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J Koskimäki

Publications and source records attributed to J Koskimäki.

14 recordsLinked to original sources
PubMed2006

Erectile dysfunction influences the subsequent incidence of lower urinary tract symptoms and bother.

It is unclear whether lower urinary tract symptoms (LUTS) cause erectile dysfunction (ED) independently or through common underlying pathophysiology and shared risk factors. The aim of this study was to investigate the effect of ED on the incidence of frequency and bother of LUTS. Target population consisted of men aged 50, 60 or 70 years residing in the study area in Finland in 1994. Questionnaires were mailed to 3143 men in 1994 and to 2837 of them 5 years later. The follow-up sample comprised 1683 men who responded to both baseline and follow-up surveys. ED was assessed by two questions on subject's ability to achieve or maintain an erection sufficient for intercourse and LUTS by the Danish Prostatic Symptom Score questionnaire. A dose-response relation was found between the severity of ED at baseline and the incidence of LUTS or bother during follow-up. After adjustment for the confounders, the incidence rate ratio (RR) of LUTS was higher in men with moderate (RR 1.5, 95% confidence interval (CI) 1.0-2.3) or severe ED (RR 2.3, 95% CI 1.4-3.8) than in those free of ED at entry. Compared with men free of ED at baseline, the RRs of urinary bother were 1.6 (95% CI 1.1-2.4), 1.9 (95% CI 1.1-3.2) and 2.2 (95% CI 1.1-4.3) for minimal, moderate or severe ED, respectively. In summary, ED is associated with an increased incidence of LUTS and bother. ED and LUTS may have a common underlying pathophysiology or shared risk factors.

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PubMed2006

Cardiovascular drug use and the incidence of erectile dysfunction.

It is unclear whether high blood pressure per se or antihypertensive drug use causes erectile dysfunction (ED). The aim of this study was to investigate the effect of cardiovascular diseases and their concomitant medications use on the incidence of ED. The target population consisted of men aged 55, 65 or 75 years old residing in the study area in Finland in 1999. Questionnaires were mailed to 2837 men in 1999 and to 2510 of them 5 years later. The follow-up sample consisted of 1665 men (66% of those eligible) who responded to both baseline and follow-up questionnaires. Men free of moderate or severe ED at baseline (N=1000) were included in the study. ED was assessed by two questions on subject ability to achieve or maintain an erection sufficient for intercourse. Poisson regression model was used in the multivariable analyses. The risk of ED was higher in men suffering from treated hypertension or heart disease than in those with the untreated condition. The risk of ED was higher in men using calcium channel inhibitor (adjusted relative risk (RR)=1.6, 95% confidence interval (CI) 1.0-2.4), angiotensin II antagonist (RR=2.2, 95% CI 1.0-4.7), non-selective beta-blocker (RR=1.7, 95% CI 0.9-3.2) or diuretic (RR=1.3, CI 0.7-2.4) compared with non-users. ED was not associated with using organic nitrates, angiotensin-converting enzyme inhibitors, selective beta-blockers and serum lipid-lowering agents. In summary, calcium channel inhibitors, angiotensin II antagonists, non-selective beta-blockers and diuretics may increase the risk of ED.

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PubMed2006

Effect of nonsteroidal anti-inflammatory drug use on the incidence of erectile dysfunction.

