Abstract
The aim of this study was to evaluate the incidence and severity of erectile dysfunction (ED) and hypogonadism in 193 men presenting with lower urinary tract symptoms (LUTSs) in the younger (20 - 39 years old) and older (40 - 60 years old) age groups depending on the presence of metabolic syndrome (MetS). Triglycerides, glucose and high-density lipoprotein cholesterol, serum total testosterone (TT), sex hormone-binding globulin, prostate-specific antigen, pituitary hormones levels were measured in serum. Standardized criteria (2009) were used to determine the prevalence of MetS. Patients were assessed based on the International Prostate Symptom Score (IPSS) and the IPSS-Quality of Life (IPSS-QoL) for LUTSs and the International Index of Erectile Function (IIEF) for ED. Hypogonadism was determined in accordance with the ISA, ISSAM, EAU, EAA and ASA recommendations. In men with MetS in the younger age group the incidence of ED was 2.4 times higher, and that of low TT level and hypogonadism was 8.4 times higher compared to men without the syndrome. In the older age group, an increased incidence of ED and low TT level in men with MetS compared to men without the syndrome was on the trend level, but the incidence of hypogonadism was for sure higher (by 1.6 times). In conclusion, the study showed that ED and hypogonadism are associated with MetS by a high degree of certainty in young men with LUTSs. In men of the older age group with LUTSs, the presence of MetS is not so clearly associated with ED and hypogonadism due to the fact that the incidence of these urogenital diseases is also high in men without MetS.
Highlights
In most countries, the representation of older age groups is increasing both among women and men
To determine the age characteristics of the studied parameters, the men were divided into two age groups: the younger one aged 20 to 39 years old, which included 84 men, and the older one aged 40 - 60 years old, which included 109 men; the average age in the groups was 30.1 ± 5.6 and 53.8 ± 5.7 (p < 0.0001), respectively
In the younger age group, the International Prostate Symptom Score (IPSS)-QoL domain scores was 1.4 ± 1.6 points, and in the older age group it was 3.6 ± 1.8 points (p = 0.0008), which is consistent with a greater severity of Lower urinary tract symptoms (LUTSs) symptoms in men of the older age group
Summary
The representation of older age groups is increasing both among women and men. Lower urinary tract symptoms (LUTSs), erectile dysfunction (ED) and late-onset hypogonadism (LOH) are the most common urogenital diseases in aging men [1] [2], and their prevalence is significantly increasing among elderly and old men [1] [3]-[6]. The age-related androgen deficiency accompanied by low testosterone level, which has a critical role in the maintenance of homeostatic and morphologic corpus cavernosum components essential for normal erectile physiology, is very significant for the mechanisms of ED pathogenesis [7]. As for LUTSs, it has been shown that absolute sex steroid hormone (testosterone and estradiol) levels and the rates at which the levels change may be important in the development of urologic conditions in aging men [8]. The agerelated androgen deficiency plays an important role in the development of numerous urogenital diseases in aging men
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