Correlations Among Urinary, Sexual, and Testicular Functions and Health-Related Quality of Life

Abstract

Background: We investigated how urinary, sexual, and testicular functions and generic health-related quality of life (HR-QOL) affect each other in aged men. Methods: Ninety patients who were negative for cancer on prostate biopsies were enrolled in this study. The mean patient age was 66±7 years (mean±s.d.). The mean prostate volume was 44.3±21.9 mL, and the mean serum total testosterone (TT) level was 3.63±1.18 ng/mL. Before conducting the prostate biopsies, the patients were asked to complete questionnaires, including the International Prostate Symptom Score (I-PSS), UCLA Prostate Cancer Index (UCLA-PCI), and the Rand Medical Outcome Study 36-Item Short Form (SF-36), to evaluate urinary symptoms, sexual function, and generic HR-QOL. The relationships between these parameters were analyzed. Other objective variables, such as the prostate volume, maximal urinary flow (Qmax), postvoid residual urine volume, and age, were also evaluated. Results: The TT level was found to be related to the I-PSS Q6 (r=−0.23108, p=0.03230) and Qmax (r=0.44210, p=0.00073). The mental component summary (MCS) score exhibited a significant negative relationship with the presence of urinary symptoms (sum of I-PSS Q1–7). When each I-PSS question was analyzed separately, nocturia (Q7) was found to have the most significant impact on SF-36; the physical component summary (PCS) and MCS were also worsened by nocturia. The UCLA-PCI sexual function was positively related to the SF-36 MCS, SF-36 PCS, and TT level and negatively related to the I-PSS Q3, Q5, Q6, and Q7. Aging also showed a negative impact on nocturia, sexual function, and the SF-36 PCS. Conclusions: TT levels are correlated with the parameters of urination. Urinary symptoms, sexual function, and generic HR-QOL were found to have close relationships. In the management of the health of aged men, physicians should consider urinary function together with testicular and sexual functions as well as overall QOL.