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''Before you go''—considering genitourinary symptoms as a sentinel indicator of the presence of, or risk for, chronic disorders in men

  • Sam Tafari1,2,*,
  • David Jesudason3,4,5
  • Gary A Wittert1,6

1Endocrine & Metabolic Unit, Royal Adelaide Hospital, 5000 Adelaide, SA, Australia

2South Australian Health and Medical Research Institute, 5000 Adelaide, SA, Australia

3Endocrine Department, Queen Elizabeth Hospital, 5011 Woodville, SA, Australia

4University of Adelaide, 5000 Adelaide, SA, Australia

5Basil Hetzel Institute, 5011 Woodville, SA, Australia

6Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and University of Adelaide, 5000 Adelaide, SA, Australia

DOI: 10.22514/jomh.2024.122

Submitted: 09 May 2024 Accepted: 14 June 2024

Online publish date: 16 August 2024

*Corresponding Author(s): Sam Tafari E-mail: sam.tafari@sa.gov.au

Abstract

Men have a significantly shorter life expectancy compared to women, with disparities further magnified among those from disadvantaged backgrounds. Non-communicable diseases (NCDs) constitute a large proportion of the health disparity between men and women. Up to 40% of the chronic disease burden in men could be mitigated through risk factor management or early intervention. This disparity is often attributed to the engagement with primary and preventive healthcare by men which is influenced by health literacy, accessibility of care and socio-economic status. The manuscript proposes that genitourinary symptoms, specifically erectile dysfunction (ED) and lower urinary tract symptoms (LUTS), are sentinel indicators of chronic diseases or their risk factors in men. LUTS and ED share risk factors with major chronic disorders like cardiovascular disease, diabetes, and obesity, and are associated with depression and obstructive sleep apnea. Both ED and LUTS are meaningful to men and can motivate seeking care, providing healthcare providers an opportunity for preventative measures and early treatment. Such an approach also ameliorates the LUTS and ED symptoms and substantially improves quality of life. We advocate for a targeted approach that uses ED and nocturia as entry points for engaging men in healthcare. This involves public health education to raise awareness about the significance of these symptoms and encouraging healthcare providers to actively inquire about them during consultations. By addressing these symptoms, healthcare practitioners can better identify and treat underlying chronic conditions early, potentially reducing morbidity and mortality among men and helping to narrow the sex related health outcome disparities between genders.


Keywords

Lower urinary tract symptoms; Nocturia; Erectile dysfunction; Cardiovascular disease; Diabetes; Sleep apnoea; Lifestyle; Metabolic syndrome; Men’s health


Cite and Share

Sam Tafari,David Jesudason,Gary A Wittert. ''Before you go''—considering genitourinary symptoms as a sentinel indicator of the presence of, or risk for, chronic disorders in men. Journal of Men's Health. 2024.doi:10.22514/jomh.2024.122.

References

[1] Mateos JT, Fernández-Sáez J, Marcos-Marcos J, Álvarez-Dardet C, Bambra C, Popay J, et al. Gender equality and the global gender gap in life expectancy: an exploratory analysis of 152 countries. International Journal of Health Policy and Management. 2022; 11: 740–746.

[2] Australian Institute of Health and Welfare (AIHW). Social determinants of health. 2023. Available at: https://www.aihw.gov.au/reports/australias-health/health-across-socioeconomic-groups (Accessed: 25 March 2024).

[3] World Health Organisation (WHO). Men’s health. 2018. Available at: https://www.who.int/europe/news-room/fact-sheets/item/men-s-health (Accessed: 25 March 2024).

[4] Australian Institute of Health and Welfare (AIHW). Health behaviours and risk factors of Australia’s males. 2023. Available at: https://www.aihw.gov.au/reports/men-women/male-health/contents/health-behaviours-and-risk-factors-of-australias-m (Accessed: 20 March 2024).

[5] Australian Institute of Health and Welfare (AIHW). The health of Australia’s females. 2023. Available at: https://www.aihw.gov.au/reports/men-women/female-health/contents/lifestyle-risk-factors (Accessed: 20 March 2024).

[6] Mursa R, Patterson C, Halcomb E. Men’s help-seeking and engagement with general practice: an integrative review. Journal of Advanced Nursing. 2022; 78: 1938–1953.

[7] Jesse E, Muncey W, Thirumavalavan N. Erectile dysfunction and treatment: an analysis of associated chronic health conditions. Urology. 2022; 160: 230–231.

