Core Lower Urinary Tract Symptom Score Research Articles

Clinical effect of phytosterol-enriched saw palmetto extract on urinary function in healthy middle-aged and older males: a double-blind, placebo-controlled randomized comparative study

Background: Saw palmetto extract (SPE) is one of the most widely used supplements for benign prostatic hyperplasia (BPH) due to its pharmacological effects. β-sitosterol-enriched saw palmetto oil (VISPO™) contains more than 3% β-sitosterol and 85% total fatty acids and has been shown to improve symptoms in patients with BPH. Lower urinary tract symptoms (LUTS) require primary preventive measures in countries with accelerated population aging, including Japan. VISPO™ is expected to be effective against the early symptoms of LUTS. However, the effect of VISPO™ on urinary function in healthy individuals has not been elucidated. Objective: This clinical study evaluated the efficacy and tolerability of VISPO™ in the management of urinary complaints among healthy middle-aged and older men who did not require treatment. Methods: We conducted a randomized, double-blind, placebo-controlled trial that included 54 male participants who were assigned to consume VISPO™ or placebo (olive oil) capsules for 12 weeks. Biometric data, uroflowmetry results, and salivary hormone levels were assessed at weeks 1 and 12. Urinary function and quality of life were assessed at weeks 1, 4, 8, and 12 using the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), Core Lower Urinary Tract Symptom Score (CLSS), and WHOQOL-26. Results: Two-way analysis of variance revealed that IPSS and OABSS were significantly lower in the VISPO™ group that in the placebo group. However, there were no significant differences in urine volume, urinary flow rate, or salivary hormone levels. In addition, no participants reported adverse effects (diarrhea, abdominal pain, etc.). Conclusion: The results of the present study, which is the first randomized controlled trial of VISPO™ conducted among healthy participants, demonstrate the effectiveness of VISPO™ in the management of lower urinary tract complaints that do not require treatment. Trial Registration: University Hospital Medical Information Network Clinical Trials Registry (UMIN000046386). Keywords: saw palmetto, VISPO™, β-sitosterol, fatty acids, healthy subjects, primary preventive, IPSS, OABSS, lower urinary tract symptoms (LUTS)

Rezūm water vapor thermal therapy in patients with benign prostatic hyperplasia: Initial real-world data from Japan.

Benign prostatic hyperplasia (BPH) is prevalent in older men. As surgery can be high risk in this group, minimally invasive procedures are preferrable. This study aimed to assess the initial results of minimally invasive Rezūm water vapor thermal therapy (WVTT) in patients with BPH. This single-center retrospective study included 25 consecutive patients with BPH who underwent WVTT between September 2022 and July 2023. Parameters including age, Charlson Comorbidity Index and Geriatric 8 (G8) scores, operative time, and number of vapor injections were evaluated. The International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score, and Core Lower Urinary Tract Symptom Score (CLSS) were used to assess symptoms before the procedure, and at 1 and 3 months after it. Urinary function indicators such as single voiding volume, maximum flow rate (MFR), and post-void residual volume were assessed at the same time points. The mean patient age was 76.0 years and the mean prostate volume was 54.8 mL. The mean G8 score was 14.4 and the Charlson Comorbidity Index score averaged 1.2. The mean operative time was 6.84 min, and included a mean of 4.8 vapor injections. Three months after WVTT, significant improvements were observed in the maximum flow rate (P = .02), post-void residual volume (P = .001), and urine volume (P < .001), as well as in the IPSS incomplete emptying (P = .01) and weak stream (P = .01) domains. No significant changes were observed in the remaining IPSS domains or in the Overactive Bladder Symptom Score or CLSS. This study provides the first report on Rezūm WVTT outcomes in Japan using the CLSS assessment tool. The initial results indicate a promising experience with this new treatment method. With a rapidly aging population, the incidence of BPH is expected to increase, making the minimally invasive Rezūm system a valuable addition to BPH treatment options.

Reliability and validity of the Turkish language version of the Core Lower Urinary Tract Symptom Score.

