Case control study of sexual dysfunction in patients with lower urinary tract symptoms at Muhimbili national hospital.

Abstract

Objectives :Erectile dysfunction can be caused by several factors and leads to reduction in quality of life of the affected patient. Lower urinary tract symptoms have been implicated as one of the causes of ED. The objective of the study is to asses the frequency and severity of erectile dysfunction in patients with LUTS. Methods: Two hundred thirty eight patients were studied in a case control study and the duration of the study was eight months. One hundred twenty two had LUTS formed the study group and one hundred sixteen without LUTS as controls were enrolled in this study. The demographic data, relevant history, physical examination and investigations were obtained. They all participated in filling self administered questionnaire on ED. Patients were assessed by their degree of ED as severe, moderate, mild or normal. They responded to the five questions of Sexual Health Inventory for Men (SHIM) abridged index of erectile function with the total score indicating the following degree of ED: Severe ED score 5 to 10; moderate score 11 to 15; mild ED score 16 to 20 and no ED, ED score 21 to 25. Descriptive profiles of two groups were compared. The two groups were divided into age groups of 18-30years, 31-40 years, 41-50 years, 51-60 years, 61-70 years and 71 - 80 years. Results: A total number of 238 responded to the questionnaire. Out of those 122 were patients with LUTS and 116 were the controls. In the study group 38 (31 %) had severe ED, 30 (25%) had mode rate ED, 35 (35%) mild ED, 14 (11.5%) were normal. And in control group 18 (15.5%) had severe ED, 20 (17.2%) had moderate ED, 27 (23.3%) had mild ED and 51 (44%) had normal ED.In the study group there were 44 (36%) of patient's in the young age group (below 40years) while majority 78(64%) were above 40 years. In control group 45(39%) patients were below 40 years and 71(61%) patients were above age of 40. The majority of patients in both group have ED however magnitude of ED in study group is higher (84.4%) compared to control group 56% and the difference is statistically significant (P value =0;008) When age is considered by eliminating the elderly age groups a comparison of ED between study and control group in the young age ( below the age of 40), the patients with LUTS are more affected and the difference is statistically different with P value = 0.028. The finding in the elderly age group (age more than 40 years) found that patients with LUTS have higher risk of ED compared to control group and difference is statistically significant with P value = 0.0065. Conclusion This study found that erectile dysfunction is more prominent in patients with LUTS compared with patients with other diseases in both young and elderly. The study further showed that LUTS as an independent variable other than age contribute separately to ED. These findings reproduce those found in other continents reinforcing the need to further investigate this association both in basic research and in clinical practice.

\