Association Between Isolated Postprandial Dyslipidemia And Erectile Dysfunction.

Erectile Dysfunction

Hyperestrogenism is believed to be harmful to male sexuality. We aimed to investigate the prevalence of and the impact of hyperestrogenism on sexual functioning in a cohort of men seeking medical attention for new-onset erectile dysfunction. Data from 547 men seeking first medical help for new-onset erectile dysfunction at a single andrology center were analyzed. Patients were assessed with a thorough medical and sexual history. Comorbidities were scored with the Charlson comorbidity index. All patients completed the International index of erectile function; the International index of erectile function-erectile function domain was categorized according to Cappelleri's criteria. Circulating hormones were measured in every patient. Hyperestrogenism was defined as estradiol levels >42.6 pg/mL (Tan etal., 2015). Descriptive statistics and logistic/linear regression models tested the association between hyperestrogenism and International index of erectile function domains score. Overall, 96 (17.6%) participants had serum estrogen levels suggestive of hyperestrogenism. Men with hyperestrogenism were older (median [interquartile range]: 46 [35-59] vs. 44 [31-56] years; p<0.001), had a higher rate of comorbidities (Charlson comorbidity index ≥1: 26.0% vs. 7.4%; p<0.001), and higher serum total testosterone values (5.4 [5.2-8.0] vs. 4.3 [4.1-5.7] ng/mL; p=0.01) than those with normal estradiol values. A higher prevalence of severe erectile dysfunction (135 [29.9%] vs. 47 [48.9%] men; p=0.01) and of hypogonadism (22 [4.8%] vs. 6 [6.3%] men; p=0.004) were found in men with hyperestrogenism. Serum estradiol levels were positively correlated with total testosterone levels (β = 0.26, p<0.001) but negatively correlated with International index of erectile function-orgasmic function (β = -0.24, p=0.002) and International index of erectile function-erectile function scores (β = -0.03, p<0.001). When International index of erectile function scores was used to stratify erectile dysfunction patients, hyperestrogenism (odds ratio 2.44, p=0.02) was associated with severe erectile dysfunction. One out of five men seeking first medical help for erectile dysfunction showed elevated serum estradiol values suggestive of hyperestrogenism. Hyperestrogenism was associated with health-significant comorbidities, orgasmic function impairment, and erectile dysfunction severity.

