LUTS associated with BPH are often accompanied by sexual dysfunction, including erectile dysfunction (ED) and ejaculatory problems. Interest in sexual intercourse declines with sever- ity of LUTS. Men with more severe LUTS have significantly lower libido, greater difficulty maintaining an erection, and lower levels of sexual satisfaction than men with less severe
LUTS. O’Leary showed that, in men with LUTS, the severity of urinary symptoms appears to exert the great- est influence on the degree of sexual dysfunction.4 Burger and colleagues found evidence of a correlation between sexual desire, erectile relia- bility, and sexual satisfaction and the degree of baseline symptoms.5 According to the U.S. National Health and Social Life Survey, both premature ejaculation difficulties and ED are associated with LUTS.6 Frankel and colleagues reported that men with storage-related complications