The purpose of this study was to develop the Turkish version of the Core Lower Urinary Tract Symptom Score (CLSS) and determine its psychometric properties in Turkish subjects. A total of 428 subjects, 259 with lower urinary tract symptoms (LUTS) and 169 without any complaints, were included in the study. In addition, 40 subjects were included in the study for test-retest analysis. After the Turkish version of the CLSS was created, all patients underwent medical history, physical examination, complete urinalysis, urinary ultrasonography, and filled out a CLSS. In addition, men were asked to fill in International Prostate Symptom Score (IPSS), International Consultation on Incontinence Questionnaire-Male LUTS and National Institutes of Health Chronic Prostatitis Symptom Index. Women completed the Bristol Female LUTS-Short Form and IPSS. The patients from the test-retest group were asked to fill out the CLSS two times at 2-week intervals. CLSS showed high internal consistency (Cronbach's α for men and women was 0.909 and 0.767, respectively). The test-retest reliability of CLSS was high for subdomains (intraclass correlation coefficient was 0.739-0.962). Scores of CLSS were significantly higher in the study group than the control group (P < 0.001). In men and women, it showed very strong convergent validity (P < 0.0001) with subdomain related to other questionnaires. In our confirmatory factor analysis, the original model of CLSS was found to be compatible. The Turkish version of CLSS is a valid and reliable questionnaire to evaluate the symptoms and disorders of patients with LUTS.

The Relationship Between Urinary Symptom Severity And Functional Status İn Patients With Stroke.

Lower Urinary Tract Dysfunction (LUTD) is a condition that is common in stroke patients and affects their quality of life and psychological state. To determine the factors affecting LUTD severity in stroke patients and to evaluate its relationship with functional status. 77 stroke patients were included in our study. Demographic and stroke characteristics of all patients were recorded. Functional Ambulation Scale (FAS), Functional Independence Measure (FIM), the Core Lower Urinary Tract Symptom Score (CLSS) Questionnaire, Beck Depression Scale were administered to the patient. 33 of 77 patients had urodynamic study and these patients constituted the subgroup of the study. Patients were grouped according to type of disorder, type of detrusor and detrusor sphincter dyssynergia (DSD) using urodynamic study findings. The mean CLSS of men was significantly higher than women (P = 0.017). A significant positive correlation was found between age and CLSS (P = 0.035 r = 0.24) and negative correlation was found between total FIM and all sub-parameter scores and mean of CLSS (P = 0.001 r = -0.467). LUTD is common in stroke patients and the presence of urinary symptoms is associated with poor functional status. No significant relationship was observed between urodynamic data except maximum flow rate and CLSS.

Influence of Lower Urinary Tract Dysfunction on Functional Status among Ambulant Stroke Survivors: A Pilot Study

Background: Stroke is one of the diseases affecting the nervous system which controls the lowerurinary tract. Lower urinary tract dysfunction is a broad term of subjective urinary tract symptomsand may vary according to the course of disease. The presence of Lower urinary tract dysfunction is anegative prognostic indicator for a variety of health and rehabilitation outcomes across the spectrumof care. This study was carried out to find whether severity of lower urinary tract dysfunction has aninfluence on functional status among ambulant stroke survivors.Methodology: 20 ambulant stroke survivors with the mean age of 68.55±8.02 were evaluated usingCore Lower Urinary Tract Symptom Score to assess the severity of lower urinary tract dysfunction andBarthel Index to assess the functional status.Conclusion: This pilot study found weak negative correlation (r=-0.26) between Core lower urinarytract symptom score and functional status; however it was found to be statistically non-significant(p&gt;0.05).

Overview of lower urinary tract symptoms post-trauma intensive care unit admission

BackgroundThe study was undertaken to assess the incidence of lower urinary tract symptoms (LUTS) after short-term indwelling urethral catheter (IUC) in polytrauma patients admitted to a level one trauma unit using core lower urinary tract symptom score (CLSS). Data of patients admitted between January 2013 and December 2015 and meeting the study criteria were retrieved from the hospital informatics system. Chart review was done, and patients were subsequently interviewed telephonically.ResultsNinety-four respondents comprising of 81.9% males and 18.1% females out of the 221 eligible patients were contacted. The most common LUTS reported was urethral pain, and 90% had mild to moderate symptoms. No severe LUTS were identified. There was a positive correlation between the duration of IUC and LUTS, but there was no statistically significant association between age and LUTS in our study population.ConclusionShort-term duration of IUC in the trauma ICU patient is associated with predominantly mild irritative LUTS which are mostly self-limiting and may not need further investigations and management. CLSS was found to be a useful screening tool. Further studies are needed to confirm findings in our study.

Flexible cystoscopy can improve anxiety and subjective feelings of bladder cancer patients during follow-up.