Prevalence of erectile dysfunction in primary care setting, Malaysia

Prevalence and determinants of erectile dysfunction in hemodialysis patients

Introduction MED3000 is an FDA-cleared, over-the-counter topical erectile dysfunction (ED) treatment. As MED3000 can be accessed by a mixed group of men with varying levels of ED severity, it is important to assess efficacy in these subgroups. Objective To assess the effects of MED3000 in men with mild, moderate, and severe ED using the International Index of Erectile Function – Erectile Function (IIEF-EF) domain score (assessed on both controlled trials for this treatment and Sexual Encounter Profile (SEP) Questions (Q) 2 and 3 (evaluated in one study). Methods Two multicenter clinical trials enrolled men with a diagnosis of ED for &amp;gt;3 months according to the NIH Consensus Statement. ED severity was defined by baseline IIEF-EF domain scores (mild = 17 or greater, moderate = 11-16, and severe = 10). Study 1 lasted 12 weeks and study 2 was of 24-week duration. Patients or their female partners were instructed to apply MED3000 immediately prior to sexual intercourse and they were required to make at least 4 intercourse attempts in each of the 4-weekly periods during treatment. Subjects in both studies were instructed to complete the IIEF-EF at the end of each 4-week treatment period and those in Study 1 were also instructed to answer SEP Q2 and Q3 after each intercourse attempt. The changes from baseline for the IIEF-EF domain changes from baseline for each 4-week interval were averaged to provide a mean change from baseline over 12 (Study 1) or 24 weeks (Study 2). The changes from baseline for percentages of patients responding “Yes” to SEP Q2 or Q3 were averaged to provide a mean change from baseline over the 12- and 24-week study periods (average of non-missing data from each 4-weekly visit). The significance of changes from baseline for all measures were determined with paired t-tests. With Bonferroni correction, P &amp;lt; 0.004 was the accepted value for statistical significance for Study 1 and P &amp;lt; 0.0125 was accepted for Study 2. Efficacy analyses were conducted using all subjects who made use of the treatment at least once and missing data were imputed. Results Study 1 enrolled 250 subjects (mean age ± standard deviation (SD) = 46.8 ± 12.5 years, duration of ED = 27.5 ± 36.5 months, 59.2%, 28.0%, and 12.8% with mild, moderate, or severe ED, respectively). Study 2 enrolled 48 subjects (44 White, 4 Black, mean age = 46.1 ± 13.5 years, duration of ED = 28.9 ± 32.3 months, 39.6%, 35.4%, and 25.0% with mild, moderate, or severe ED). MED3000 treatment resulted in significant improvements from baseline in the IIEF-EF domain scores over 12 or 24 weeks in total cohorts and those with mild, moderate or severe ED (Table 1). Changes from baseline for IIEF-EF scores in both studies exceeded the minimal clinically important differences (MCID) for mild (2 points), moderate (5 points), and severe (7 points) ED. Results from Study 1 indicated significant improvements from baseline for SEP Q2 and Q3 that also exceeded the MCIDs for these measures for all ED severities. Conclusions Results from these studies of MED3000 demonstrated statistically and clinically significant improvements from baseline for IIEF-EF domain scores (both studies) and SEP Q2 and Q3 (Study 1 only), measures commonly employed to assess treatment-related improvements in erectile function, in patients with mild, moderate or severe ED. Disclosure Yes, this is sponsored by industry/sponsor: Haleon. Clarification: Industry initiated, executed and funded study. Any of the authors act as a consultant, employee or shareholder of an industry for: Haleon.

Introduction Stress urinary incontinence (SUI) and erectile dysfunction (ED) are significant complications that have a negative impact on patients' quality of life following radical prostatectomy (RP). Objective This study aimed to assess the prevalence of ED in men with SUI who underwent RP the first year after RP. Methods This study included men who underwent RP and followed up for 1 year post-surgery. Men who received androgen deprivation therapy (ADT) or radiation therapy before or after RP were excluded. We performed a descriptive assessment of demographics, comorbidities, erectile function (EF), laboratory, surgical pathology, and nerve-sparing status (NSS). Post-op SUI was described based on the number of pads used per day, categorized as 0 to 1 pad per day (continent or mild/social SUI), 2 pads per day (moderate SUI), and ≥ 3 pads per day (severe SUI) at 3, 6, and 12 months post-RP. ED was described based on IIEF score as normal EF normal (≥24), mild ED (18-23), moderate ED (11-17), and severe ED (≤10) at 3, 6, and 12 months post-RP. We reported the prevalence of ED among men with SUI during the first year after RP. We assessed if the severity of the SUI was a predictor of severe ED in a multivariable logistic regression model at 3, 6, and 12 months post-RP. Factors entered into the model included: patient age, number of comorbidities (≥ 3), NVB status (both resected), pre-RP EF, PDE5i exposure post-RP (yes), and severe SUI (≥ 3 pads per day). Results 9953 men were included in this study, with a median age of 62 (56, 67). The median number of comorbidities was 1 (0, 2). 10% had diabetes, 27% obstructive sleep apnea, and 19% reported 3 or more comorbidities. Preoperative median PSA was 5.7 ng/ml, with a median Gleason grade of 2 (2, 3).73% had Bilateral NSS, 20% unilateral, and 7% had both sides resected. The prevalence of severe ED was higher among men with severe SUI compared to men with 0 to 1 pad per day at 3, 6, and 12 months post-RP. At 3 months, men with 0 to 1 pad per day reported 31% no/mild ED and 59% severe ED, vs. men with severe SUI described 18% no/mild ED and 75% severe ED (p-value &amp;lt;0.001). At 6 months, for men with continence/mild SUI, 35% described no/mild Ed and 51% severe ED vs. men with severe SUI who had 20% no/mild ED and 70% severe ED (p-value &amp;lt;0.001). And at 12 months, men with 0 to 1 pad per day reported 42% no/mild ED and 46% severe ED, vs. men with severe SUI described 22% no/mild ED and 70% severe ED (p-value &amp;lt;0.001). In the multivariable regression model, severe SUI significantly predicted severe ED at 3, 6, and 12 months (Table1). Conclusions Men experiencing severe SUI have a high prevalence of severe erectile dysfunction. Severe SUI significantly predicted severe ED during the first year following RP. Disclosure No.

