Lower urinary tract symptoms (LUTS) occur in men increasingly with age, LUTS is often concurrent with benign prostatic hyperplasia (BPH). Men with LUTS/BPH tend to seek medical attention when symptoms become disabling and worsen quality of life especially for the reduction of sexual activity. Approximately 70% of men with LUTS/BPH have co-existing Sexual Dysfunction (SD).
LUTS/BPH is generally classified as a storing and/or voiding symptoms, among the complications of voiding disorders urinary retention represents the worst aspect as it inevitably affects sexual activity due to the consequent discomfort.
Urinary retention is the acute or chronic inability to voluntarily pass an adequate amount of urine, benign prostatic hyperplasia accounting for 53% cases.
The aim of the study is to evaluate SD in patients suffering from severe bladder emptying disorders who perform bladder management with intermittent catheterization (IC).

From February to November 2024, 39 consecutive patients suffering from LUTS/BPH complicated by Urinary Retention Chronic (URC) or Acute on chronic (URAc) were enrolled, advised and trained to perform bladder management with IC.
The patients were divided into two groups, group A included patients affects by URC in management with urinations due to physiological patterns, group B included patients affects by URAc management with indwelling urinary catheter (IUC).
SD was investigated with the International Index of Erectile Function (IIEF-5) questionnaire before intermittent catheterization training (T0) and after one month (T1).

30 patients decided to join the study and completed the study, 15 in group A (URC) and 15 patients in group B (URAc).
The average age of the patients was 70 years. The median number of urinations per day in group A before CI training was 4.6 and after training was 2.6. The median number of urinations per day in group B after CI training 1.4.
The average IIEF-5 at T0 of group A was equal to 0 and at T1 it was equal to 5, 4 patients recorded a notable improvement in sexual activity (table 1).
The average IIEF-5 at T0 of group B was equal to 0 and at T1 it was equal to 13, 8 patients recorded a notable improvement in sexual activity (table 2).

Patients benefited from bladder management with IC as 40% recovered normal sexual activity (Group A 13% Group B 27%), they represent in Group A 27% (4/15) in Group B 53% (8/15); adherence to the medical indication regarding the number of catheterizations to be performed daily did not influence the resumption of sexual activity therefore.
IC represents an alternative to IUC to the bladder management of patients suffering from chronic or acute-on-chronic urinary retention related to BPH; this therapeutic option allows patients to be able to resume their sexual activity.

IC may be considered an indirect means of resuming sexual activity in patients suffering from urinary retention caused by BPH.