Development of a Clinically Relevant Men's Health Phenotype and Correlation of Systemic and Urologic Conditions

Urology. 2018 Apr;114:77-82. doi: 10.1016/j.urology.2017.12.035. Epub 2018 Jan 31.


Objective: 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, erectile dysfunction or chronic prostatitis or chronic pelvic pain syndrome. Urologic symptoms were assessed with the International Prostate Symptom Score, Sexual Health Inventory for Men, and National Institute of Health Chronic Prostatitis Symptom Score. Each was graded as absent or 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.

Results: 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 < .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 erectile dysfunction.

Conclusion: Systemic health conditions correlate strongly with urologic symptoms in men who present for urologic care. Phenotyping with ACTIONS (anxiety, cardiovascular, testosterone deficiency, insulin, obesity, neurologic, sleep apnea) can identify modifiable conditions that may impact urologic symptoms and outcome of interventions. Future validation in the general population is needed.

MeSH terms

  • Adult
  • Aged
  • Attitude to Health*
  • Chronic Disease
  • Cluster Analysis
  • Cohort Studies
  • Erectile Dysfunction / diagnosis
  • Erectile Dysfunction / epidemiology
  • Erectile Dysfunction / therapy
  • Humans
  • Logistic Models
  • Male
  • Men's Health*
  • Middle Aged
  • Pelvic Pain / diagnosis
  • Pelvic Pain / epidemiology
  • Pelvic Pain / therapy
  • Phenotype*
  • Prostatic Hyperplasia / diagnosis
  • Prostatic Hyperplasia / epidemiology
  • Prostatic Hyperplasia / therapy
  • Prostatitis / diagnosis
  • Prostatitis / epidemiology
  • Prostatitis / therapy
  • Retrospective Studies
  • United States
  • Urologic Diseases / diagnosis*
  • Urologic Diseases / epidemiology*
  • Urologic Diseases / therapy