Background: Erectile dysfunction (ED) is a very common complication of diabetes mellitus. The prevalence of ED in diabetic patients, especially those with type 2 diabetes mellitus (T2DM) is very high compared with their non-diabetic counterparts. There are few studies on ED and its correlation with testicular volume in eugonadal type 2 diabetics globally and especially in sub-Saharan Africa. Objective: To access the prevalence and correlation of ED with testicular volume in T2DM patients attending the diabetes outpatient clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi in South-eastern Nigeria. Materials and Methods: This was a cross sectional prevalence study comprising 124 subjects with T2DM and 62 non diabetic controls. Data collection was done using a study protocol. Hospital Anxiety and Depression Scale (HADS) and the International Index of Erectile function (IIEF) questionnaires were used for diagnosis of anxiety/depression and erectile dysfunction respectively. Testicular volumes for the study subjects were estimated using Prader-orchidometer. Serum total testosterone, follicle stimulating hormone and luteinizing hormone levels were determined. Participants who had anxiety, depression or hypogonadism were excluded from the study. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 20. Results: The mean age of the subjects was 58.29 ± 10.02 while that of the controls was 56.48 ± 10.58 (P = 0.255). 48.4% of the subjects had ED while 4.8% of the controls had erectile dysfunction (P &lt; 0.001). Of the subjects that had ED, 26.7% had mild, 11.7% had moderate while 61.7% had severe erectile dysfunction. Severe ED was more associated with subjects (χ2= 7.230, P = 0.027). IIEF score has significant positive correlation with the mean testicular volume. Conclusion: Prevalence of ED in men with T2DM in Nigeria is high and there is a significant positive correlation between ED and testicular volume in this group of subjects.

Introduction:Erectile dysfunction (ED) has become a public health issue in Nigeria because of its increasing magnitude, association with chronic medical conditions and negative impact on sexual life.Materials and Methods:Cross-sectional study of 450 male patients aged 18-70years who presented with non-ED related complaints. Main outcome measurements were prevalence and severity of ED which was assessed with International Index of Erectile Function (IIEF-5) and single-item sexual function questionnaire. Also assessed were socio-demographic characteristics, physical activities, sexual satisfaction and morbidities.Results:The prevalence of ED was 55.1% (mild, moderate and severe were 32.6%, 17.8% and 4.7% respectively). Prevalence of ED was significantly associated with age (p < 0.0001), marital status (p = 0.032), income (p = 0.001), social class (p = 0.004), physical activities (p = 0.006) and BMI (p = 0.012). Prevalence of ED was significantly high among men with diabetes mellitus (72.7%), hypertension (70.7%), peptic ulcer disease (70.4%) and previous prostate surgery (76.2%). Logistic regression showed dissatisfaction with sexual life (OR = 0.689, CI = 1.233-5.866; p = 0.013) and having sexual activities less than desired (OR = 3.331, CI = 1.416-7.839; p = 0.006) to be the most significant factors associated with ED. There was a strong positive correlation between the IIEF-5 and single-item sexual function questionnaire (r = 0.747, p < 0.0001).Conclusion:The prevalence of ED is high among males attending a primary care clinic in Nigeria with non-ED related complaints. ED was more prevalent in men with chronic medical illnesses and sedentary lifestyle. Family physicians should inquire about this condition in these men and refer them early for specialist consultation.

