Chronic Prostatitis Is A Risk Factor For Erectile Dysfunction

摘要

Objectives. Chronic prostatitis (CP) is associated with a variety of irritative and obstructive voiding symptoms. A significant number of patients also complain of sexual dysfunction. Ejaculatory dysfunction has been reported in more than half of patients with CP. Our goal was to determine whether CP is a risk factor for erectile dysfunction (ED).Methods. The Sexual Health Inventory for Men (SHIM) was administered in our clinic and online at the Interstitial Cystitis Network. 305 men completed the SHIM questionnaire, which included 47 controls (healthy volunteers), 150 men for evaluation of other urologic complaints (urology group), and 108 men being treated for CP. The total SHIM score and response to each SHIM question were analyzed using ANOVA.Results: In the control group, the mean SHIM score was 22.7 of a possible 25 points, and mean SHIM Q1 score was 4.0 of a possible 5 points. In the general urology group, the mean SHIM score was 21 and mean SHIM Q1 score was 3.3. In the CP group, the mean SHIM score was 17 and mean SHIM Q1 was 2.91. The results had statistical significance (p=0.05). Patients with CP have significantly lower total SHIM and SHIM Q1 scores when compared with controls and patients seen for urologic complaints. Patients with prostatitis are younger than those typically seen for general urologic complaints. Conclusion: CP is a risk factor for ED. Patients with CP should be questioned about ED as part of their routine urologic care and offered treatment options. Introduction Prostatitis is the most common urologic diagnosis in men under 50 years of age and the third most common urologic diagnosis in men more than 50 years of age, which accounted for 8% of urology office visits.1 Prostatitis is defined pathologically as an increased number of inflammatory cells within the prostatic parenchyma;2 however, prostatic inflammation does not need to be present to make the diagnosis of prostatitis.3 In December 1995, the National Institutes of Health consensus meeting on prostatitis was held and a new classification system for the prostatitis syndromes was developed,4 which reflects the infectious, inflammatory, and noninflammatory variants of prostatitis. The predominant symptoms of prostatitis include, but are not limited to, pain during or after ejaculation, pain in the perineum, penis, groin, testicle, low back or suprapubic region, frequent and urgent need to urinate, burning during urination, excessive urination at night, difficulty starting urinary stream, diminished urinary flow, and blood in urine or semen. In addition, a significant number of men with prostatitis complain of sexual dysfunction. Ejaculatory dysfunction has been reported in more than half of chronic prostatitis patients. Keltikangas-Jarvinen and colleagues demonstrated sexual dysfunction, in the form of decreased libido and erectile dysfunction (ED), in 52% of chronic prostatitis patients.5 In a study by Mehik et al., ED was present in 43% of men with symptomatic prostatitis.6 Sexual health has an important role in a person’s overall physical and emotional well-being.The authors administered the Sexual Health Inventory for Men (SHIM) questionnaire to determine whether chronic prostatitis is a risk factor for ED. Material And Methods The authors conducted a prospective, voluntary study using the SHIM questionnaire to assess for ED in chronic prostatitis. The SHIM questionnaire was administered in our clinic and online at the Interstitial Cystitis Network (www.ic-network.com). The questionnaire is composed of five questions regarding sexual health for men. Of the 305 men who completed the SHIM questionnaire, 47 were healthy volunteers (controls), 150 were seen in the urology clinic for evaluation of another urologic complaint (urology group), and 108 were being treated for chronic prostatitis (Table I). Patients in the urology group included 70 with hematuria, 60 with nephrolithiasis, and 20 desiring elective sterilization.