[8] Holden CA, McLachlan RI, Pitts M, Cumming R, Wittert G, Ehsani JP, et al. Determinants of male reproductive health disorders: the men in Australia telephone survey (MATeS). BMC Public Health. 2010; 10: 96.

[9] Smith JA, Braunack-Mayer AJ, Wittert GA, Warin MJ. Qualities men value when communicating with general practitioners: implications for primary care settings. The Medical Journal of Australia. BMC Public Health. 2008; 189: 618–621.

[10] Britt HC, Valenti L, Miller GC. Determinants of consultation length in Australian general practice. The Medical Journal of Australia. 2005; 183: 68–71.

[11] Vincent AD, Drioli-Phillips PG, Le J, Cusack L, Schultz TJ, McGee MA, et al. Health behaviours of Australian men and the likelihood of attending a dedicated men’s health service. BMC Public Health. 2018; 18: 1078.

[12] Smith JA, Braunack-Mayer A, Wittert G. What do we know about men’s help-seeking and health service use? The Medical Journal of Australia. 2006; 184: 81–83.

[13] Australian Institute of Health and Welfare (AIHW). The health of Australia’s males. 2023. Available at: https://www.aihw.gov.au/reports/men-women/male-health/contents/access-health-care (Accessed: 20 March 2024).

[14] Ng SK, Martin SA, Adams RJ, O’Loughlin P, Wittert GA. The effect of multimorbidity patterns and the impact of comorbid anxiety and depression on primary health service use: the men androgen inflammation lifestyle environment and stress (MAILES) study. American Journal of Men’s Health. 2020; 14: 1557988320959993.

[15] Goodman C, Lambert K. Scoping review of preference of older adults for patient education materials. Patient Education and Counseling. 2023; 108: 107591.

[16] Garfield CF, Isacco A, Rogers TE. A review of men’s health and masculinity. American Journal of Lifestyle Medicine. 2008; 2: 474–487.

[17] MacArthur KR. Physician–patient interaction and gender differences. In Cockerham WC, Dingwall R, Quah S (ed(s).) The Wiley Blackwell Encyclopedia of Health, Illness, Behaviour, and Society (pp. 1–5). 1st edn. John Wiley & Sons: Hoboken, NJ, USA. 2014.

[18] Sadovsky R. Asking the questions and offering solutions: the ongoing dialogue between the primary care physician and the patient with erectile dysfunction. Reviews in Urology. 2003; 5: S35–S48.

[19] Martin S, Zajac I, Vincent A, Adams RJ, Appleton S, Wittert GA. Effect of depression on health service utilisation in men: a prospective cohort study of Australian men aged 35 to 80 years. BMJ Open. 2021; 11: e044893.

[20] Milner A, Shields M, King T. The influence of masculine norms and mental health on health literacy among men: evidence from the ten to men study. American Journal of Men’s Health. 2019; 13: 1557988319873532.

[21] Stiawa M, Müller-Stierlin A, Staiger T, Kilian R, Becker T, Gündel H, et al. Mental health professionals view about the impact of male gender for the treatment of men with depression—a qualitative study. BMC Psychiatry. 2020; 20: 276.

[22] Lyons Z, Janca A. Diagnosis of male depression—does general practitioner gender play a part? Australian Family Physician. 2009; 38: 743–746.

[23] Ceresa A, Esposito CM, Surace T, Legnani F, Cirella L, Cetti D, et al. Gender differences in clinical and biochemical parameters of patients consecutively hospitalized for unipolar depression. Psychiatry Research. 2022; 310: 114476.

[24] Smith JA, Braunack-Mayer A, Wittert G, Warin M. “It’s sort of like being a detective”: understanding how Australian men self-monitor their health prior to seeking help. BMC Health Services Research. 2008; 8: 56.

[25] Novak JR, Peak T, Gast J, Arnell M. Associations between masculine norms and health-care utilization in highly religious, heterosexual men. American Journal of Men’s Health. 2019; 13: 1557988319856739.

[26] Schillinger D. Social Determinants, health literacy, and disparities: intersections and controversies. Health Literacy Research and Practice. 2021; 5: e234–e243.

[27] Khatri RB, Assefa Y. Access to health services among culturally and linguistically diverse populations in the Australian universal health care system: issues and challenges. BMC Public Health. 2022; 22: 880.

[28] Oliffe JL, Rossnagel E, Kelly MT, Bottorff JL, Seaton C, Darroch F. Men’s health literacy: a review and recommendations. Health Promotion International. 2020; 35: 1037–1051.

