, Apaydin, Erdal, Cikili, Necmettin
• Format: Journal Article
• Language: English
• Published: Turkey 2014
• Subjects: Adrenergic alpha-1 Receptor Antagonists - pharmacology; Aged; Autonomic Nervous System - drug effects; Autonomic Nervous System - physiopathology; Blood Glucose - metabolism; Body Mass Index; Erectile Dysfunction - blood; Erectile Dysfunction - complications; Erectile Dysfunction - physiopathology; Humans; Lipids - blood; Lower Urinary Tract Symptoms - blood; Lower Urinary Tract Symptoms - complications; Lower Urinary Tract Symptoms - physiopathology; Male; Middle Aged; Prostatic Hyperplasia - blood; Prostatic Hyperplasia - complications; Prostatic Hyperplasia - physiopathology; Quinazolines - pharmacology; Risk Factors; Sulfonamides - pharmacology; Testosterone - blood
• ISSN: 1300-0144; 1303-6165
• DOI: 10.3906/sag-1304-122

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).
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.
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).
This current study suggested that the effect of ANS hyperactivity is not the fundamental factor underlying the relationship between LUTS and ED.