PURPOSE: We estimated the effect of nonsteroidal anti-inflammatory drug use on the incidence of erectile dysfunction. MATERIALS AND METHODS: The target population consisted of men 50, 60 or 70 years old residing in the study area in Finland in 1994. Questionnaires were mailed to 3,143 men in 1994 and to 2,864 men 5 years later. The followup sample consisted of 1,683 men who responded to baseline and followup questionnaires. We estimated the effect of NSAIDs on the incidence of ED in men free from moderate or complete ED at baseline (in 1,126). ED was assessed by 2 questions on subject ability to achieve or maintain an erection sufficient for intercourse. Confounding was assessed by stratification and by adjustment in multivariate Poisson regression model. RESULTS: The incidence of ED was 93 cases per 1,000 person-years in men who used and 35 in those who did not use NSAIDs. Among men with arthritis, the most common indication for NSAID use, ED incidence was 97 cases per 1,000 in those using and 52 in men who did not use NSAIDs. Compared with men who did not use NSAIDs and were free from arthritis, the relative risk of ED after controlling for the effects of age, smoking, and other medical conditions and medications was higher in men who used NSAIDs but were free of arthritis (IDR 2.0, 95% CI 1.2-3.5) and in those who used NSAIDs and had arthritis (IDR 1.9, 95% CI 1.2-3.1). The relative risk was only somewhat higher in men who had arthritis but did not use NSAIDs (IDR 1.3, 95% CI 0.9-1.8). CONCLUSIONS: The use of nonsteroidal anti-inflammatory drugs increases the risk of ED and the effect is independent of indication.

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PubMed2004

Effect of life-style factors on incidence of erectile dysfunction.

We estimated the incidence of erectile dysfunction (ED) in a population-based sample during 5-y follow-up and determined how the rate was affected by sociodemographic and life-style factors. The target population comprised all men aged 50, 60 or 70 y residing in the city of Tampere or 11 surrounding municipalities in Finland at the start of follow-up. A questionnaire was mailed to 3143 men in 1994 and to 2864 in 1999. The follow-up sample consisted of 1442 men who responded to both baseline and follow-up questionnaires. We estimated the effect of sociodemographic and life-style factors on the incidence of ED among the 1130 men free of ED at baseline. We found no differences in the incidence of ED by the level of education, marital status, urban/rural place of residence, amount of alcohol and coffee consumption. Obesity (rate ratio (RR)=1.7, 95% confidence interval (CI): 1.1-2.5) and current smoking (RR=1.5, 95% CI: 0.9-2.2) increased the incidence of ED. Current smokers free of comorbidity were also at higher risk of ED (RR=1.3, 95% CI: 0.8-2.1), but no effect was observed among past smokers. Our results indicate that sociodemographic and life-style factors, except age and obesity, have little influence on ED.

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PubMed2001

Association of non-urological diseases with lower urinary tract symptoms.

OBJECTIVE: Clinical observations indicate that many non-urological diseases seem to be associated with lower urinary tract symptoms (LUTS). This has also been shown in studies usually concerning single diseases. This study investigated the impact of non-urological diseases on LUTS in the general population. MATERIAL AND METHODS: A questionnaire on LUTS and medical history was mailed to all 50-, 60- and 70 year-old men in Tampere and in 11 municipalities in the same county, in total 3143 subjects. Day-time frequency, nocturia, urge, urge incontinence, hesitancy and incomplete emptying were used to form an index for LUTS. The men were asked to report any disease that they had. The number of the following diseases reported by the participants was large enough for statistical analysis: lower back pain, hypertension, arthritis, heart disease, pulmonary disease, diabetes, constipation. stroke, transient ischaemic attack, cancer (other than prostate or bladder), neurological disease, inguinal hernia, rheumatoid arthritis and faecal incontinence. The association between LUTS and non-urological diseases was estimated by logistic regression as a prevalence odds ratio (OR) with 95% confidence intervals (CI). RESULTS: In the multivariate analysis a significant association was found between LUTS and the following diseases: faecal incontinence (OR 4.5, CI 2 .3-9.1), neurological disease (OR 2.4, CI 1.3-4.4), constipation (OR 2.3, CI 1.5-3.3) and arthritis (OR 1.5, CI 1.2-2.0). CONCLUSIONS: According to this population-based study LUTS is an important part of the symptomatology of faecal incontinence, neurological disease, constipation and arthritis. Thus, the patients with these diseases and presenting with LUTS require careful investigation, at least in the cases in which the primary therapy of LUTS has failed.