[29] Shahid R, Shoker M, Chu LM, Frehlick R, Ward H, Pahwa P. Impact of low health literacy on patients’ health outcomes: a multicenter cohort study. BMC Health Services Research. 2022; 22: 1148.

[30] Hinchliff S, Lewis R, Wellings K, Datta J, Mitchell K. Pathways to help-seeking for sexual difficulties in older adults: qualitative findings from the third national survey of sexual attitudes and lifestyles (Natsal-3). Age and Ageing. 2021; 50: 546–553.

[31] Rastrelli G, Maggi M. Erectile dysfunction in fit and healthy young men: psychological or pathological? Translational Andrology and Urology. 2017; 6: 79–90.

[32] Macdonald JA, Mansour KA, Wynter K, Francis LM, Rogers A, Angeles MR, et al. Men’s and boys’ barriers to health system access: a literature review. Canberra; 08 August 2023.

[33] Irving G, Neves AL, Dambha-Miller H, Oishi A, Tagashira H, Verho A, et al. International variations in primary care physician consultation time: a systematic review of 67 countries. BMJ Open. 2017; 7: e017902.

[34] Leslie SW, Sooriyamoorthy T. Erectile dysfunction. StatPearls Publishing: Treasure Island, Florida, USA. 2024.

[35] Kessler A, Sollie S, Challacombe B, Briggs K, Van Hemelrijck M. The global prevalence of erectile dysfunction: a review. BJU International. 2019; 124: 587–599.

[36] Shiri R, Koskimäki J, Hakama M, Häkkinen J, Tammela TL, Huhtala H, et al. Prevalence and severity of erectile dysfunction in 50 to 75-year-old Finnish men. The Journal of Urology. 2003; 170: 2342–2344.

[37] DeLay KJ, Haney N, Hellstrom WJ. Modifying risk factors in the management of erectile dysfunction: a review. The World Journal of Men’s Health. 2016; 34: 89–100.

[38] Cignarelli A, Genchi VA, D’Oria R, Giordano F, Caruso I, Perrini S, et al. Role of Glucose-lowering medications in erectile dysfunction. Journal of Clinical Medicine. 2021; 10: 2501.

[39] Martin SA, Atlantis E, Lange K, Taylor AW, O’Loughlin P, Wittert GA. Predictors of sexual dysfunction incidence and remission in men. The Journal of Sexual Medicine. 2014; 11: 1136–1147.

[40] Martin-Morales A, Sanchez-Cruz JJ, Saenz de Tejada I, Rodriguez-Vela L, Jimenez-Cruz JF, Burgos-Rodriguez R. Prevalence and independent risk factors for erectile dysfunction in Spain: results of the Epidemiologia de la Disfuncion Erectil Masculina Study. The Journal of Urology. 2001; 166: 569–575.

[41] Ning L, Yang L. Hypertension might be a risk factor for erectile dysfunction: a meta-analysis. Andrologia. 2017; 49: e12644.

[42] Defeudis G, Mazzilli R, Tenuta M, Rossini G, Zamponi V, Olana S, et al. Erectile dysfunction and diabetes: a melting pot of circumstances and treatments. Diabetes/Metabolism Research and Reviews. 2021; 38: e3494.

[43] Li JZ, Maguire TA, Zou KH, Lee LJ, Donde SS, Taylor DG. Prevalence, comorbidities, and risk factors of erectile dysfunction: results from a prospective real-world study in the United Kingdom. International Journal of Clinical Practice. 2022; 2022: 5229702.

[44] Lisco G, Bartolomeo N, Ramunni MI, De Tullio A, Carbone MD, Guastamcchia E, et al. Erectile dysfunction in patients with multiple chronic conditions: a cross-sectional study. Endocrine, Metabolic & Immune Disorders Drug Targets. 2023; 23: 396–404.

[45] Banks E, Joshy G, Abhayaratna WP, Kritharides L, Macdonald PS, Korda RJ, et al. Erectile dysfunction severity as a risk marker for cardiovascular disease hospitalisation and all-cause mortality: a prospective cohort study. PLOS Medicine. 2013; 10: e1001372.

[46] Terentes-Printzios D, Ioakeimidis N, Rokkas K, Vlachopoulos C. Interactions between erectile dysfunction, cardiovascular disease and cardiovascular drugs. Nature Reviews. Cardiology. 2022; 19: 59–74.

