Military service and risks for urinary, sexual dysfunction

Research presented recently at theannual Scientific Meeting of the American Urological Association (AUA) addresses the increased risk for urinary and sexual dysfunction among men who have served in the military.In a press release issued by UroToday, it is noted that men who have prior military service have up to 3 times the risk for developing urinary incontinence. Data was collected on nearly 5300 men and the results were categorized into 3 age groups: < 55, 55-59, and > 70 years of age. 23% of the men in this general population sample reported military exposure, and the rate of urinary incontinence (UI) was 18.8% in the military group versus in the men without military experience (10.4%). Interestingly, it was the age group of < 55 years that had the most significant increase in risk for UI, as the men older than 55 did not have a significant difference in rates of incontinence.

Not only has prior military service been found to be an independent risk factor for men under age 55 developing urinary incontinence, but the diagnosis of posttraumatic stress syndrome (PTSD) in male Iraq and Afghanistan veterans is linked with a higher rate of lower urinary tract symptoms as well as sexual dysfunction. Male veterans who suffer from PTSD are more likely to suffer lower urinary tract symptoms (LUTS) than men without PTSD, even when medications for the syndrome are taken into consideration. In other research presented at the AUA meeting, the prevalence of sexual dysfunction in men who have PTSD was discussed. Conditions including erectile dysfunction and premature ejaculation were analyzed in health histories of men with and without PTSD. The rate of sexual dysfunction in men with PTSD was nearly 10%, while in men without PTSD, the rate was 3.3%. The authors concluded that while certain medications taken for PTSD can cause sexual dysfunction, medications alone are not responsible for all cases of sexual dysfunction in men with a military service history. Issues of avoidance, emotional numbing, and hyperarousal (all symptoms of PTSD) were found to be important factors in the dysfunction.

Increased awareness of these issues may lead to better identification of the conditions as well as improved emphasis on effective treatments. In my role as faculty for the Herman & Wallace Pelvic Rehabilitation Institute, I have met several pelvic rehab providers who work within the VA system, providing care for the men and women who have served in the military. There is increased awareness of and interest in integrating pelvic rehabilitation programs for veterans, and this is a trend that will hopefully expand into comprehensive pelvic rehab care. With Memorial Day so recently behind us, it is timely to have increased light shed on these significant issues so that care may be directed to treat these sensitive issues that can impair quality of life.