下尿路症状与勃起功能障碍关系的研究进展

Association Between Lower Urinary Tract Symptoms and Erectile Dysfunction

下尿路症状(LUTS)和勃起功能障碍(ED)均为老年男性的常见疾病,严重影响患者的生活质量。近年来许多流行病学调查对LUTS与ED的关联性进行研究分析,认为LUTS,尤其是其排尿症状、夜尿症状及个人困扰为ED的独立危险因素。LUTS与ED伴随发病可能主要涉及以下机制:①Rho-激酶表达/活性增强;②一氧化氮释放减少及内皮素-1的海绵体平滑肌收缩作用增强;③海绵体平滑肌肌球蛋白亚型组成改变;④自主神经兴奋性增强及海绵体平滑肌神经分布减少。LUTS与ED间关联性的研究为两者的临床诊疗提供了新的思路。现简要综述近年来LUTS与ED关系的研究进展。

Lower urinary tract symptoms（LUTS） and erectile dysfunction（ED） are highly prevalent in aging men and both of the conditions have a significant impact on the quality of life. In the past few years, various epidemiological trials were conducted to assess the association between LUTS and ED. These studies showed that LUTS, particularly the voiding symptoms, nocturia and the bothers caused by LUTS, independently increased the incidence of ED. There are some factors involved in the link between LUTS and ED- ①rho-kinase expression/activity increased; ②nitric oxide release decreased and corpus cavernosum smooth muscle contraction strengthened due to endothelin-1 ; ③the composition of myosin isoform altered; （A）sympathetic hyperactivity and innervation of the corpus cavernosum smooth muscles decreased. These findings concerning the relationship between LUTS and ED have offered some new insights into the evaluation and treatment of patients with these conditions. The present paper briefly reviews the recent studies of the association between LUTS and ED.