Tuesday, September 18, 2012

Medical Management of Comorbid BPH/LUTS and ED: Defining the Current Treatment Algorithm part 2


Patients who have erectile dysfunction (ED) should be screened for which of the following conditions?
Dementia
Benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS)
Colon cancer
All of the above
None of the above


































Epidemiologic studies report an association between BPH/LUTS and ED independent of age and comorbidities. LUTS and ED share a pathophysiology, and the presence and severity of LUTS are independent risk factors for sexual dysfunction, according to the Multinational Survey of the Aging Male (MSAM-7). Men seeking care for ED should be screened for BPH/LUTS and vice versa, and sexual function should be assessed and discussed with the patient when choosing BPH/LUTS treatment and evaluating his response. McVary et al's retrospective study of 81,658 men with ED highlights a significant disparity between primary care and urology clinics in screening, diagnosing, and treating BPH. Men with ED seeing a urologist are more likely to be screened for BPH (OR, 2.4), diagnosed (OR, 1.8), or treated (OR, 1.3; P < .0001), and time to screening was shorter for those seeing urologists (121.1 versus 282.2 days).

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