Erectile dysfunction and its associations with type 2 diabetes, neuropathy, metabolic syndrome in men seeking specialty care for urinary urgency: a cross-sectional study.

Pennathur, Harini V; Lu, Ting; Wiseman, Jonathan B; Lane, Giulia Ippolito; Clemens, James Quentin; Cameron, Anne P; Wessells, Hunter; Jelovsek, John Eric et al. · BMJ Open · 2026

cross_sectional · Level IV

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Abstract

To examine the relationships between erectile dysfunction (ED) and diabetes and related complications, metabolic syndrome (MetS) components and lower urinary tract symptoms (LUTSs) in a cohort of men seeking care for urinary urgency and other LUTSs. Cross-sectional analysis of baseline data from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN II) Urinary Urgency Phenotyping study, which aimed to characterise subgroups of persons with urinary urgency. Six clinical sites of the NIH/NIDDK-sponsored Symptoms of LURN, US. 305 men enrolled in the LURN II Urinary Urgency Phenotyping study who provided complete baseline erectile function data. Erectile function was assessed using the erectile function domain of the International Index of Erectile Function (IIEF). MetS components, diabetes-related complications and LUTS severity were compared between men with and without ED. Among 305 men with urinary urgency, 181 (59%) had ED. Men with ED were significantly older and more likely to have type 2 diabetes (25% vs 12%, p<0.01). Peripheral neuropathy (38% vs 25%, p=0.02) and autonomic neuropathy (57% vs 43%, p=0.02) were more common in men with ED. The majority of men without ED correspondingly did not report MetS components. Finally, men with ED reported more severe LUTS, including higher total LUTS scores and a greater burden of storage symptoms. These data suggest that diabetes as well as markers of metabolic dysfunction are important factors in ED in treatment-seeking men with urinary urgency and other LUTS. Studies evaluating the mechanisms contributing to these interactions are warranted for targeting effective prevention or treatment.

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