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PubMed2001

Is reduced quality of life in men with lower urinary tract symptoms due to concomitant diseases?

OBJECTIVES: To establish the effect of lower urinary tract symptoms (LUTS) on general health in an unselected male population in Finland using a reduction in general health as outcome. A further special focus was on the question of whether the effects can be accounted for by other concomitant health problems or solely by LUTS. METHODS: A population-based questionnaire study among 50-, 60- and 70-year-old men was conducted. The subjects were divided into 5 different groups according to the severity of the LUTS. Odds ratios (ORs) of reduced general health with 95% confidence intervals (CIs) were counted for every group and the effects of age and diseases were controlled. The population etiologic fraction was determined. RESULTS: The crude relative risks of reduced general health increased with any of the LUTS compared to men not having LUTS. Adjustment for age and concomitant diseases reduced the ORs, but the associations remained similar. Relatively the effect of adjustment was greatest in men with several and serious symptoms, i.e. in men with the highest scores (OR 11.1 vs. 6.9). CONCLUSIONS: LUTS and perceived general health are strongly correlated. About half of the association was accounted for by age and concomitant diseases, but the other half of the crude effect would appear to be independent of these factors. Severe LUTS severely affects the general health.

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PubMed2000

Immunocompetence, developmental stability and wingspot size in the damselfly Calopteryx splendens L.

Calopteryx splendens males exhibit a remarkable variation in wing pigmentation both within and between populations. In this study, we examined whether the wingspots of male C. splendens are related to male quality. We measured the nylon implant encapsulation rate for 85 males and found that males with larger wingspots had a faster encapsulation rate, indicating a better immunocompetence. We also found that the encapsulation rate was positively correlated with the density of haemocytes in the haemolymph. Another measurement of male quality, fluctuating asymmetry of wingspots, correlated negatively with the size of the wingspots. Males with asymmetrical wingspots also had lower encapsulation rates than more symmetrical males. Our results suggest that the size of wingspot is an indicator of male quality in C. splendens.

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PubMed2000

Association of dietary elements and lower urinary tract symptoms.

OBJECTIVE: The purpose of the study was to establish whether dietary elements are related to lower urinary tract symptoms (LUTS) and thus to diseases causing LUTS. MATERIALS AND METHODS: This population-based study was carried out in 1994; a questionnaire was mailed to all men born in 1924, 1934 or 1944 living in Tampere or 11 rural or semi-rural municipalities in the same county, altogether 3143 men. Of this population, 68% were ultimately included in the study. A modified version of the DAN-PSS-1 questionnaire (10 of the questions) was used to assess urinary symptoms and problems arising from them. A symptom index was formed by multiplying the symptom and problem scores for hesitancy, incomplete emptying, urge, urge incontinence, nocturia and daytime frequency, and totalling the products. The men were also asked to report on their medical history, how often they ate vegetables and meat, whether they used butter, margarine or vegetable oil in food, how much alcohol and coffee they consumed, their smoking history and their weight and height. The risk of LUTS was estimated according to the frequency of meat and vegetable intake and the kind of fat used. RESULTS: The confounder-adjusted risk of LUTS was 0.68 (95% CI 0.54-0.86) among men consuming vegetables daily compared with men consuming vegetables less frequently. Compared with men who eat meat less frequently, the confounder-adjusted risk of LUTS was 2.08 (95% CI 1.00-4.10) among men consuming meat weekly, and 2.56 (95% CI 1.30-5.02) among men consuming meat daily. The confounder-adjusted risk of LUTS was 0.73 (95% CI 0.58-0.93) among men who consumed butter compared to those who did not. CONCLUSIONS: Dietary elements may also have an important role in the development of diseases causing LUTS. Direct effects of food components may likewise influence the occurrence of LUTS.

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PubMed2000

Effect of erectile dysfunction on frequency of intercourse: a population based prevalence study in Finland.

