Serum total testosterone level is not associated with nocturia in men with erectile dysfunction without LUTS/benign prostatic
Boeri, L1; Capogrosso, P1; Pederzoli, F1; Ventimiglia, E1; Cazzaniga, W1; Chierigo, F1; Frego, N1; Pozzi, E1; Dehò, F1; Montanari, E2; Mirone, V3; Gaboardi, F1; Montorsi, F1; Salonia, A1
1: Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele, Milan, Italy; 2: IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Dep. pf Urology; Milan; Italy; 3: Department of Urology, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
Objectives: Recent studies focusing on the link between nocturia and serum testosterone (tT) levels have shown conflicting results, irrespectively of benign prostatic hyperplasia (BPH). To better understand the association between nocturia and tT we analysed prevalence of and severity of nocturia and its possible association with tT in patients seeking first medical help for new onset erectile dysfunction (ED) without LUTS/BPH (BPH-).
Materials and Methods: Demographic, clinical and laboratory data from 355 consecutive patients men seeking first medical help for ED (ED+/BPH-) were analysed. Exclusion criteria were: concomitant ED and LUTS/BPH; history of diabetes mellitus; current therapy with diuretics, hormones, or 5-alpha-reductase inhibitor agents; previous surgery for BPH. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients were invited to complete the International Prostate Symptom Score (IPSS) and International Index of Erectile Function – Erectile Function (IIEF-EF) domain. Nocturia was defined as ≥1 nocturnal voiding episodes. Nocturia was assessed using IPSS question 7. Descriptive statistics and logistic regression models tested the association between clinical and hormonal variables and nocturia prevalence.
Results: Mean (SD) age was 47.5 (12.8) years; mean tT value was 5.01 (2.6) ng/ml. Of all, 128 patients (36.1%) voided ≥2 a night (mean number of voiding per night was 1.51 (1.56) [range 0-5] in the whole population). Patients with nocturia were older (46.0 vs. 50.1 yrs; p=0.003) and had higher IPSS scores (8.04 vs. 5.64; p<0.001) than those without nocturia. Groups did not differ in terms of BMI, CCI, tT values and IIEF-EF scores. Multivariable logistic regression analysis showed that age (OR 1.03, p=0.007) and IPSS QoL (OR 1.23, p=0.012) were the only independent predictors of nocturia after accounting for BMI, CCI, IIEF-EF and tT values.
Conclusions: One out of three ED+/BPH- men seeking first medical help for new onset ED reported to void more than once a night. Serum tT was not associated with the prevalence of nocturia in our cohort. Additional studies are needed to increase our understanding on the contribution of T to nocturia.
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