Association Of Erectile Dysfunction Research Articles

Association of erectile dysfunction and peripheral arterial disease in NHANES 2001-2004: a cross-sectional study

ObjectiveTo evaluate the association between Erectile dysfunction (ED) and peripheral arterial disease (PAD) in adult American males using a large database.MethodsThe relationship between ED and PAD prevalence among participants in the 2001-2004 National Health and Nutrition Examination Survey (NHANES) database was assessed using a series of statistical analyses. ED was evaluated based on a single-item measure of self-reported erection problems from the Massachusetts Male Aging Study. PAD was defined as ankle-brachial index (ABI) < 0.9 in at least one leg. Multifactorial logistic regression models were used to investigate the association between ED and PAD.ResultsA total of 2394 participants were enrolled, of whom 905 individuals (37.8%) were diagnosed with ED. After adjusting for confounding variables, the association between ED and PAD remained positive, with an odds ratio of 2.05 (95% confidence interval 1.24-3.39). Subgroup analysis revealed that the relationship between ED and PAD was significant in patients aged >50 years old, without hypertension, without diabetes, without cardiovascular disease, without high cholesterol, former smokers, low physical activity levels, and a body mass index of 25-30 (P < 0.05). In addition, all subgroups analyzed were evaluated for any potential interaction, and no statistically significant association was discovered.ConclusionsIn a sample of US adults aged ≥40, this cross-sectional study found that ED is related to a higher occurrence of PAD. ED may be an independent predictor of PAD, and thus it should be considered in the treatment of patients with ED.

Lipid metabolism and neuromuscular junction as common pathways underlying the genetic basis of erectile dysfunction and obstructive sleep apnea.

Erectile dysfunction (ED) incidence is higher in patients with obstructive sleep apnea (OSA). Studies have suggested that ED and OSA may activate similar pathways; however, few have investigated the links between their underlying genotypic profiles. Therefore, we conducted an in-silico analysis to test whether ED and OSA share genetic variants of risk and to identify any molecular, cellular and biological interactions between them. Two gene lists were manually curated through a literature review based on a PUBMED search, which resulted in one gene list associated with ED (total of 205 genes) and the other with OSA (total of 2622 genes). Between those gene sets, 35 were common for both lists (Fisher exact test, p-value = 0.027). The Protein-protein interaction (PPI) analysis using the intersect list as input showed that 3 of them had direct interactions (LPL, DGKB and PLCB1). In addition, the biological function of the genes contained in the intersect list suggested that pathways related to lipid metabolism and the neuromuscular junction were commonly found in the genetic basis of ED and OSA. From the shared genes between both conditions, the biological pathways highlighted in this study may serve as preliminary findings for future functional investigations on OSA and ED association.

#4211 PULSE WAVE VELOCITY AND ERECTILE DYSFUNCTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Abstract Background and Aims Erectile dysfunction is a frequent problem and adversely affects quality of life. In recent years, it has been shown to be an early indicator of cardiovascular disease and endothelial damage. For patients with chronic kidney disease, the incidence of cardiovascular events is increased, while erectile dysfunction is also more frequent. In this study we evaluated in patients with chronic kidney disease the incidence and the association of erectile dysfunction with pulse wave velocity (PWV) and reflection wave parameters. Method The incidence of erectile dysfunction was examined with the use of IIEF (5) Sexual Health Questionnaire in adult male patients aged less than 65 years with chronic kidney disease stage I-V or a history of kidney transplantation that were actively monitored or treated as outpatients. Peripheral blood pressure, central blood pressure, PWV and reflection wave parameters (augmentation pressure and augmentation index) were evaluated using the Mobil-o-graph device in office measurements. Results Overall, 69 men with a mean age of 46.5 ± 11.79 years were included in the study. Chronic kidney disease (CKD) classification according to baseline eGFR calculation was as follows: 12 patients with CKD-I, 27 with CKD-II, 12 with CKD-III, 6 with CKD-IV and 12 with CKD-V on maintenance hemodialysis. Erectile dysfunction of all degrees (mild to severe) was detected in 52% of patients. From the correlation of the various parameters assessed with the degree of erectile function, as calculated by the IIEF questionnaires, it was found that renal function as expressed by eGFR showed a positive correlation (r = 0.24, p = 0.047), while age and PWV showed a negative correlation (r = -0.384, p = 0.002 and r = -0.474, p<0.001 respectively). Moreover, pulse wave velocity was the only parameter which could predict erectile dysfunction (β = -0.995, 95% CI -0.465 to -10.074, p = 0.032). Conclusion The results of the study showed that worsening kidney function is associated with an increase in arterial stiffness and an increase in the incidence of erectile dysfunction. Moreover, erectile dysfunction was more common in patients with increased PWV.

Elevated Cardiac Biomarkers, Erectile Dysfunction, and Mortality in U.S. Men: NHANES 2001 to 2004

BackgroundThe prevalence of elevated cardiac biomarkers and their link to mortality in men with erectile dysfunction in the U.S. population are unknown. ObjectivesThe purpose of this study was to evaluate the prevalence of elevations in N-terminal prohormone B-type natriuretic peptide, high sensitivity troponin (hs-troponin) T, and 3 hs-troponin I assays and their associations with mortality in U.S. men with and without erectile dysfunction. MethodsWe conducted cross-sectional analyses using logistic regression to examine associations of elevated cardiac biomarkers (>90th percentile) with erectile dysfunction in 2,971 male participants aged 20 years or older in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2004. We conducted prospective analyses using Cox regression to examine the mortality implications of elevations in cardiac biomarkers in the setting of erectile dysfunction. ResultsElevations in hs-troponin T and the 3 hs-troponin I assays were associated with erectile dysfunction, with the strongest association for hs-troponin T (adjusted OR: 2.01; 95% CI: 1.22-3.30). Elevated N-terminal prohormone B-type natriuretic peptide was not significantly associated with erectile dysfunction (OR: 1.22; 95% CI: 0.74-2.03). There were 673 deaths during a median of 16 years of follow-up. Men with erectile dysfunction were at an elevated risk of death (adjusted HR: 1.23; 95% CI: 1.04-1.46). Those men with elevated cardiac biomarkers in the setting of erectile dysfunction were at highest risk of all-cause and cardiovascular mortality (adjusted HRs ranging from ∼1.5 to 2.4). ConclusionsIn this national study, the association of erectile dysfunction with elevated hs-troponin and excess mortality risk suggests that men with erectile dysfunction should be evaluated and targeted for intensive cardiovascular risk management.