IntroductionThe effect of repeated cystoscopy on bladder cancer (BC) patient anxiety and feelings is rarely evaluated.AimTo compare the difference of patients’ anxiety and subjective feelings caused by different cystoscopes.Material and methodsWe prospectively included 192 BC patients who accepted regular cystoscopy follow-up after transurethral resection of bladder tumor (TURBT): 93 in the flexible group and 99 in the rigid group. The method of anesthesia and the order of examinations were consistent between different groups. We analyzed the anxiety level before cystoscopy, the maximum pain during the examination and the change of lower urinary tract symptoms (LUTS) before and after cystoscopy. Meanwhile, we analyzed the rate of gross hematuria and pyuria after cystoscopy. The anxiety and pain levels were evaluated by the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and visual analogue scale (VAS). LUTS was reflected by the Core Lower Urinary Tract Symptom Score (CLSS). We distinguished gender during analysis.ResultsThe median APAIS score of male patients undergoing flexible or rigid cystoscopy was 8 vs. 12 (p < 0.01), and this result for females was 8 vs. 9 (p = 0.048). The median pain scores for men in the two groups was 1 vs. 2 (p < 0.01), respectively, and this outcome in female patients was 0 vs. 1 (p < 0.01). Patients in the rigid group had more CLSS change (0 vs. 1, p < 0.01). There was no difference in pyuria or gross hematuria rate after examination. Analysis in respective groups showed that men have more severe pain than women, 1 vs. 0 (p = 0.001) in the flexible group and 2 vs. 1 (p = 0.009) in the rigid group.ConclusionsA flexible cystoscope can improve anxiety and subjective feelings of BC patients during cystoscopy follow-up.

Longitudinal change of comprehensive lower urinary tract symptoms and various types of urinary incontinence during robot-assisted radical prostatectomy.

To clarify longitudinal change of lower urinary tract symptoms (LUTS) and various types of urinary incontinence following robot-assisted radical prostatectomy (RARP) using validated questionnaires. The core lower urinary tract symptom score (CLSS) and the International Consultation on Incontinence Questionnaire (ICIQ)-Short Form (SF) questionnaires were administered to 607 consecutive, treatment-naïve men receiving RARP before and after surgery. The time course of comprehensive LUTS and various types of urinary incontinence, including stress-, urgency-, and urinary incontinence with no obvious reason, were evaluated. Continence recovery rates were compared for the different types of incontinence using Cox hazard regression analysis. After surgery, stress urinary incontinence (SUI) was reported most frequently (32% of cases) as the chief complaint with the most impact on daily life, as assessed by the CLSS questionnaire, followed by urgency urinary incontinence (UUI; 27% of cases). The rates of continence recovery differed among the different types of urinary incontinence, such as after urinating, when dressed, when asleep, when physically active or exercising, when coughing or sneezing, before reaching the toilet, and for no obvious reason. Incontinence for no obvious reason at 1 month after RARP was a strongest prognostic factor of delayed continence recovery (hazard ratio, 0.61; P < 0.0001), whereas patients reporting SUI and UUI gradually regained continence. Further time course on continent recovery after RARP would be more precisely predictable based on the incontinence status at one month postoperatively. Especially, incontinence with no obvious reason would be a significant factor for delayed recovery.

Validation of a novel digital health monitoring system to measure the volume of voided urine.

To validate a novel digital health monitoring system to measure the volume of voided urine. Micturition volume was calculated using our novel digital self-health monitoring system of urine excretion (s-HMSU) in 18 participants (16 women and 2 men; average age, 40.8 years), without a history of voiding symptoms. Participants completed a self-reported questionnaire regarding their medical history and water intake during the period of observation, as well as the Core Lower Urinary Tract Symptom Score (CLSS) questionnaire. To assess the reliability of the voided volumes measured using the s-HMSU, the intraclass correlation coefficient (ICC) was calculated between the volume and the change in body weight before and after micturition. The CLSS questionnaire confirmed the absence of urinary system diseases in all participants. The medical history was also negative with the exception of hypertension in one participant. The ICC (1,1) between the measured volume of urine excretion using the s-HMSU and the change in body weight was 0.972 (95% confidence interval, 0.957-0.982). The s-HMSU system provides a reliable measure of voiding volume and is appropriate for home use. It has the potential to facilitate large-scale clinical research to examine the relationship between medical diseases and voiding dysfunction.

Effect of salt intake reduction on nocturia in patients with excessive salt intake.

