Вопросы этиологии эректильной дисфункции у мужчин с расстройствами мочеиспускания

Abstract

Introduction. Erectile dysfunction is an urgent problem of modern urology. There is a consistent correlation between the sexual dysfunction incidence and the aging changes in the man’s body. In this study, an attempt was made to analyze the causes of the discussed correlation. An analysis comparing the data obtained with the worldwide figures and the results previously reported in Russia was performed. Materials and methods. The prospective multicenter epidemiological study was carried out using the data acquired from April 1 to May 31, 2017 during the anonymous questioning of 525 men (average age 64.2±9.93) living in Moscow, who had contacted the urologist due to urination disorders. The respondents answered the questions of the specially developed 140-point questionnaire. All demographic and medical data was taken into account, including information on comorbidities and age of onset. The IIEF, IPSS, QoL and AMS (Aging Male Screening) questionnaires were completed. Statistical processing of the results was carried out. Results. Complaints of sexual dysfunction are a relatively rare reason for the urologist’s consultation in men with LUTS living in the Moscow region. However, the survey has revealed that 39.9% of men did not consider themselves sexually active. The particularly low sexual health rate was detected in the age group over 70. The average IIEF questionnaire score for the respondents was 39.40±21.14. Less than a third of respondents reported their sexual life quality as acceptable. The correlation coefficient between the total IIEF score and the birth year was +0.422, and for the IPSS score it was -0.205. Correlations were considered significant when p<0.001. The erectile dysfunction risk increases with age, however, according to numerous publications it is not due to natural aging process, but due to severe comorbidities, particularly hypertension, infections, vascular diseases and diabetes mellitus. The patients' compliance with healthy lifestyle, abstention from smoking and regular drinking, is of great importance. In this study, the 152 of 525 (29%) respondents were smokers at the time of the survey. Strong liquor was routinely consumed by 250 respondents (47.6%), and low-alcohol beverages were consumed by 167 people (31.8%). The onset of the listed above comorbidities occurs at the age of 50–60, which makes it possible to explain the rapid ED incidence increase in the corresponding age group. The pattern identified constitutes evidence of the organic causes of erectile dysfunction. Conclusion. Analysis of the erectile dysfunction type and incidence in patients with LUTS living in the Moscow region demonstrated certain differences between the results obtained and the results of similar American and European studies. A steady trend of sexual health deterioration was observed in patients aged over 55–65. We have proved correlation between these changes and various cardiovascular diseases manifestations (CAD, hypertension), the peak period of which falls on the described age group. Comparison of the data obtained to those of 2012 has demonstrated increased severity of the “age-related” symptoms.