Presentation Authors: Phil Hyun Song*, Daegu, Korea, Republic of, Gyeong Eun Min, Seoul, Korea, Republic of, Yeong Uk Kim, Jae Young Choi, Young Hwii Ko, Ki Hak Moon, Hee Chang Jung, Daegu, Korea, Republic of
Introduction: Ejaculation frequency, including sexual intercourse, nocturnal emissions, and masturbation, affect the development of prostate disease, such as benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS), and cancer. We previously reported that ejaculation frequency was related to a decreased risk of BPH/LUTS. In this prospective study, we investigated the association between ejaculation frequency and risk of prostate cancer.
Methods: Between May 2015 and September 2016, a total of 304 men (154 in our health examination center, 150 in our urology outpatient department) participated in this study. The monthly ejaculation frequency, overall sexual satisfaction, and other determinants of sexual function including alcohol consumption, smoking, body mass index, and history of sexually transmitted infections were assessed using a self-administered questionnaire. Ejaculation frequency was assessed by asking participants to report the average number of ejaculations they had per month. Prostate specific antigen (PSA), prostate volume (PV) and International Prostate Symptom Score (IPSS) were also assessed in all participants. BPH/LUTS was defined as PV â‰¥ 25 gm, and IPSS â‰¥ 8. Prostate biopsy was performed on patients with PSA â‰¥ 4 ng/ml, or those who had abnormal findings in the rectal examination or transrectal ultrasound.
Results: Of 304 patients, 140 were diagnosed with BPH/LUTS (Group I, mean age Â± SD: 59.2 Â± 4.1 years), 40 were diagnosed with prostate cancer (Group II, mean age Â± SD: 57.6 Â± 4.2 years) and 124 were in the healthy control group (Group III, mean age Â± SD: 51.1 Â± 9.4 years). Mean number of ejaculations per month was 4.8 Â± 1.7. Ejaculation frequency was inversely associated with age, but positively associated with degree of sexual satisfaction, history of sexually transmitted infection, and consumption of alcohol. After controlling for potential confounders, a higher monthly ejaculation frequency was associated with a statistically significantly decreased risk of prostate cancer and BPH/LUTS (P = 0.002, P = 0.001, respectively). The hazard ratios (95% CI) comparing > 6 ejaculations/month to < 6 ejaculations/month were 0.181 (0.072-0.481; P < 0.0001) and 0.294 (0.127-0.672; P=0.0002) at ages 40-59 years.
Conclusions: Our findings suggest that ejaculation frequency is related to a decreased risk of BPH/LUTS as well as prostate cancer. These results may support a role for ejaculation frequency in the etiology of prostate cancer, as has been previously reported for BPH/LUTS.