Relationship between Chronic Prostatitis/Chronic Pelvic Pain Syndrome and Erectile dysfunction
Jun Ho Lee (1), Jae Duck Choi (2)
(1) National Police Hospital, Seoul, South Korea, (2) KEPCO Medical Center, Seoul, South Korea
The relationship of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with erectile dysfunction (ED) has been investigated in a few studies. However, previous studies are limited by having a small participant number or minimal adjustment for potential confounding factors including testosterone and metabolic syndrome. Therefore, the current data are insufficient to support routine screening of ED in men with CP/CPPS or CP/CPPS in men with ED. This study aims to evaluate the relationship between ED and CP/CPPS.
A total of 8,261 men in their 40s and 50s were included. The National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI), and the International Index of Erectile Function-5(IIEF) were used for symptoms assessment. Symptoms were classified as a “mild prostatitis-like symptom” if respondents reported perineal or ejaculatory pain and had a NIH-CPSI pain score of ≥4 and <8; the symptoms were classified as moderate to severe if the pain score was ≥8 according to previous reports. Moderate to severe ED was defined as IIEF<12. A full metabolic work-up and serum testosterone level checks also performed.
The mean age was 50.4±5.5 years. In total, (2)4.9% men had prostatitis-like symptoms(NIH-CPSI pain score of ≥4 and perineal or ejaculatory pain), and 7.0% men had moderate to severe symptoms. Additionally, (1) (2).6% men were classified as moderate to severe ED. The IIEF was found to have a significant negative correlation with the NIH-CPSI pain domain (correlation coefficient = -0. (1)98; P < 0.00 (1)). After adjusting for age, metabolic syndrome status, and testosterone level, there was no change in the negative correlation between the NIH-CPSI pain domain and IIEF (Beta = -0.395; P < 0.00 (1)). After adjusting for age, testosterone level, and metabolic syndrome, the odds ratio(OR) for moderate to severe ED significantly increased with the severity of pelvic pain (mild prostatitis-like symptoms, OR for moderate to severe ED: (2).557, 95% confidence interval: (2).09 (2)–3. (1) (2)5; moderate to severe symptoms, OR for moderate to severe ED: 5. (1)64: 95% confidence interval: 4.433–6.0 (1)6).
ED and chronic prostatitis-like symptoms are significantly and independently correlated with each other. The severity of prostatitis-like symptoms is also related to ED. Based on our data, we suggest routine screening for CP/CPPS in men with ED and ED in men with CP/CPPS.