To develop a clinically relevant men's health phenotype and investigate the correlation between severity of urologic symptoms and systemic health conditions METHODS: Retrospective chart review was performed for men seeking care for benign prostatic hypertrophy (BPH), erectile dysfunction (ED) or chronic prostatitis/chronic pelvic pain syndrome (CPPS). Urologic symptoms were assessed with the International Prostate Symptom Score, Sexual Health Inventory for Men and NIH Chronic Prostatitis Symptom Score. Each was graded as absent/mild (0), moderate (1) or severe (2) and totaled for a Urologic Score (US). Seven comorbidities with known impact on urologic symptoms were similarly graded (0-2 for each) and totaled for a Systemic Score (SS). These domains were Anxiety, Cardiovascular, Testosterone deficiency, Insulin (diabetes), Obesity, Neurologic and Sleep apnea (acronym ACTIONS).
The study included 415 men with median age of 53.8 (range 19-92). Mean total US was 2.1 (range 0-6) and mean SS was 4.1 (0-12). There was a strong correlation between US and SS (Spearman Rho=0.37, p<0.00001) which was consistent regardless of age. The hierarchy of systemic condition impact on US was cardiovascular> neurologic> diabetes> anxiety> sleep apnea> obesity> testosterone. By cluster analysis the tightest correlations were age with cardiovascular, anxiety with CPPS, and diabetes with ED.
Systemic health conditions correlate strongly with urologic symptoms in men who present for urologic care. Phenotyping with ACTIONS can identify modifiable conditions that may impact urologic symptoms and outcome of interventions. Future validation in the general population is needed.
Urology. 2018 Jan 19 [Epub ahead of print]
Daniel A Shoskes, Sarah C Vij, Aaron Shoskes, Yaw Nyame, Tianming Gao
Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44192., Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44192. Electronic address: .