To assess the efficacy of salt reduction for improving nocturia in patients with high salt intake. Changes in lower urinary symptoms and frequency volume chart by salt intake (men: 8 g/day; women: ≥7 g/day) were analyzed in this prospective study. Patients were instructed to use a brochure for salt intake restriction via interview once every four weeks. The daily salt intake was estimated by using spot urine samples. Two-hundred twenty-three (69.5%) patients were successful in reducing their daily salt intake (S group), whereas 98 (30.5%) patients failed to reduce their salt intake (F group). In the S group, nocturia improved from 2.3 ± 0.9 to 1.4 ± 1.0, and nocturnal polyuria index (NPi) improved from 30.2 ± 7.5 to 27.7 ± 7.3% (P < 0.001). In the Core Lower Urinary Tract Symptom Score (CLSS) of the S group, Q3 (urgency) improved from 1.0 ± 1.0 to 0.9 ± 1.0 (P = 0.001); Q1 (diurnal frequency) (P < 0.001), and Q2 (nocturia) also improved (P < 0.001). Moreover, the quality of life parameter improved significantly (P < 0.001). The patients in the F group did not have improvements in any symptom during the study period. Patients with nocturia who also have high salt intake should be advised to reduce their salt intake, as a lifestyle modification. Our results support the importance of randomized clinical trials with larger populations and the appropriate inclusion/exclusion criteria to conclude the clinical usefulness of salt reduction in this patient cohort.

A questionnaire survey to assess lower urinary tract symptoms in patients with chronic stroke.

In this study, we evaluated the prevalence of lower urinary tract symptoms and the associated clinical features in patients with chronic stroke. Patients with stroke who had been regularly followed up at general medical hospitals in Okinawa, Japan were enrolled in the study. The patients were asked to complete a self-reported questionnaire regarding their physical activity, medical history, and the core lower urinary tract symptom score (CLSS) questionnaire, with anonymity. The association between each urinary disturbance category and the clinical characteristics of the patients such as age, gender, physical activity, and underlying disease was evaluated. In total, 51 patients (33 men and 18 women; mean age, 71.7 years) were eligible for analysis. The average time after the first stroke onset was 8.5 years. Nocturia and urgency incontinence had the greatest impact on the quality of life. Overactive bladder symptoms such as nocturia, urgency, urgency incontinence, and stress urinary incontinence were associated with age, female sex, and having a co-existing medical condition (such as ischemic heart disease, hypertension, and depression). Voiding symptoms such as slow stream and straining were associated with age and physical activity after stroke. Storage symptom is associated with not only neurological deficits but also sex and the presence of general diseases, whereas voiding symptom is influenced by physical activity in patients with chronic stroke. Therefore, lower urinary tract symptoms should be carefully monitored and physical rehabilitation should also be considered in patients with stroke.

当院における腹腔鏡下仙骨腟固定術に対する取り組み

Laparoscopic sacrocolpopexy (LSC) provides patients with a safe and low relapse-rate procedure for Pelvic Organ Prolapse (POP), and a shift has been observed from traditional vaginal surgery to laparoscopic surgery in our hospital. From March 2015 to September 2016, 25 cases with POP underwent LSC after an uterus subtotal hysterectomy was performed, which fixed the double mesh suture of the vaginal wall and the L5 anterior longitudinal ligament. Upon introduction, patient's age, comorbidities, and lower urinary tract disorders were evaluated preoperatively to determine the adaptation by the appropriate questionnaire, Core Lower urinary tract Symptom Score (CLSS) and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Surgical manipulation in the pouch of Douglas seems to be a rate-limiting step of surgery. Identification of the Levator ani muscles is crucial for accurate recognition of the pelvic floor midline, including the rectum, by appropriate towing. In addition, this stage is also important to prevent the complications of de novo defecation disorders.

Prospective analyses of female urinary incontinence symptoms following total hip arthroplasty.

