Frankel S J, Donovan J L, Peters T I, Abrams P, Dabhoiwala N F, Osawa D, Lin A T
Department of Social Medicine, University of Bristol, United Kingdom.
J Clin Epidemiol. 1998 Aug;51(8):677-85. doi: 10.1016/s0895-4356(98)00044-4.
The conventional view that sexual function is not adversely affected by lower urinary tract symptoms (LUTS), assumed to be caused by enlargement secondary to benign prostatic hyperplasia (BPH), was investigated in this study of 423 men aged 40 years and over in a community population in the UK and 1271 urology clinic attenders aged 45 years and over in 12 countries, using the ICSmale and ICSsex questionnaires. Sexual dysfunction was found to be common: in the community, age standardized prevalences of reduced rigidity of erections were 53%, reduced ejaculation 47%, and pain on ejaculation 5%; in clinic men, age standardized prevalences of reduced rigidity of erections were 60%, reduced ejaculation 62%, and pain on ejaculation 17%. Sex lives were reported to be spoiled by LUTS in 8% of community men and 46% in the clinic. There were negative trends for age in the extent to which clinic men were bothered by these symptoms, although older men were still very concerned. Significantly raised odds ratios of sexual dysfunction were found in those with LUTS, especially storage symptoms associated with incontinence. Urinary flow rates were not associated with sexual symptoms. Sexual dysfunction is, therefore, strongly associated with LUTS, is a matter of concern to the men affected, and should be taken into account when managing patients with LUTS.
传统观点认为性功能不会受到下尿路症状（LUTS）的不利影响，下尿路症状被认为是由良性前列腺增生（BPH）继发的前列腺肿大所致。在这项研究中，使用国际尿控学会男性问卷（ICSmale）和国际尿控学会性问卷（ICSsex），对英国社区中423名40岁及以上的男性以及12个国家的1271名45岁及以上的泌尿科门诊患者进行了调查。结果发现性功能障碍很常见：在社区中，年龄标准化后的阴茎勃起硬度降低患病率为53%，射精减少患病率为47%，射精疼痛患病率为5%；在门诊患者中，年龄标准化后的阴茎勃起硬度降低患病率为60%，射精减少患病率为62%，射精疼痛患病率为17%。据报告，8%的社区男性和46%的门诊患者的性生活受到下尿路症状的影响。门诊患者受这些症状困扰的程度随年龄呈负相关趋势，尽管老年男性仍然非常担忧。下尿路症状患者出现性功能障碍的比值比显著升高，尤其是与尿失禁相关的储尿期症状。尿流率与性症状无关。因此，性功能障碍与下尿路症状密切相关，是受影响男性关注的问题，在管理下尿路症状患者时应予以考虑。
