Lower urinary tract symptoms and male sexual dysfunction in Asia: a survey of ageing men from five Asian countries

• Man-Kay Li‡‡Gleneagles Medical Center, Singapore, Man-Kay Li, Gleneagles Medical Center, Napier Road 2–18, Singapore 258499.
  e-mail: mkli56@singnet.com.sg,
• Lester A. Garcia**East Avenue Medical Center, Manila, The Philippines and and
• Raymond Rosen††Department of Psychiatry, UMDNJ – Robert Wood Johnson Medical School, Piscataway, NJ, USA

• ‡Gleneagles Medical Center, Singapore, *East Avenue Medical Center, Manila, The Philippines and †Department of Psychiatry, UMDNJ – Robert Wood Johnson Medical School, Piscataway, NJ, USA

ASAM, Asian Survey of Aging Males; DAN-PSS-Sex, Danish Prostatic Symptoms Score; IIEF, International Index of Erectile Function; ED, erectile dysfunction; EjD, ejaculatory dysfunction; MSAM-7, Multinational Survey of the Aging Male; OR, odds ratio.

To determine, using the Asian Survey of Aging Males (ASAM), the prevalence of lower urinary tract symptoms (LUTS) and sexual disorders in Asian men aged 50–80 years, and to investigate the relationship between LUTS and sexual dysfunction, as community-based studies have shown a relationship between LUTS and sexual dysfunction.

SUBJECTS AND METHODS

The ASAM survey was conducted in selected cities in five Asian countries, using a combination of face-to-face and mail-survey methods. The survey evaluated demographics, urinary symptoms (using the International Prostate Symptom Score, IPSS, and bother score), functional problems (using the Danish Prostatic Symptoms Score, DAN-PSS-Sex, and International Index of Erectile Function, IIEF) and comorbidity factors. In all, 1155 men aged 50–80 years completed the survey.

RESULTS

The prevalence of LUTS varied among the countries, ranging from 14% in Singapore to 59% in the Philippines. Moderate to severe LUTS were reported by 36% of men aged 50–59 years, 50% aged 60–69 years and 60% aged 70–79 years. About three-quarters of all respondents (72%) aged 50–80 years were sexually active. Erectile dysfunction was reported by 63% of men in the study, of whom 57% were bothered by their symptoms. Ejaculation disorders were present in 68% of respondents (52% reported bothersomeness) and pain on ejaculation was experienced by 19% of the men in the study (88% reported bothersomeness). Sexual disorders increased with age and increasing severity of their LUTS. Erectile and ejaculation problems were more common in subjects with diabetes or hypertension; these two groups showed the same relationship between LUTS severity and sexual disorders.

CONCLUSION

These results confirmed that sexual activity is common in Asian men aged 50–80 years, even at an advanced age. They also confirmed the correlation between LUTS and sexual dysfunction.

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