The Relationship between Erectile Dysfunction and Lower Urinary Tract Symptoms in Subjects with Moderate-to-Severe Symptoms as Predictive Signs of Benign Prostatic Hyperplasia

Abstract Background: In the current work, a specific cohort of benign prostatic hyperplasia (BPH) cases with symptoms of moderate-to-severe BPH who were scheduled for either an open or transurethral prostatectomy were examined for associations between lower urinary tract symptoms (LUTS), various diagnostic factors of erectile dysfunction (ED), and BPH. Materials and Methods: The study was performed at Al-Ramadi Teaching Hospital between 2021 and 2023 and involved a total of 453 patients. Using recognized symptom-scoring approaches, LUTS and ED were assessed. All patients had their postvoid residual urine volumes (PVRU) and maximum and typical urine flow rates were measured. Ultrasonography was used to determine the prostate volumes. Results: Age-related increases in the incidence of ED and LUTS were significant ( P < 0.001). The results indicated that the frequency of ED was 36% in males who experienced mild LUTS and 94% in cases who suffered severe LUTS. There was an odds ratio of 28.7 for ED in males with severe LUTS. LUTS represents a substantial risk factor for ED regardless of age, according to an analysis of age, “International Prostate Symptom Score,” and “International Index of Erectile Function” (IIEF) scores ( P < 0.001). The average urine flow rate and the maximum urine flow rate were found to positively correlate ( P < 0.001) with IIEF scores ( r = 0.441, and r = 0.326), respectively. On the contrary, there was a strong negative association ( P < 0.001) found between IIEF scores and PVRU ( r = −0.486) and prostate volume ( r = −0.299). Conclusion: Symptoms of LUT, specifically severe form, are considered an independent risk factor for ED. It is essential to evaluate ED patients preoperatively to avoid misdiagnosing postoperative ED as a preexisting problem.