Background and Objectives: This study estimates the prevalence and severity of erectile dysfunction and its association with cardiovascular risk factors in patients after a myocardial infarction. Materials and Methods: This study included men aged 35–80 years, diagnosed with myocardial infarction and examined in the Department of Preventive Cardiology of Vilnius University Hospital Santaros Klinikos between 2016 and 2020. Anthropometric characteristics, blood pressure, lipid profile, blood glucose levels and prevalence of cardiovascular risk factors were evaluated. The International Index of Erectile Function-5 was used to assess patients’ erectile function. Results: A total of 171 patients were analysed. The mean age was 57.6 ± 8.8 years. Of the patients, 42.1, 25.1 and 11.7% had three, four and five established cardiovascular risk factors, respectively. Of the patients, 100% were diagnosed with dyslipidaemia, 90.0%—arterial hypertension, 14.6%—diabetes, 23.3%—smoking, 43.7%—positive familial history and 54.5%—insufficient physical activity. The overall prevalence of erectile dysfunction was 62%. It was scored mild in 37.4%, mild-to-moderate—15.2%, moderate—5.3% and severe in 4.1% of the patients. The mean age was significantly different between severity groups (p < 0.001). The study demonstrated a negative correlation between age and total score of the questionnaire (r = −0.308, p < 0.001). Arterial hypertension was more frequent in the patients with erectile dysfunction (p = 0.02). Other cardiovascular risk factors were distributed similarly. Conclusions: Erectile dysfunction is common in patients after a myocardial infarction and its severity is age dependent. The prevalence of cardiovascular risk factors is high, with arterial hypertension significantly more frequent in patients with erectile dysfunction.

To investigate the prevalence, correlates, attitude and treatment seeking behavior of erectile dysfunction (ED) in type 2 diabetes mellitus (T2DM) patients in the primary care setting, a multi-center cross-sectional survey using a structured anonymous self-administered questionnaire was performed in 10 general outpatient clinics. Of the 603 subjects (91% response rate), the prevalence of ED men, as defined by the International Index of Erectile Function, was 79.1%. Most subjects had mild ED (28.9%), followed by mild-to-moderate ED (27.9%), then moderate ED (13.4%) and severe ED (9%). Nearly 55% of those with ED did not consider themselves as having ED. Less than 10% of them had ever sought medical treatment, although 76.1% of them wished to receive management from doctor(s) should they be diagnosed with ED. They considered the most important management from doctors to be clinical assessment (41.7%), followed by management of potential underlying cause (37.8%), referral to specialist (27.5%), education (23.9%), prescription of phosphodiesterase type 5 inhibitors (16.9%) and referral to counseling service (6.7%). The prevalence of ED was strongly associated with subjects who thought they had ED (odds ratio (OR) = 90.49 (20.00–409.48, P< 0.001)) and were from the older age group (OR = 1.043 (1.011–1.076, P = 0.008)). In conclusion, ED is highly prevalent among T2DM men. The majority of them wanted management from doctors should they have ED, but only a minority would actually voice out the request. Screening of ED among T2DM men using structural questionnaire allowed the diagnosis of more than half of the ED cases, which otherwise would have gone undiagnosed.

To determine, in a population-based survey, the prevalence of lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and incontinence in community-dwelling men in multiethnic Malaysia, as currently available Western demographic data might not be applicable in the Asian population. A cross-sectional population-based survey was carried out in the State of Penang, Malaysia, with a target population of men aged > or = 40 years. Using a multistage study design, random systematic sampling was used to represent the target population, who were weighted based on ethnicity and rural-urban ratios so as to represent the general population distribution. Trained field-workers conducted direct interviews and administered the American Urological Association Symptom Index (AUA-SI), the International Index of Erectile Function (IIEF-5) questionnaire and questions on incontinence based on the International Continence Society 2002 definition. In all, 418 men aged > or = 40 years were interviewed, of whom 353 completed the AUA-SI questionnaire (84.5% response rate). The prevalence of mild, moderate and severe LUTS was 80.6%, 6% and 0.3%, respectively. The prevalent symptoms were frequency and nocturia. There was moderate and severe ED in 45.9% of men, whereas incontinence was reported by 8.2%. The AUA-SI correlated strongly with age (R = 0.291, P < 0.001), IIEF-5 (R = - 0.265, P < 0.001) and diabetes mellitus. The prevalence and severity of LUTS, ED and incontinence increased with age in this multiethnic Asian population, in which ED correlated strongly with LUTS. Compared to the Western population, the prevalence of LUTS was significantly lower, while the prevalence of ED and incontinence were comparable.

