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American Journal of Epidemiology Advance Access published online on September 21, 2005
American Journal of Epidemiology, doi:10.1093/aje/kwi299
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Received February 24, 2005
Accepted June 10, 2005

ORIGINAL CONTRIBUTIONS

Sexually Transmitted Infections, Prostatitis, Ejaculation Frequency, and the Odds of Lower Urinary Tract Symptoms

Siobhan Sutcliffe 1, Edward Giovannucci 2, Angelo M. De Marzo 3, Walter C. Willett 2, and Elizabeth A. Platz 4*

1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
2 Departments of Nutrition and Epidemiology, Harvard School of Public Health, and the Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA
3 James Buchanan Brady Urological Institute and the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medical Institutions, Baltimore, MD; Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD
4 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; James Buchanan Brady Urological Institute and the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medical Institutions, Baltimore, MD

* To whom correspondence should be addressed.
Elizabeth A. Platz, E-mail: eplatz{at}jhsph.edu


  Abstract

Early life sexual factors, including histories of sexually transmitted infections, young-onset prostatitis, and frequency of ejaculation, were investigated in relation to lower urinary tract symptoms (LUTS) in a large case-control study nested within the Health Professionals Follow-up Study. In 1992, study participants were asked to provide information on their histories of sexually transmitted infections, prostatitis, ejaculation frequency, surgery for an enlarged prostate, and LUTS. Information on prostate surgery and LUTS was updated every 2 years. LUTS cases were defined as men who reported surgery for an enlarged prostate or high-moderate to severe LUTS (≥15 points on the American Urological Association symptom index) on any study questionnaires (n = 4,608). Controls were men who did not report surgery for an enlarged prostate and who scored 0-7 points on the American Urological Association symptom index on all questionnaires (n = 17,967). History of gonorrhea (adjusted odds ratio = 1.76, 95% confidence interval: 1.43, 2.15) or young-onset prostatitis (adjusted OR = 1.55, 95% confidence interval: 1.22, 1.96) was positively associated with LUTS. No association was observed between ejaculation frequency in early adulthood and LUTS. These results suggest that early genitourinary infections may contribute to later development of LUTS, although confirmation in additional population settings is warranted.

Keywords: ejaculation; gonorrhea; prostatic hyperplasia; prostatitis; sexually transmitted diseases; syphilis.
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