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Volume 15, Issue 6 (November 2013) 15, 785–789; 10.1038/aja.2013.44

Erectile function and late-onset hypogonadism symptoms related to lower urinary tract symptom severity in elderly men

Ozan Bozkurt, Deniz Bolat, Omer Demir, Oktay Ucer, Ali Şahin, Burak Ozcift, Abdulkadir Pektaş, Tahir Turan, Bilal H Gümüş, Ertan Can, Ahmet Bolukbasi, Haluk Erol and Adil Esen

1 Department of Urology, Dokuz Eylul University, Faculty of Medicine, Izmir 35340, Turkey
2 Division of Urology, Doc. Dr. Yasar Eryilmaz Dogubayazit State Hospital, Agri 04900, Turkey
3 Department of Urology, Celal Bayar University, Manisa 45040, Turkey
4 Department of Urology, Sifa University, Izmir 35230, Turkey
5 Clinic of Urology, Ataturk Training and Research Hospital, Izmir 35965, Turkey
6 Division of Urology, Adiyaman 82. Y1l State Hospital, Adiyaman 02040, Turkey
7 Department of Urology, Pamukkale University, Faculty of Medicine, Denizli 20020, Turkey
8 Clinic of Urology, Tepecik Training and Research Hospital, Izmir 35120, Turkey
9 Department of Urology, Adnan Menderes University, Faculty of Medicine, Aydin 09100, Turkey

Correspondence: Dr O Bozkurt, (ozan.bozkurt@deu.edu.tr)

Advance online publication 1 July 2013


The aim of this study was to evaluate the relationship between lower urinary tract symptoms (LUTSs), erectile dysfunction (ED) and symptomatic late-onset hypogonadism (SLOH) in ageing men in the Aegean region of Turkey. Five hundred consecutive patients >40 years old who had been in a steady sexual relationship for the past 6 months and were admitted to one of six urology clinics were included in the study. Serum prostate-specific antigen and testosterone levels and urinary flow rates were measured. All patients filled out the International Prostate Symptom Score and Quality of Life (IPSS–QoL), International Index of Erectile Function (IIEF) and Aging Males' Symptoms (AMS) scale forms. Of the patients, 23.9% had mild LUTSs, 53.3% had moderate LUTSs and 22.8% had severe LUTSs. The total testosterone level did not differ between groups. Additionally, 69.6% had ED. The presence of impotence increased with increasing LUTS severity. Symptomatic late-onset hypogonadism (AMS >27) was observed in 71.2% of the patients. The prevalence of severe hypogonadism symptoms increased with the IPSS scores. A correlation analysis revealed that all three questionnaire scores were significantly correlated. In conclusion, LUTS severity is an age-independent risk factor for ED and SLOH. LUTS severity and SLOH symptoms appear to have a strong link that requires etiological and biological clarification in future studies.

Keywords: ageing male; erectile dysfunction; lower urinary tract symptoms; symptomatic late-onset hypogonadism; symptom scores; testosterone

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