Abstract

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 < 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.

Highlights

  • Erectile dysfunction (ED) is a very common complication of diabetes mellitus

  • Erectile function is dependent on relaxation of the cavernous smooth muscle and its mechanism of action is mediated by nitric oxide (NO) [1]

  • This study showed that the prevalence of ED among subjects with type 2 diabetes mellitus (T2DM) was 48.4% while that of the non-diabetic controls was 4.8% (P < 0.001, OR = 18.437, 95% C.I for OR = 5.485-61.972)

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Summary

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. 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
Conclusion
Methods and materials
Discussion
Limitations of the study
How often were you able to get an erection during sexual activity?
How many times have you attempted sexual intercourse?
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