New Research: Overactive Bladder Symptoms Can Affect Sexual Health in Men
By Zoe Kopp, PhD, MPH
Overactive bladder (OAB) is a condition associated with needing to urinate often, urgently and at times not getting to the bathroom in time. The condition affects men and women equally although women are more likely to have urgency incontinence than men. Symptoms of urinary frequency and urgency in men are often attributed to enlargement of the prostate, also called benign prostate hyperplasia. Since the prostate wraps around the urethra, or bladder outlet, enlargement of this gland can make it difficult for the bladder to empty, referred to as bladder outlet obstruction. All of these symptoms are categories of a broader condition known as lower urinary tract symptoms (LUTS).
LUTS has three categories of symptoms related to the three stages of bladder function:
Storage symptoms: frequent or urgent urination (OAB) and loss of bladder control for any reason (urinary incontinence)
Emptying (urination) symptoms: difficulty starting urination, slow urination, trouble maintaining a stream, and difficulty completely emptying the bladder
Post-urination symptoms: dribbling of urine after urination is finished
Past research demonstrates an association between LUTS and erectile dysfunction in men, meaning that many men with LUTS also have problems achieving an erection and vice-versa. But what about storage symptoms and OAB specifically? And does LUTS impact other aspects of male sexual health in addition to erections?
A new study (funded by Pfizer, Inc.) surveyed almost 12,000 men, with an average age of 57, about whether they had any lower urinary tract symptoms or difficulties with erections or ejaculation.
There were several noteworthy findings from this research. Nearly three-quarters of men were not sexually active. The most common reason men were not sexually active was because they did not have a sexual partner. Half of the men did not have OAB symptoms; one quarter had frequency and urgency incontinence (loss of bladder control). Eight out of ten men with no urinary symptoms were sexually active compared to six out of ten with frequency and urgency. Only five out of ten men with urgency incontinence reported being sexually active. One quarter of the men reported their OAB symptoms were the reason they decreased or stopped having sex. Problems with erections occurred in one-third of the men with OAB. Problems with ejaculation were less common. Erectile problems increased as men got older and premature ejaculation was more common in younger men.
Why is this research important? Knowing that urinary symptoms are associated with sexual problems identified earlier and perhaps treated more effectively. How? Talking about sexual problems is not easy for anyone. Bringing up problems with urination may be easier for men. This recent study, which shows the connection between OAB and sexual problems may help physicians and patients think about the conditions together—making it easier for men to get their concerns addressed.
About the Author:
Dr. Kopp is a Senior Director in Outcomes Research at Pfizer, Inc. She has done extensive research and published in urological epidemiology and patient-reported outcomes. Prior to joining Pfizer, she worked in international public health specializing in sexual and reproductive health. She has no substantial financial relationships in connection with this article to otherwise disclose.