In this study we determine the sexual problems and the prevalence of erectile dysfunction (ED) in male hemodialysis patients by means of the International Index of Erectile Function (IIEF). A total of 187 male patients were included in the study. All of the patients who underwent hemodialysis were asked to complete the IIEF questionnaire. The IIEF domain scores were calculated and erectile dysfunction grading was determined on erectile function domain. Patients were also asked to report whether they had disclosed their sexual problems to physicians or not.The mean age was 49.3+/-13.2 y and the duration of hemodialysis was 38.1+/-8.4 months. By means of the IIEF, the prevalence of erectile dysfunction of any degree was 80.7%. The prevalence of any ED for the patients <50 y and >or=50 y was 74.5% and 86.6%, respectively. The prevalence and the severity of ED was significantly higher in patients >or=50 y. The frequency of intercourse attempts during the last four weeks was 1-2 in 130 (69.5%) of patients. Only 1% of patients disclosed their erectile problems and sought medical assistance prior to our study.Erectile dysfunction is highly prevalent in hemodialysis patients. The prevalence and the severity of ED increased with age. Evaluations for ED should be included in routine assessment of hemodialysis patients.

Erectile dysfunction (ED) is common among elderly men and patients suffering from chronic diseases, the latter probably including also HIV infection. No studies, however, compared the prevalence of ED in HIV-infected and HIV-uninfected individuals using the international index of erectile function (IIEF-15). The aim of this study is to compare ED prevalence in young to middle-aged men with and without HIV infection using the IIEF-15 questionnaire. We conducted a cross-sectional, observational, controlled study on 444 HIV-infected men and 71 HIV-uninfected men. The IIEF-15 questionnaire was used to assess ED. A cutoff score of ≤25 of the erectile domain was used to diagnose ED. Serum testosterone, demographic, and anthropometric (weight, height, and body mass index [BMI]) characteristics were obtained from all participants. Statistics included the T-test, the Fisher's test, univariable and multivariable logistic regression, and univariate and multivariate Spearman's correlation analysis. The HIV-uninfected group was significantly younger than the HIV-infected group and presented a higher BMI (P < 0.001). The prevalence of mild, moderate, and severe ED was higher in HIV-infected men than in HIV-uninfected men of all decades of age. In univariate analysis, HIV infection was associated with ED (odds ratio [OR] = 34.19, P < 0.001). In multivariable logistic regression analysis, HIV infection remained the strongest predictors of ED (OR = 42.26, P < 0.001) followed by hypogonadism, after adjusting for age and BMI. This study demonstrates a clear association between ED and HIV infection, after adjusting for age and BMI. Other than HIV infection, hypogonadism was associated with ED. In addition, the prevalence of ED was higher in HIV-infected men than in HIV-uninfected men, in all decades of age. The early onset of ED in HIV-infected men could be considered a peculiar clinical hallmark of HIV and confirms precocious aging in these patients. ED should be of concern to clinicians when managing HIV-infected men even if the latter are young or middle aged.

