The Link Between Urological Health and Quality of Life in Men

Credit: Adobe Stock/mangostock

Genitourinary health, including issues like erectile dysfunction (ED) and lower urinary tract symptoms (LUTS), plays a crucial role in men’s quality of life, especially after the age of 40. A recent study found that over half of participants experienced some degree of ED and about one-third had LUTS. Both conditions became more common with age and were linked to lower quality of life, highlighting the importance of addressing these concerns with healthcare providers to improve well-being.

The causes of these conditions often involve problems with blood flow, nerve function and the lining of blood vessels. They can lead to ongoing symptoms that affect daily life, including needing to urinate frequently during the day (pollakiuria), waking up at night to urinate (nocturia), feeling an urgent need to urinate, difficulty starting or maintaining a urine stream (such as straining, weak or stop-and-go flow, or not fully emptying the bladder), and dripping urine after finishing (post-micturition dribbling).

“Despite their prevalence and impact, social taboos and a cultural tendency among men to perceive themselves as invulnerable contribute to a reluctance to seek medical help,” wrote Jean Sousa Cavalcante, M.D., and her team from the University of São Paulo, Brazil. “This reticence exacerbates health disparities and challenges faced by men, underscoring the need for targeted public health strategies to address these critical issues.”

The observational, cross-sectional study was performed in Bauru, São Paulo, between July 2021 and August 2022. Information on age, religion, marital status and self-declared color was collected via face-to-face interviews with participants. Other assessments included the World Health Organization Quality of Life scale, the International Index of Erectile Function-6 (IIEF-6) and the International Prostate Symptom Score (IPSS).

In total, 375 men (median age 53 years) were included in the study, Most (60.0%) were White, 54.1% were Catholic and 56.6% were married, aligning with the current historical context of this region in Brazil. Health perception was rated as “good” or “very good” by 74.4% of participants, and 71.2% rated their health satisfaction as “satisfied” or “very satisfied.”

According to the IIEF-6, 51.1% of participants exhibited some degree of ED (median score 25), which is in line with national and international research findings. IPSS results showed 35.2% of men had some degree of LUTS (median score 5). The urological assessments demonstrated a direct correlation with age, as well as significant differences between the medians of different marital statuses.

The severity or presence of ED and LUTS was correlated with quality of life. That is, the more severe the condition, the worse perceived quality of life. Investigators hypothesized that quality of life may be indicative of better health outcomes within individual, cultural and societal frameworks, and can be associated with the complex nature of men’s perceptions of their health, well-being and masculinity.

Investigators noted limitations of the study such as generalizability of the findings and their inability to perform multivariate analysis or confirm causal relationships. Additionally, using self-reported data to identify ED and LUTS may have potentially hindered the accuracy of results.

“The highlighted prevalence of these disorders in this study, coupled with their considerable impact on the quality of life, underscores the urgency for further investigation in this field and heightens the necessity for health services at all levels to prioritize these health issues, recognizing their potential widespread influence on individuals’ lives,” investigators concluded.