Beyond The Lower Urinary Tract: The Association Of Urologic And Sexual Symptoms With Common Illnesses

Main Category: Urology / Nephrology
Also Included In: Sexual Health / STDs;  Erectile Dysfunction / Premature Ejaculation;  Public Health
Article Date: 17 Sep 2007 - 0:00 PST

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UroToday.com- The question of whether there are links between common urologic symptoms and medical and psychological illness remains understudied. Fitzgerald and coworkers from Loyola University in Illinois and New England Research Institutes in Massachusetts sought to determine whether there is an association between urologic and sexual symptoms and medical and psychological illness in a large, cross-sectional study of American adults. Data from the Boston Area Community Health Survey (BACH) was analyzed with regard to 10 urologic or sexual symptoms. Surrogates for lower urinary tract symptoms, painful bladder syndrome, urinary incontinence, prostatitis, frequency, urgency, nocturia, overactive bladder, erectile dysfunction, and female sexual dysfunction were identified in the collected data.

In total, 5506 people completed the BACH survey. All urologic and sexual symptoms studies were significantly associated with depression. Most symptoms are significantly more prevalent in the presence of other illnesses than when they exist alone. Cardiac disease was associated with many urologic symptoms even after adjusting for other co morbid illnesses and other covariates. An association of urologic symptoms with type II diabetes and hypertension was also suggested.

The results add to the growing literature that suggests underlying medical and psychological illnesses contribute to or are reflected in urologic symptoms. This has now become a cornerstone of management in men with erectile dysfunction (ED), wherein the ED must be evaluated as a harbinger of possible cardiovascular disease. While this study is primarily best described as "data mining", it will lead to hypothesis driven studies that may better categorize such relationships and suggest appropriate interventions in the future.

Fitzgerald MP, Link CL, Litman HJ, Travison TG, McKinlay JB

Euro Urol. 52(2): 407-15, August 2007
doi:10.1016/j.eururo.2007.03.014
Reported by UroToday.com Contributing Editor Philip Hanno, MD, MPH

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