Clinical correlates of enlarged prostate size in subjects with sexual dysfunction

作     者：Giovanni Corona Mauro Gacci Elisa Maseroli Giulia Rastrelli Linda Vignozzi Alessandra Sforza Gianni Forti Edoardo Mannucci Mario Maggi 

作者机构：Endocrinology Unit Maggiore-Bellaria Hospital Medical Department Azienda-Usl Bologna Bologna Italy Department of Urology Sexual Medicine and Andrology Unit Department of Clinical Physiopathology Endocrinology Unit Department of Clinical Physiopathology University of Florence Florence Italy Diabetes Agency Careggi Hospital Florence Italy 

出 版 物：《Asian Journal of Andrology》 (亚洲男性学杂志（英文版）)

年 卷 期：2014年第16卷第5期

页      面：767-773,I0011页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：benign prostatic hyperplasia metabolic syndrome enlarged prostate size testosterone 

摘      要：Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction （SD）. A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects （n = 1823; mean age 54.7± 11.4） selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome （HR = 1.346 （1,129-1.759）; P = 0.030）, type 2 diabetes mellitus （HR = 1.489 （1.120-1.980）; P = 0.006）, increased LDL cholesterol （〉100mgdl^-1; HR = 1.354 （1.018-1.801）; P = 0.037） and increased mean blood pressure （BP） values （HR = 1.017 （1.007-1.027） for each mmHg increment; P = 0.001）. Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction （ED）, as well as with other andrological conditions, such as varicocele and premature ejaculation （PE）. PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample （HR = 3.318 （2.304; 4.799） for each log unit increment in PSA levels; P 〈 0.0001）. Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical （DRE） or biochemical （PSA） inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular （CV） background of the patient.