[47] Jackson G. Erectile dysfunction and cardiovascular disease. Arab Journal of Urology. 2013; 11: 212–216.

[48] Yannas D, Frizza F, Vignozzi L, Corona G, Maggi M, Rastrelli G. Erectile dysfunction is a hallmark of cardiovascular disease: unavoidable matter of fact or opportunity to improve men’s health? Journal of Clinical Medicine. 2021; 10: 2221.

[49] Esposito K, Ciotola M, Giugliano F, Maiorino MI, Autorino R, De Sio M, et al. Effects of intensive lifestyle changes on erectile dysfunction in men. The Journal of Sexual Medicine. 2009; 6: 243–250.

[50] Pitta RM, Kaufmann O, Louzada ACS, Astolfi RH, de Lima Queiroga L, Ritti Dias RM, et al. The association between physical activity and erectile dysfunction: a cross-sectional study in 20,789 Brazilian men. PLOS ONE. 2022; 17: e0276963.

[51] Bauer SR, Cawthon PM, Ensrud KE, Suskind AM, Newman JC, Fink HA, et al. Lower urinary tract symptoms and incident functional limitations among older community-dwelling men. Journal of the American Geriatrics Society. 2022; 70: 1082–1094.

[52] Mazzilli R, Zamponi V, Mangini F, Olana S, Defeudis G, Faggiano A, et al. The effects of non-andrological medications on erectile dysfunction: a large single-center retrospective study. Journal of Endocrinological Investigation. 2023; 46: 1465–1473.

[53] Chiesa AD, Pfiffner D, Meier B, Hess OM. Sexual activity in hypertensive men. Journal of Human Hypertension. 2003; 17: 515–521.

[54] Allen MS, Tostes RC. Cigarette smoking and erectile dysfunction: an updated review with a focus on pathophysiology, e-cigarettes, and smoking cessation. Sexual Medicine Reviews. 2023; 11: 61–73.

[55] Karunakaran A, Michael JP. The impact of abstinence from alcohol on erectile dysfunction: a prospective follow up in patients with alcohol use disorder. The Journal of Sexual Medicine. 2022; 19: 581–589.

[56] Martin SA, Haren MT, Marshall VR, Lange K, Wittert GA. Prevalence and factors associated with uncomplicated storage and voiding lower urinary tract symptoms in community-dwelling Australian men. World Journal of Urology. 2011; 29: 179–184.

[57] Smith B, Moss TJ, Marshall B, Halim N, Palmer R, von Saldern S. Engaging Australian men in disease prevention—priorities and opportunities from a national survey. Public Health Research & Practice. 2024; 34: e33342310.

[58] Wright LN, Moghalu OI, Das R, Horns J, Campbell A, Hotaling J, et al. Erectile dysfunction and treatment: an analysis of associated chronic health conditions. Urology. 2021; 157: 148–154.

[59] Schneider D, Loeb CA, Brevik A, El-Khatib F, Jenkins LC, Yafi FA. Contemporary cost-analysis comparison of direct-to-consumer vs. traditional prescriptions of phosphodiesterase-5 inhibitors. International Journal of Impotence Research. 2023; 35: 460–464.

[60] Shahinyan RH, Amighi A, Carey AN, Yoffe DA, Hodge DC, Pollard ME, et al. Direct-to-consumer internet prescription platforms overlook crucial pathology found during traditional office evaluation of young men with erectile dysfunction. Urology. 2020; 143: 165–172.

[61] Althof SE, Rosen RC, Perelman MA, Rubio-Aurioles E. Standard operating procedures for taking a sexual history. The Journal of Sexual Medicine. 2013; 10: 26–35.

[62] Holden CA, Jolley DJ, McLachlan RI, Pitts M, Cumming R, Wittert G, et al. Men in Australia Telephone Survey (MATeS): predictors of men’s help-seeking behaviour for reproductive health disorders. The Medical journal of Australia. 2006; 185: 418–422.

[63] Delaruelle K, Buffel V, Van Canegem T, Bracke P, Ceuterick M. Mind the gate: general practitioner’s attitudes towards depressed patients with diverse migration backgrounds. Community Mental Health Journal. 2022; 58: 499–511.

[64] Åkerla J, Pesonen JS, Pöyhönen A, Koskimäki J, Häkkinen J, Huhtala H, et al. Lower urinary tract symptoms and mortality among Finnish men: the roles of symptom severity and bother. The Journal of Urology. 2022; 207: 1285–1294.

