Kein Folientitel

1
Multinational Survey of the Aging Male MSAM-7
Prof. Raymond Rosen University of Medicine and
Dentistry of New Jersey
2
Background (1)

• LUTS are common in middle age and older men
• Sexual function is an important aspect of
  quality of life
• sexual activity decreases with age
• sexual problems increase with age

3
Background (2)

• Erectile dysfunction is often associated with
  chronic diseases (i.e. diabetes, hypertension,
  )
• Recent community-based studies have shown a
  possible relationship between LUTS and sexual
  dysfunction (1,2,3)

(1) Mc Farlane et al. - J.Clin.Epidemiol. 1996
491171-76(2) Franckel et al. -
J.Clin.Epidemiol. 1998 51677-68(3) Braun et
al. - International Journal of Impotence
Research 2000 12305-311
4
MSAM-7

• Objectives
• To evaluate in a population of men aged 50 to 80
  years
• The incidence of LUTS
• The sexuality and the incidence of sexual
  disorders
• The possible relationship between LUTS and sexual
  dysfunction

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MSAM-7

• Methodology (1)
• Patients
• 14,000 men aged 50 to 80 in
• 7 countries (US, UK, F, D, I, Sp, NL)
• In each country, the sample was representative of
  the target population

6
Methodology (2)
MSAM-7

• Postal questionnaire
• - Demographic characteristics - I-PSS and
  Quality of Life index - Dan-PSS sex (6
  questions) - IIEF (15 questions) - Co-morbidity
  factors
• 12 815 questionnaire were exploitable (89.9)

7
MSAM-7 Demographic characteristics
Total
Total
Total
Countries
Europe
USA
In
Base
12815
10900
1915
Age
50-59
45
43
49
60-69
33
35
29
70-80
22
22
22
Co-morbidity
Diabetes
13
11
15
among them, treated
87
88
86
Hypertension
33
29
38
among them, treated
89
90
89
Cardiac disease
17
15
18
among them, treated
90
92
88
Hyperlipidemia
25
23
28
among them, treated
76
67
85
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MSAM-7

• Urinary Symptoms - I-PSS

Total countries 12815
Total Europe 10900
USA 1915
9
Average Number of Sexual Intercourse or Activity
per Month
Base Total sample
10
9
8
6.5
6.5
6.3
6.0
7
5.8
5.8
5.6
5.4
5.3
6
5
4
3
2
1
0
USA
Italy
France
Germany
Europe
UK
Netherlands
Spain
Global
10
Average Number of Sexual Intercourse or Activity
per Month
Base Total sample
10
9
8
8.6
7
7.6
6
6.6
5
5.7
5.7
4.9
4
4.6
4.0
3
3.7
3.5
2
2.6
1
1.7
0
LUTS
Mild
Mild
Mild
0
0
0
Severe
Severe
Severe
Moderate
Moderate
Moderate
11
DAN-PSSsex Prevalence of functional problems
Erection (reduced / none)
50
Ejaculation (reduced / none)
47
Ejaculation (pain / discomfort)
7
Among total sample
12
DAN-PSSsex Bothersomeness of functional problems
Erection (reduced / none)
78
Ejaculation (reduced / none)
59
Ejaculation (pain / discomfort)
89
Among men with problems
13
DAN-PSSsex Erectile dysfunction
Base Total sample
100
In
89
90
83
83
80
70
70
70
65
45
57
60
52
50
49
64
50
53
50
40
40
53
41
27
30
45
43
44
33
20
14
31
25
19
20
10
17
16
12
12
7
6
5
2
2
0
LUTS
0
0
0
Mild
Mild
Mild
Severe
Severe
Severe
Moderate
Moderate
Moderate
14
DAN-PSSsex Erectile dysfunction
Base Total sample
In
92
100
90
79
79
80
63
70
61
52
56
60
50
55
40
50
41
40
50
40
30
22
35
40
20
29
19
24
20
10
16
13
5
3
0
0
0
LUTS
Mild
Mild
Severe
Severe
Moderate
Moderate
NO DIABETES
DIABETES
15
DAN-PSSsex Erectile dysfunction
Base Total sample
In
89
100
90
76
74
80
70
60
54
58
60
51
50
38
54
37
40
47
22
44
30
27
32
20
31
25
19
20
10
13
10
10
6
3
0
LUTS
0
0
Mild
Mild
Severe
Severe
Moderate
Moderate
HYPERTENSION
NO HYPERTENSION
16
DAN-PSSsex Ejaculatory dysfunction
Base Men who have erections
In
100
88
90
81
78
80
70
64
63
70
60
50
69
45
45
50
67
38
73
57
40
58
27
62
30
36
44
43
18
31
20
25
16
19
10
14
13
9
7
2
6
5
5
2
2
2
0
0
LUTS
0
0
Mild
Mild
Mild
Severe
Moderate
Severe
Moderate
Severe
Moderate
17
DAN-PSSsex Bother vs Ejaculation Problems
Base People who have problems of ejaculation
In
100
90
85
80
76
80
71
66
66
70
54
60
54
52
58
50
54
50
44
55
39
56
40
56
58
43
47
30
46
44
34
32
20
27
26
21
10
15
11
10
10
8
7
7
6
6
0
LUTS
0
0
0
Mild
Mild
Mild
Severe
Severe
Severe
Moderate
Moderate
Moderate
18
DAN-PSSsex Ejaculatory dysfunction
Base Men who have erections
In
90
78
76
73
80
70
59
60
49
50
40
68
68
34
68
40
53
25
30
42
36
29
20
21
10
10
8
7
5
6
5
4
4
0
0
0
Mild
Mild
LUTS
Severe
Severe
Moderate
Moderate
DIABETES
NO DIABETES
19
IIEF Erectile Function Index
Base Men sexually active / sexual intercourse
over past 4 weeks
Average score on a scalefrom 1 to 30 (6
questions) Per question 1 Negative 5
Positive
30
22.3
21.0
19.3
18.9
18.3
20
15.9
Erectile function index
15.2
15.0
13.2
12.6
10.3
10
7.5
0
0
0
0
LUTS
Mild
Mild
Mild
Severe
Severe
Severe
Moderate
Moderate
Moderate
20
IIEF Sexual Desire Index
Base Total sample
Average score on a scalefrom 1 to 10 (2
questions) Per question 1 Negative 5
Positive
10
7.8
7.3
8
7.0
6.8
6.7
6.5
6.3
5.9
5.8
5.5
6
5.0
4.6
4
2
0
LUTS
0
0
0
Mild
Mild
Mild
Severe
Severe
Severe
Moderate
Moderate
Moderate
21
IIEF Overall Satisfaction Index
Base Total sample
Average score on a scalefrom 1 to 10 (2
questions) Per question 1 Negative 5
Positive
10
8.4
7.8
7.7
8
7.2
6.8
6.8
6.5
6.5
5.6
5.4
5.3
6
4.6
4
2
0
LUTS
0
0
0
Mild
Mild
Mild
Severe
Severe
Severe
Moderate
Moderate
Moderate
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MSAM-7

• Conclusion (1)
• Older men still have an active sex life
• Severity of LUTS has an impact on sexual
  disorders independently of the other risk factors

23
MSAM-7

• Conclusion (2)
• Men are bothered not only by erectile
  dysfunction but also by ejaculatory problems
• Sexual function should be taken into account in
  the initial evaluation of BPH patients and in the
  choice of the treatment