Some patients with hip osteoarthritis report that urinary incontinence (UI) is improved following total hip arthroplasty (THA). However, the type and severity of UI remain unclear. In this study, we hypothesize that both stress urinary incontinence (SUI) and urge urinary incontinence (UUI) are improved after THA. We assess the characteristics of UI and discuss the anatomical factors related to UI and THA for improved treatment outcome. Fifty patients with UI who underwent direct anterior-approach THA were evaluated. Type of UI was assessed using four questionnaires: Core Lower Urinary Tract Symptom Score (CLSS), Urogenital Distress Inventory Short Form (UDI-6), International Prostate Symptom Score (IPSS), and Overactive Bladder Symptom Score (OABSS). Uroflowmetry and postvoid residual urine were measured using ultrasound technology. Hip-joint function was evaluated using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and range of motion (ROM). Of the 50 patients, 21 had SUI, 16 had mixed urinary incontinence (MUI), and eight had urgency urinary incontinence (UUI). In total, 36 patients were better than improved (72%). The rate of cured and improved was 76% for SUI, 100% MUI, and 50% UUI. The improvement of ROM was more significant in cured or improved patients than in stable or worse patients. Improvement in mild UI may be an added benefit for those undergoing THA for hip-joint disorders. These data suggest that for patients with hip-joint disorder, hip-joint treatment could prove to also be a useful treatment for UI.

LOWER URINARY TRACT SYMPTOMS AND FUNCTIONS AFTER RENAL TRANSPLANTATION AT OUR HOSPITAL

We investigated lower urinary tract symptoms (LUTS) and function in patients who had undergone renal transplantation (RTx). Fifty patients (34 males and 16 females; age 16-68 years) undergoing RTx at our hospital were included in this study. Average follow-up after RTx was 6.1 years (range 0.5-28). The pre-transplant dialysis period averaged 2.5 years (range preemptive-18.6 years). We conducted the evaluation of lower urinary tract symptoms (LUTS) and function using uroflowmetry (UFM) , residual urine measurement, 24h bladder diary, International Prostate Symptom Score (IPSS), QOL score, Overactive Bladder Symptom Score (OABSS) and Core Lower Urinary Tract Symptom Score (CLSS). Average first desire to void and maximum desire to void were 89.9 mL and 185 mL respectively in cystometry before RTx. Atrophy of the bladder before RTx showed a correlation with the dialysis period. UFM of post-RTx was maximum urinary flow rate of 21.8 mL/s and a voided volume of 287.6 mL. Severe cases of IPSS, QOL, OABSS and CLSS were not observed. Average 24h voided volume, urination times and nocturia were 2,329 mL, 8.2 times and 0.9 times respectively. Polyuria after RTx was observed in 21 patients (42%). Aging and vascular lesions such as diabetes and cardiovascular disease were the most important factor of LUTS. After RTx, LUTS were present in a number of cases after RTx. Patients undergoing RTx has been aging, it is considered necessary to perform the evaluation of LUTS before RTx.

Study on the relationship between LUTS and the background of female community residents

ABSTRACTThis study aimed to clarify the relationship between lower urinary tract symptoms (LUTS) and the backgrounds of female community residents. The subjects were 928 female residents. The questionnaire comprised questions on their background and LUTS based on core lower urinary tract symptom score (CLSS) questionnaire. Among the 10 items of LUTS were related to age, sleep, exercise habits, going out, hospital visits or medication needs.

PD21-12 NOCTURIA IS CHAOTIC CONDITION CAUSED BY NOCTURNAL POLYURIA, AGE, COMORBIDITY, INSOMNIA, URGENCY, AND BLADDER CAPACITY.

PD21-12 NOCTURIA IS CHAOTIC CONDITION CAUSED BY NOCTURNAL POLYURIA, AGE, COMORBIDITY, INSOMNIA, URGENCY, AND BLADDER CAPACITY.

The quality of life in patients during intravesical treatment and correlation with local symptoms

Objective:To evaluate the quality of life (QoL) in patients who had undergone intravesical treatment for non-muscle invasive bladder cancer and analyse the correlation between QoL and local symptoms.Methods:A total of 106 non-muscle invasive bladder cancer patients were enrolled. Quality of life was measured using the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Local symptoms were measured with Core Lower Urinary Tract Symptom Score (CLSS) questionnaire. Both questionnaires were administered before starting the instillation and after instillation. The correlation between local symptoms and QoL was analyzed.Results:Quality of life was significantly impaired by intravesical treatment. The scores of global health status and social functioning significantly decreased from 83·3±11·8 and 100 to 74·5±17·2 and 83·6±15·4 respectively. The symptoms of pain, diarrhea, and financial difficulties scored higher than that of baseline. The CLSS and QoL index increased significantly compared to baseline. The scores of global health status and pain were significant associated with CLSS.Conclusion:Long-term intravesical treatment could decline the QoL of patients. Local symptom was an important factor found to be associated with impairment of QoL. Appropriate therapy for local symptoms might improve the patients’ overall QoL.

