In men, LUTS severity and sexual function worsen with increasing waist circumference, study finds


ANAHEIM, Calif.—Central obesity is associated with an increased risk of male pelvic dysfunction.

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Previous published studies have shown significant associations between BPH, prostate volume (PV), and components of the metabolic syndrome. The new study tested whether measuring waist circumference in inches could predict PV and severity of lower urinary tract symptoms (LUTS), as well as other measures of the metabolic syndrome.


The study, which was presented here at the annual meeting of the American Urological Association, included 88 men aged 50-75 years (mean 62.4 years) with moderate or severe LUTS (International Prostate Symptom Score [IPSS] of 8 or greater) with no prior treatment. The men were divided into three groups according to waist circumference: 30-36 inches (27 men), 36-40 inches (36 men), and greater than 40 inches (25 men). At baseline, the investigators measured IPSS, PV (as determined by transrectal ultrasound), serum PSA, and peak flow rate.


Men with a waist circumference of 30-36, 36-40, and more than 40 inches had a mean PV of 28.53, 31.67, and 36.78 cc, respectively. Their PSA levels were 2.32, 2.92, and 3.54 ng/mL, respectively, and their IPSS at screening was 11.57, 13.67, and 15.78. Peak flow rate was 10.6, 9.45, and 8.65 mL/sec. The proportion of men with erectile dysfunction was 34.6%, 49.5%, and 78.6% and the proportion with ejaculatory dysfunc- tion was 27.8%, 47.2%, and 74.5%.


In addition, central obesity was positively associated with the incidence of diabetes and hypertension. The proportion of men with diabetes was 11.2%, 22.3%, and 34.5%; the proportion with hypertension was 12.6%, 24.7%, and 37.8%. All differences between the groups were significant.


“Every parameter we looked at increased as waist size increased,” said investigator Steven Kaplan, MD, professor of urology at the WeillCornellMedicalCollege in New York. “So one can argue that we don’t have to do any evaluation of the patient except measure their waist, and we would be able to predict a lot of things. Obviously, we need more data to understand the role of using indices of obesity such as BMI and waist circumference in our evaluation of men with pelvic dysfunction.”