PURPOSE: We estimate the prevalence of erectile dysfunction in Finland and its effect on frequency of sexual intercourse. MATERIALS AND METHODS: A population based study of 3,143, 50, 60 and 70-year-old men in Tampere and 11 municipalities in the same county was conducted by mailed questionnaire. The definition of erectile dysfunction was based on difficulties in achieving an erection before sexual intercourse and maintaining it. Erectile dysfunction was classified into 4 groups as none, minimal, moderate and complete. To estimate the effect of erectile dysfunction on the frequency of sexual intercourse the men were divided into those who had intercourse at least an average of once weekly and those who did not. RESULTS: A total of 2,198 questionnaires (70%) were returned and 1, 983 men (63%) were included in the study. Of these men 26% had no, 48% minimal, 14% and 12% complete erectile dysfunction, which increased with age (compared with 50-year-old men, the odds ratios for complete erectile dysfunction were 4.5 (95% confidence interval [CI] 2.6-7.5) for 60 and 21 (95% CI 12.5 to 34.7) to 70-year-old men. The effect of erectile dysfunction on the frequency of sexual intercourse could not be accounted for by age or marital status. The adjusted effect was strong among men with moderate (odds ratio 3.5, 95% CI 2.2-5.1) and complete (173, 68-443) erectile dysfunction but minimal erectile dysfunction had no impact (odds ratio 0.9, 95% CI 0. 6-1.3) on the frequency of intercourse. CONCLUSIONS: Erectile difficulties are common and complete erectile dysfunction increases with age. Erectile dysfunction regulates the sex life of men with moderate or complete dysfunction but this association cannot be accounted for by age or marital status. Although mild erectile dysfunction did not completely regulate sex life, its significance is the risk of progression to a more severe sexual life disturbing dysfunction.

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PubMed1998

Prevalence of lower urinary tract symptoms in Finnish men: a population-based study.

OBJECTIVE: To determine the prevalence of lower urinary tract symptoms (LUTS) in Finnish men, using a population-based cross-sectional survey. SUBJECTS AND METHODS: In 1994, a modified Danish prostatic symptom score system (DAN-PSS-1) questionnaire on the occurrence and severity of LUTS was mailed to all men (3143) born in 1924, 1934 or 1944 living in the city of Tampere or 11 rural and semi-rural municipalities in the same county. RESULTS: After exclusions, 68% of the men were ultimately included in the study. LUTS were common and increased with age so that the prevalence of at least one symptom was 89% in the whole population (84%) among 50-year-old, 91% among 60-year-old and 94% among 70-year-old men). Most of the symptoms were mild, with post-micturition dribbling and nocturia the most prevalent symptoms, and stress incontinence the least prevalent. CONCLUSIONS: The high incidence of LUTS may indicate a high prevalence of benign prostatic enlargement secondary to benign prostatic hyperplasia, but other causes are also involved. With the increase in the mean age of the general population, the number of individuals with LUTS is likely to increase and must be considered when resources are planned for medical care.

Age Factors↗
PubMed1998

Association of smoking with lower urinary tract symptoms.

