Associations of carotid artery plaque with lower urinary tract symptoms and erectile dysfunction.

purposeTo evaluate the relationship of carotid artery plaque with international prostate symptom score (IPSS) and international index of erectile function-5 (IIEF).

methodsWe enrolled 799 men who had participated in a health examination. They received an IPSS, IIEF, a carotid duplex ultrasound, and a full metabolic work-up. Data were analyzed using Spearman's correlation test, the Mantel-Haenszel Extension test, and logistic regression analyses.

resultsThe median age of the study population was 57 years, and the median IPSS and IIEF were 11 and 15, respectively. The IPSS voiding sub-score was significantly correlated with maximum intima-media thickness (max IMT) (P = 0.002). We observed a significant increase in the severity of the voiding sub-score with increasing severity of plaque size (P = 0.003). Additionally, there was an increased likelihood of having a higher IPSS voiding sub-score as severity of plaque size increased after adjusting for age and components of metabolic syndrome. The IIEF showed a significant negative correlation with max IMT (P < 0.001). Additionally, there was a significant increase in the severity of erectile dysfunction (ED) with increased plaque size (P < 0.001). There was a greater likelihood of having moderate ED in the moderate and severe plaque size groups than in the group with an absence of plaque, after adjusting for age and components of metabolic syndrome (odds ratio = 1.672, P = 0.021).

conclusionOur data suggest that atherosclerosis may play a role in the development of lower urinary tract symptoms (LUTS) and ED and indicate a potential role of ED and LUTS in the prediction of carotid artery plaque.