Studies have found that erectile dysfunction (ED) may be a short-term or long-term complication in coronavirus disease 2019 (COVID-19) patients, but no relevant studies have completed a pooled analysis of this claim. The purpose of the review was to comprehensively search the relevant literature, summarize the prevalence of ED in COVID-19 patients, assess risk factors for its development, and explore the effect of the COVID-19 infection on erectile function. Medline, Embase, and the Cochrane Library was performed from database inception until April 14, 2022. Heterogeneity was analyzed by χ2 tests and I2 was used as a quantitative test of heterogeneity. Subgroup analyses, meta-regression, and sensitivity analyses were used to analyze sources of heterogeneity. Our review included 8 studies, 4 of which functioned as a control group. There were 250,606 COVID-19 patients (mean age: 31-47.1years, sample size: 23-246,990). The control group consisted of 10,844,200 individuals (mean age: 32.76-42.4years, sample size 75-10,836,663). The prevalence of ED was 33% (95% CI 18-47%, I2 = 99.48%) in COVID-19 patients. The prevalence of ED based on the international coding of diseases (ICD-10) was 9% (95% CI 2-19%), which was significantly lower than the prevalence of ED diagnosed based on the International Index of Erectile Function (IIEF-5) (46%, 95% CI 22-71%, I2 = 96.72%). The pooling prevalence of ED was 50% (95% CI 34-67%, I2 = 81.54%) for articles published in 2021, significantly higher than that for articles published in 2022 (17%, 95% CI 7-30%, I2 = 99.55%). The relative risk of developing ED was 2.64times in COVID-19 patients higher than in non-COVID-19 patients (RR: 2.64, 95% CI 1.01-6.88). The GRADE-pro score showed that the mean incidence of ED events in COVID-19 patients was 1,333/50,606 (2.6%) compared with 52,937/844,200 (0.4%) in controls; the absolute impact of COVID-19 on ED was 656/100,000 (ranging from 4/100,000 to 2352/100,000). Anxiety (OR: 1.13, 95% CI 1.03-1.26, I2 = 0.0%) in COVID-19 patients was a risk factor for ED. COVID-19 patients have a high risk and prevalence of ED, mainly driven by anxiety. Attention should be paid to patient's erectile functioning when treating COVID-19.

We tried to compare the parameters of nocturnal penile tumescence and rigidity (NPTR) testing with erectile function (EF) domain score of International Index of Erectile Function (IIEF), which is used in diagnosis and determining the severity of erectile dysfunction (ED), and to assess the sufficiency of IIEF in the diagnosis of ED. A total of 90 men, mean age 46 years (24-75), presenting with ED to our clinic between January 2001 and March 2003 were included in the trial. All the men answered the standard IIEF (15 questions) forms and was divided into four groups as mild ED, moderate ED, severe ED and no ED according to the EF domain score that is obtained from 1st, 2nd, 3rd, 4th, 5th and 15th questions. Then NPTR testing with the RigiScan Plus monitoring device was performed for two consecutive nights on those men. The distribution of the six parameters of NPTR testing (number of erections, duration of erections, TAU base, RAU base, TAU tip, RAU tip) among the four groups and the correlation with IIEF-EF domain score were evaluated. Additionally, the distribution of the risk factors (diabetes mellitus, hypertension, atherosclerotic heart disease, dyslipidemia and smoking) was analyzed both among the four groups and in each group. According to IIEF-EF domain scores of 90 patients, 16 (18%) had severe ED, 21 (23%) moderate ED, 41 (46%) mild ED and 12 (13%) no ED. There was no statistically significant difference between the risk factors among the men in these groups (P > 0.05). When the IIEF-EF domain scores were compared with parameters of NPTR testing, no statistically significant difference was obtained among ED groups (mild, moderate, severe) (P > 0.05). However, we observed a statistically significant difference between three ED groups and no ED group (P < 0.05). If NPTR testing is considered as a gold standard test, sensitivity, specificity, positive predictive value and negative predictive value of IIEF-EF domain score in ED diagnosis are 100, 17.9, 29.4 and 100% respectively. In conclusion, we did not observe a clinical correlation between IIEF-EF domain scores and NPTR parameters in the whole population; however, we observed that if IIEF-EF domain scores were normal, NPTR parameters were also normal. In other words, we can say that if the initial IIEF-EF domain scores are normal, then we do not have to perform NPTR testing. This could be helpful to make a cost-effective diagnosis.