[65] Gacci M, Sebastianelli A, Spatafora P, Corona G, Serni S, De Ridder D, et al. Best practice in the management of storage symptoms in male lower urinary tract symptoms: a review of the evidence base. Therapeutic Advances in Urology. 2018; 10: 79–92.

[66] Mohamad Anuar MF, Solihin Rezali M, Mohamed Daud MA, Ismail SB. A community-based study on lower urinary tract symptoms in Malaysian males aged 40 years and above. Scientific Reports. 2022; 12: 2345.

[67] Smith DP, Weber MF, Soga K, Korda RJ, Tikellis G, Patel MI, et al. Relationship between lifestyle and health factors and severe lower urinary tract symptoms (LUTS) in 106,435 middle-aged and older Australian men: population-based study. PLOS ONE. 2014; 9: e109278.

[68] Kovacic J, Dhar A, Shepherd A, Chung A. A rude awakening: management of nocturia in men. Trends in Urology and Men’s Health. 2022; 13: 24–28.

[69] Calogero AE, Burgio G, Condorelli RA, Cannarella R, La Vignera S. Epidemiology and risk factors of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction. The Aging Male: The Official Journal of the International Society for the Study of the Aging Male. 2019; 22: 12–19.

[70] Gacci M, Sebastianelli A, Salvi M, Vignozzi L, Corona G, McVary KT, et al. PDE5-Is for the treatment of concomitant ED and LUTS/BPH. Current Bladder Dysfunction Reports. 2013; 8: 150–159.

[71] Song G, Wang M, Chen B, Long G, Li H, Li R, et al. Lower urinary tract symptoms and sexual dysfunction in male: a systematic review and meta-analysis. Frontiers in Medicine. 2021; 8: 653510.

[72] Corona G, Vignozzi L, Rastrelli G, Lotti F, Cipriani S, Maggi M. Benign prostatic hyperplasia: a new metabolic disease of the aging male and its correlation with sexual dysfunctions. International Journal of Endocrinology. 2014; 2014: 329456.

[73] Anderson DJ, Aucoin A, Toups CR, Cormier D, McDonald M, Hasoon J, et al. Lower urinary tract symptoms in depression: a review. Health Psychology Research. 2023; 11: 81040.

[74] McVary K, Rosen R, Gacci M, Yao-Chi C, Kaplan S, Eardley I, et al. Pathogenic mechanisms. In: Chapple C., Abrams P.(ed(s).) Male Lower Urinary Tract Symptoms (LUTS). 1st edn. Société Internationale d’Urologie: Montreal, Canada. 2012.

[75] Rohrmann S, Crespo CJ, Weber JR, Smit E, Giovannucci E, Platz EA. Association of cigarette smoking, alcohol consumption and physical activity with lower urinary tract symptoms in older American men: findings from the third national health and nutrition examination survey. BJU International. 2005; 96: 77–82.

[76] Kawahara T, Ito H, Uemura H. The impact of smoking on male lower urinary tract symptoms (LUTS). Scientific Reports. 2020; 10: 20212.

[77] Oh MJ, Eom CS, Lee HJ, Choi HC, Cho B, Park JH. Alcohol consumption shows a J-shaped association with lower urinary tract symptoms in the general screening population. The Journal of Urology. 2012; 187: 1312–1317.

[78] Maserejian NN, Giovannucci EL, McKinlay JB. Dietary macronutrients, cholesterol, and sodium and lower urinary tract symptoms in men. European Urology. 2009; 55: 1179–1189.

[79] Xiong Y, Zhang Y, Tan J, Qin F, Yuan J. The association between metabolic syndrome and lower urinary tract symptoms suggestive of benign prostatic hyperplasia in aging males: evidence based on propensity score matching. Translational Andrology and Urology. 2021; 10: 384–396.

[80] Penson DF, Munro HM, Signorello LB, Blot WJ, Fowke JH. Obesity, physical activity and lower urinary tract symptoms: results from the southern community cohort study. The Journal of Urology. 2011; 186: 2316–2322.

[81] Kupelian V, Araujo AB, Wittert GA, McKinlay JB. Association of moderate to severe lower urinary tract symptoms with incident type 2 diabetes and heart disease. The Journal of Urology. 2015; 193: 581–586.

[82] V Van Den Eeden SK, Ferrara A, Shan J, Jacobsen SJ, Quinn VP, Haque R, et al. Impact of type 2 diabetes on lower urinary tract symptoms in men: a cohort study. BMC Urology. 2013; 13: 12.

