CODE: 13.1 - Sexual functions and nocturnal penile tumescence and rigidity monitoring in men with lower urinary tract symptoms
Article published in Urologia Polska 2006/59/Suplement 1.

authors

Tomasz Jakubczyk, Piotr Kryst, Bartosz Dybowski, Ryszard Hanecki, Albert Gugała, Andrzej Borkowski

Katedra i Klinika Urologii AM w Warszawie

summary

Introduction. Sexual functions may be affected by lower urinary tract symptoms (LUTS). The reasons of erectile dysfunction (ED) in men with LUTS include ageing with its related organic risk factors, co-morbidities and their treatment, as well as psychological issues related to LUTS. Nocturnal penile tumescence and rigidity (NPTR) monitoring is a valuable tool in diagnosis of ED. However data on NPTR monitoring in patients with LUTS and their correlation with self-assessment of erectile function are lacking.

Objectives. Our objective was to analyze urinary symptoms, self-assessed sexual functions and NPTR monitoring in men with LUTS.

Materials and methods. Intensity of LUTS was assessed by IPSS, sexual functions by erectile domain of IIEF questionnaire (IIEF-ED). Subsequently all patients underwent NPTR monitoring during 2 consecutive nights. Time of rigidity exceeding 60%, rigidity activity units (RAU), tumescence activity units (TAU) separately at base and tip, number of erectile events per hour and total event time during the night with better erections were recorded. Average rigidity and tumescence at tip and base during the best erectile event were also analyzed.

Results. Twenty men aged 38-75 (mean - 61.6, SD 11.68) presenting with LUTS were evaluated. Average IPSS was 17.35 (7-32, SD 7,44), quality of life 3,4 (1-5, SD 1,43) frequency of sexual activity 4.45 per month (2-11, SD 2.42), IIEF-ED 22.1 (6-29, SD 5.82). NPTR recording revealed 0.45 erections per hour of sleep (0.11-0.72, SD 0.16), with total erections time 54 minutes (11-110, SD 31.47). Time of rigidity exceeding 60% at tip and base were 18.65 (0-90, SD 24.62) and 36.78 (0-94, SD 30.96) minutes, average best event rigidity respectively 51.65% (23-84, SD 18,51) and 68.4% (18-98, SD 19.18), while tumescence 8.85 (0-13, SD 2.68) and 9.55 (0-14, SD 2.74) cm. RAU at the tip and base reached 22.05 (0-73, SD 20.40) and 33.7 (0-85, SD 26.07), while TAU 15.8 (0-56, SD 14.49) and 19.3 (0-75, SD 18,02) respectively. Intensity of LUTS was correlated only with quality of life, frequency of sexual activity, tip RAU and TAU and base rigidity, but not with IIEF-ED neither majority of NPTR parameters. IIEF-ED was not correlated with any of the NPTR parameters. Age was correlated with number and time of erections, tumescence, and TAU both at tip and base, while with time of rigidity exceeding 60% and RAU only at base.

Conclusions. LUTS decreased the frequency of sexual activity, but did not impact IIEF-ED, neither the majority of NPTR parameters. There was no correlation between IIEF-ED and NPTR findings. Only ageing was correlated with the decrease in the majority of NPTR parameters, however it did not influenced self-assessment of erectile function.