Editorial Comment to Evaluation and validation of the Core Lower Urinary Tract Symptom Score as an outcome assessment tool for the treatment of benign prostatic hyperplasia: Effects of the α1‐adrenoreceptor antagonist silodosin

Ito et al. carried out a longitudinal symptom assessment of men receiving silodosin, an α1-adrenoreceptor antagonist, using the Core Lower Urinary Tract Symptom Score (CLSS), International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS) in a cohort of 241 patients with benign prostate hyperplasia (BPH) and BPH/overactive bladder (OAB).1 The results showed that the CLSS questionnaire is reflective of lower urinary tract symptoms (LUTS) in men with BPH and BPH/OAB, as well as IPSS and OABSS questionnaires. The correlation between baseline CLSS and the quality of life (QOL) index was relatively low in men with BPH (coefficient value = 0.314) and those with BPH/OAB (coefficient value = 0.244), thus the authors recommended that both the CLSS and QOL index should be used together. The 10 symptoms addressed in the CLSS questionnaire were selected from 25 symptoms defined by the International Continence Society Standardization Committee if more than one-quarter of patients with nine common conditions/diseases indicated the symptom as one of three most bothersome symptoms.2 Thus, the CLSS questionnaire is a non-disease-specific gender-free symptom assessment tool to capture important symptoms that might be overlooked by disease-specific questionnaires, such as IPSS or OABSS.2-5 In other words, the CLSS is not a disease-specific questionnaire and should have a low correlation with the QOL index in a cohort with definite diagnosis. The CLSS would be more useful for symptom assessment of subjects with multiple conditions or at the initial assessment and during a long-term follow up. For example, the prevalence of urgency incontinence or pain, which is addressed by the CLSS questionnaire alone, was low in this cohort. However these symptoms are relatively common in men with LUTS and have a definite impact on QOL.3, 5 None declared.

A pilot study on intravesical administration of curcumin for cystitis glandularis.

Cystitis glandularis (CG) is a proliferative disorder in the urinary bladder. The outcome of current treatments in some patients is not satisfactory. Curcumin, a herbal medicine that has been used for centuries, has shown great potential in treating various diseases. Our pilot study aimed to explore the feasibility of an intravesical treatment for CG using curcumin. 14 patients diagnosed with CG that remained symptomatic after primary treatments were enrolled, underwent a 3-month curcumin intravesical treatment (50 mg/50 mL, 1 hour, once per week for first 4 weeks and once per month for next 2 months) and were followed up for 3 months. Efficacy of the treatment was evaluated using core lower urinary tract symptom score (CLSS) questionnaire. 10 patients demonstrated persistent improvement in symptoms up to the end of the 6-month study. Their CLSS decreased significantly after the 3-month treatment (6.0 ± 0.8; P < 0.01) from the baseline (10.5 ± 1.6) and maintained decreasing till the end of the study (6.2 ± 0.7; P < 0.01). 4 patients were classified as nonresponders. Our study suggests the feasibility of further randomized controlled trials on curcumin intravesical treatment in CG patients who remain symptomatic after primary treatments.

Association between lower urinary tract symptoms and sexual dysfunction assessed using the core lower urinary tract symptom score and International index of erectile function-5 questionnaires

Objective: The aim of this study is to assess the association between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) using the Core Lower Urinary Tract Symptom Score (CLSS) and the International Index of Erectile Dysfunction (IIEF)-5 questionnaires. Methods: A total of 220 consecutive treatment-naive men completed the International Prostate Symptom Score (IPSS), CLSS, and IIEF-5 questionnaires. The clinical diagnoses were benign prostate hyperplasia (BPH, n = 58), prostatic cancer (n = 51), prostatitis (n = 28), overactive bladder wet (OAB wet, n = 16), other diagnoses (n = 39), and controls (n = 28). Simple statistics and predictability of low IIEF-5 score were examined. Results: The total IIEF-5 score significantly correlated with both the IPSS and CLSS questionnaires (p = 0.0001). Among IPSS and CLSS symptoms, factors other than daytime frequency and incomplete emptying showed significant correlation with the total IIEF-5 score. A multivariate regression model indicated nocturia and urethral pain as independent factors for low IIEF-5 scores. Conclusion: Urethral pain was identified as an independent factor for erectile dysfunction. The extraction of pain symptoms using CLSS questionnaire may be useful to evaluate LUTS in men with pelvic health problems.