BENIGN PROSTATIC HYPERPLASIA (K MCVARY, SECTION EDITOR)
Erectile Dysfunction and Lower Urinary Tract Symptoms
Cosimo De Nunzio
Springer Science+Business Media, LLC, part of Springer Nature 2018
Purpose of Review In the past years, the relationship between lower urinary tract symptoms and erectile dysfunction has been
widely explored. The aim of our systematic review is to summarize the published evidence over the past year on lower urinary
tract symptoms (LUTS) and erectile dysfunction (ED).
Recent Findings Recent data support the relationship between LUTS and ED in Eastern Europe and in Asia. The role of
phosphodiesterase inhibitors alone or in combination with alpha blockers to treat LUTS and ED, especially in younger patients,
is strongly supported by high level of evidence.
Summary LUTS and ED are prevalent conditions in men over 50; epidemiologically, the relationship between both conditions
has beenconfirmed all over the world. PDE5ialone or in combination with alpha blockers can be considered the gold standard for
the treatment of young patients with storage symptoms and concomitant ED. In clinical research, a better understanding of the
molecular pathways behind this association may also help to identify new possible targets and develop novel therapeutic
approaches to manage both disorders; the identification of new biomarkers of both disorders is also compulsory in this area.
Lower urinary tract symptoms (LUTS) and erectile dysfunc-
tion are two prevalent conditions with a significant impact on
men’s health specially related to the gradual aging of the pop-
ulation. . Lower urinary tract symptom, including voiding,
storage, and post-micturition symptoms are common in men
over 50 years, with benign prostatic hyperplasia being the
primary cause. Erectile dysfunction (ED), defined as a persis-
tent inability to achieve and maintain an erection sufficient for
satisfactory sexual performance, is generally considered a nat-
ural consequence of the aging process. Several age-
independent comorbidities such as diabetes, depression, hy-
pertension, and heart disease were also found to be also sig-
nificantly associated with ED prevalence. Based on these data,
it has been estimated that the worldwide prevalence of ED will
be more than 200 million men in 2025 [1, 2].
Several large-scale epidemiological studies in different
populations have demonstrated a possible relationship be-
tween these two conditions in aging men that is indepen-
dent of the effects of age or other comorbidities [1–3].
Today, although the molecular and pathological pathways
potentially linking LUTS and ED are not yet completely
defined, this possible association has resulted in new pos-
sible approaches for the management of both disorders and
new possible targets for prevention and treatment [4, 5].
The possibility to manage both disorders using the same
treatment has also opened new therapeutic strategies par-
ticularly investigated in the last years.
The aim of our systematic review is to summarize the pub-
lished evidence over the past year on LUTS and ED.
This article is part of the Topical Collection on Benign Prostatic
Take Home message: LUTS and ED are age-independent associated
disorders. A comprehensive evaluation of both diseases is warranted to
improve patients’ care and men’shealth.
* Cosimo De Nunzio
Department of Urology, Sant’Andrea Hospital, “La Sapienza”
University, Via di Grottarossa 1035, 00189 Rome, Italy
Current Urology Reports (2018) 19:61