PURPOSE: We studied the association of smoking with lower urinary tract symptoms. MATERIALS AND METHODS: In 1994 we performed a population based study by mailing a questionnaire to all 3,143 men born in 1924, 1934 or 1944 who resided in Tampere, or in 11 rural or semirural municipalities in the same county. Of this population 68% were ultimately included in the study. A modified Danish Prostate Symptom Score-1 was used to assess urinary symptoms and associated bothersomeness. A symptom index was created by multiplying the symptom and bothersomeness scores of hesitancy, incomplete emptying, urge, urge incontinence, nocturia and daytime frequency, and totaling the products. The index for lower urinary tract symptoms was defined as positive when it reached 7 points. Subjects were also asked whether they had smoked for at least a year, and they were defined as smoking currently, formerly and never according to the response. RESULTS: Compared with respondents who never smoked age adjusted odds ratios were 1.47 (95% confidence interval 1.09 to 1.98) and 1.38 (1.08 to 1.78), respectively, for those who currently and formerly smoked. After further adjusting for alcohol consumption, body mass index, previous prostate surgery, pelvic area surgery, prostate cancer and bladder cancer, the odds ratios for current and former smokers were 1.39 (95% confidence interval 1.02 to 1.93) and 1.34 (1.03 to 1.75), respectively. CONCLUSIONS: Smoking increases the prevalence of lower urinary tract symptoms. The similarity in the odds ratios of these symptoms between current and former smokers suggests that changes caused by smoking occur long term or the pathological process resulting in symptoms starts early in smokers. The decreased risk of lower urinary tract symptoms after the cessation of smoking suggests that the process is reversible but recovery is a long-term process.

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PubMedDate not supplied

Relationship between smoking and erectile dysfunction.

We estimated the effects of smoking on the risk and prognosis of erectile dysfunction (ED), and of ED on smoking behavior. The follow-up sample consisted of the 1442 men aged 50-75 y, who responded to both baseline and follow-up questionnaires. We estimated the effect of smoking on the incidence of ED among the 1130 men free from ED, ED on risk to start smoking in the 502 nonsmokers, smoking on the prognosis of ED among the 312 with ED and ED on quitting smoking among the 292 current smokers at baseline. Risk of ED increased nonsignificantly with smoking (odds ratio (OR)=1.4), while ED recovery reduced (OR=0.6). Therefore, there was the ratio of 2.3 (1.4/0.6) describing the total effect of smoking on the risk of ED. Both quitting (OR=1.7) and starting (OR=1.9) smoking were rare and nonsignificantly higher in men with ED. Most of the OR estimates on smoking-ED relationships were not statistically significant, probably due to small numbers. There are two bidirectional relations between ED and smoking. Those who smoked had a higher risk of ED than nonsmokers. The men with ED were more likely to start smoking than those free from ED. The estimates of effects were not statistically significant, but they were consistent with each other and with the hypothesis that smoking causes ED and ED causes smoking. The recovery from ED was less in smokers than among nonsmokers, and current smokers with ED were more likely to stop smoking than men free from ED. Numbers were few and estimates of effects were not significant, but consistent with the hypothesis of smoking preventing recovery from ED and ED improving the success of smoking cessation. Such transitions in four directions explain indirectly the known positive association between the prevalence of smoking and the prevalence of ED.

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PubMedDate not supplied

Are questions on both achieving and maintaining an erection needed to define erectile dysfunction?

Our aim was to ascertain if the assessment of erectile dysfunction (ED) should include questions on difficulty in both achieving and maintaining erection. A population-based study of 3143 men in Tampere region in Finland was conducted by mailed questionnaire. The 1983 men who responded questions on erectile function were included in the analysis. Different levels in the severity of ED were used to examine the agreement between the two questions. Consistency was measured by kappa coefficient. Consistency was fairly high (kappa=0.71) when the severity of ED was examined in four groups. In those cases where alternative responses were categorized into three groups, consistency was best (kappa=0.86) when the alternatives 'never' and 'sometimes' were combined. Consistency was almost perfect (kappa=0.97) when ED dichotomized into two groups and the cutoff was set between the alternatives 'quite often' and 'intercourse does succeed'. The kappa index was 0.86 with the cutoff level between 'sometimes' and 'quite often' and 0.67 with the cutoff between 'never' and 'sometimes'. When ED was examined in different age groups, the consistency was the highest among the oldest respondents. Responses on both symptoms are needed to distinguish between normal erectile function and minimal ED, and also between minimal and moderate ED, especially in young men. When the aim is to distinguish between complete ED and a milder form, the information from one question is the same as that from two questions.

Age Factors↗