[83] Martin S, Vincent A, Taylor AW, Atlantis E, Jenkins A, Januszewski A, et al. Lower urinary tract symptoms, depression, anxiety and systemic inflammatory factors in men: a population-based cohort study. PLOS ONE. 2015; 10: e0137903.

[84] Martin SA, Appleton SL, Adams RJ, Taylor AW, Catcheside PG, Vakulin A, et al. Nocturia, other lower urinary tract symptoms and sleep dysfunction in a community-dwelling cohort of men. Urology. 2016; 97: 219–226.

[85] Yin F, He QD, Chen J, Gui TJ, Cai RJ, Wang Y, et al. Benign prostatic hyperplasia associated with white matter hyperintensities in men. Clinical Neurology and Neurosurgery. 2023; 229: 107738.

[86] Semczuk-Kaczmarek K, Rys-Czaporowska A, Platek AE, Szymanski FM. Prevalence of lower urinary tract symptoms in patients with cardiovascular disease. Central European Journal of Urology. 2021; 74: 190–195.

[87] Zhang J, Nie J, Zou M, Zeng Q, Feng Y, Luo Z, et al. Prevalence and associated factors of sexual dysfunction in patients with inflammatory bowel disease. Frontiers in Endocrinology. 2022; 13: 881485.

[88] Leng Y, Hu Q, Ling Q, Yao X, Liu M, Chen J, et al. Periodontal disease is associated with the risk of cardiovascular disease independent of sex: a meta-analysis. Frontiers in Cardiovascular Medicine. 2023; 10: 1114927.

[89] HHyun H, Park YW, Kwon YC, Cho BK, Lee JH. Relationship between chronic periodontitis and lower urinary tract symptoms/benign prostatic hyperplasia. International Neurourology Journal. 2021; 25: 77–83.

[90] Hwang SE, Yun JM, Cho SH, Min K, Kim JY, Kwon H, et al. Higher physical activity is associated with reduced lower urinary tract symptoms in Korean men. To be published in The World Journal of Men’s Health. 2024. [Preprint].

[91] Nosrati F, Nikoobakht MR, Oskouie IM, Rahimdoost N, Inanloo H, Abolhassani M, et al. Does significant weight loss after bariatric surgery affect sexual function and urinary symptoms? An Iranian study. Obesity Surgery. 2023; 33: 2509–2516.

[92] Martin S, Lange K, Haren MT, Taylor AW, Wittert G. Risk factors for progression or improvement of lower urinary tract symptoms in a prospective cohort of men. The Journal of Urology. 2014; 191: 130–137.

[93] Di Bello F, Napolitano L, Abate M, Collà Ruvolo C, Morra S, Califano G, et al. “Nocturia and obstructive sleep apnea syndrome: a systematic review”. Sleep Medicine Reviews. 2023; 69: 101787.

[94] Kant P, Inbaraj LR, Nirupama NN, Norman G. Prevalence, risk factors and quality of life of lower urinary tract symptoms (LUTS) among men attending primary care slum clinics in Bangalore: a cross-sectional study. Journal of Family Medicine and Primary Care. 2021; 10: 2241–2245.

[95] Nnabugwu II, Okoronkwo IL, Nnabugwu CA. Lower urinary tract symptoms in men: challenges to early hospital presentation in a resource-poor health system. BMC Urology. 2020; 20: 87.

[96] Lai UC, Wun YT, Luo TC, Pang SM. In a free healthcare system, why do men not consult for lower urinary tract symptoms (LUTS)? Asia Pacific Family Medicine. 2011; 10: 7.

[97] Kupelian V, Wei JT, O’Leary MP, Norgaard JP, Rosen RC, McKinlay JB. Nocturia and quality of life: results from the Boston area community health survey. European Urology. 2012; 61: 78–84.

[98] Moon S, Kim YJ, Chung HS, Yu JM, Park II, Park SG, et al. The relationship between nocturia and mortality: data from the national health and nutrition examination survey. International Neurourology Journal. 2022; 26: 144–152.

[99] Elterman DS, Bhattacharyya SK, Mafilios M, Woodward E, Nitschelm K, Burnett AL. The quality of life and economic burden of erectile dysfunction. Research and Reports in Urology. 2021; 13: 79–86.

[100] Launer BM, McVary KT, Ricke WA, Lloyd GL. The rising worldwide impact of benign prostatic hyperplasia. BJU International. 2021; 127: 722–728.


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