Male sexuality and the risk of developing benign prostatic hyperplasia and prostate cancer: is there a connection?

Introduction . Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are diseases associated with morphological changes in prostate tissue, which have a proven hormone-dependent pathogenesis. The identification of risk factors for the development of these diseases and the development of an etiological prevention concept are important clinical objectives. Objective . To assess male sexuality (sexual constitution) as a potential risk factor for BPH or PCa. Materials & methods . The study included 47 men (Group 1) aged 49 – 71 years with Lower Urinary Tract Symptoms (LUTS) caused by BPH, as well as 87 patients aged 47 – 70 years with a newly diagnosed PCa T 1c-3b N 0-1 M 0-1a. The main laboratory and instrumental parameters (PSA, testosterone, prostate volume) were studied, and an assessment and grading of male sexuality throughout life were conducted using the Rostov Questionnaire. Results . Among men with BPH, individuals with hypo-, normo-, and hypersexuality are found with approximately equal frequency, while PCa patients are hyposexual in 90.8% of cases, with only 9.2% being normosexual. In the BPH patient group, there is a direct statistically significant relationship between sexuality and testosterone levels, ranging from moderate (total score at the time of diagnosis) to high (early and middle stages of sexual life), p < 0.001. In PCa patients, no relationship between testosterone and sexuality was established (p > 0.05). The identification of the relationship between male sexuality and prostate diseases allowed for the evaluation of three logistic regression models predicting the development of BPH or PCa depending on the level of male sexuality. Conclusion . Male sexual constitution is a risk factor for the development of BPH and PCa. All three variants of male sexual constitution correlate with blood testosterone levels in BPH, while such correlation is absent in PCa. Numerical values of male sexuality, prostate volume levels, and blood PSA allow determining the likelihood of detecting BPH or PCa in a patient.