Possible Clinical Benefits of Cardio-Ankle Vascular Index Measurement in Urological Diseases.

Many factors are considered to affect vascular physiology. It is known that one of the reasons for many diseases is a pathology at the microvascular level. Therefore, the relationship between endothelial dysfunction and many diseases is currently being investigated. The clinical evaluations of arterial stiffness have made it possible to perform necessary risk assessment regarding cardiovascular diseases. In this way, protective measures can be taken against microvascular pathologies in many organs. In this paper, we present a review of studies investigating the relationship between urological conditions and the cardio-ankle vascular index (CAVI), a marker of arterial stiffness. As with erectile dysfunction, some studies have shown that conditions such as lower urinary tract symptoms, overactive bladder, and chronic kidney disease are also associated with an elevated CAVI. The association of erectile dysfunction and chronic kidney disease with vascular pathologies has been clearly demonstrated. In addition, lower urinary tract symptoms may be the first sign of silent vascular dysfunction. Assessing arterial stiffness with CAVI can help prevent future cardiovascular events in these patients.

Erectile Dysfunction in Alcohol Use Disorder and the change in erectile function after one month of abstinence

Objective The association between alcohol use and erectile dysfunction (ED) has not been explored adequately. The aim of this study is (i) to determine the prevalence of ED in patients with Alcohol use disorder (AUD), (ii) the association of ED with sociodemographic and clinical variables, (iii) the association between severity of drinking and sociodemographic and clinical variables, and (iv) the assess the change in ED after one month of abstinence from alcohol. Methods 203 consecutive patients were recruited into the study after taking written informed consent. Sociodemographic data was collected using a proforma and ED was assessed using International Index of Erectile Function-5 (IIEF-5). The patients were also followed up after 1 month of abstinence to assess the change in erectile function. Results The prevalence of ED was 68.5%. Out of the 203 subjects, 28.1% had mild ED, 24.1% had mild to moderate ED, 9.9% had moderate ED and 6.4% had severe ED. Significant association were seen between ED and age, marital status, diabetes mellitus, hypertension, total duration, and severity of drinking. A significant association was seen between severity of drinking and age, diabetes mellitus, hypertension, alcoholic liver disease, tobacco use and duration of drinking. The improvement in ED after 1 month abstinence was found to be significant. Conclusions ED is a common problem in patients with AUD. Routine assessment of sexual functioning is warranted in patients with AUD and the information that ED improves with abstinence can provide an impetus to change.

Association of erectile dysfunction with diabetic foot and its outcomes in type 2 diabetic men.

Erectile dysfunction (ED) and diabetic foot (DF) are common complications in patients with diabetes. However, the relationship between ED and DF has been little studied. In particular, no study has evaluated whether ED is associated with the outcomes of DF. The aim of this retrospective cohort study was to investigate whether ED is a predictor of the outcomes of DF in a large population of men with DF. Three hundred and twenty-six consecutive men with type 2 diabetes and a recent and single DF ulcer were recruited and followed up for 41.7 ± 22.7months. Among men with DF, 56.1% had ED (ED group) and 43.9% did not (NO ED group). Wound healing rate was significantly higher in the NO ED than in the ED group (90.2 versus 73.3%; p = 0.0001). Minor amputation rate (13.7 versus 4.8%; p = 0.007) and mortality (25.7 versus 0.7%; p < 0.001) were significantly greater in the ED than in the NO ED group. Among 263 patients with healed ulcers, recurrence rate was significantly higher in the ED than in the NO ED group (51.5 versus 26.3%; p < 0.001). Multivariate analysis showed that the absence of ED was associated with wound healing (OR: 0.459; 95% CI: 0.213-0.993; p = 0.048), while the presence of ED predicted mortality (OR: 22.644; 95% CI: 2.976-34.271; p = 0.002) and DF recurrence (OR: 3.498; 95% CI: 1.882-6.499; p < 0.001). Our data show that among men with DF the prevalence of ED is very high. Moreover, ED may be a strong predictor of wound healing, mortality, and ulcer recurrence.

MP21-01 CONTEMPORARY COMORBIDITY PROFILE OF MEN WITH ERECTILE DYSFUNCTION

You have accessJournal of UrologyCME1 May 2022MP21-01 CONTEMPORARY COMORBIDITY PROFILE OF MEN WITH ERECTILE DYSFUNCTION Garrick Greear, Tristan Nicholson, Sarah Holt, Marah Hehemann, Hunter Wessells, and Thomas Walsh Garrick GreearGarrick Greear More articles by this author , Tristan NicholsonTristan Nicholson More articles by this author , Sarah HoltSarah Holt More articles by this author , Marah HehemannMarah Hehemann More articles by this author , Hunter WessellsHunter Wessells More articles by this author , and Thomas WalshThomas Walsh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002554.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The modern understanding of the comorbidities associated with erectile dysfunction (ED) was shaped by decades-old survey-based epidemiologic studies. The demographics and comorbidities of the United States population have since changed. A contemporary assessment of the comorbidity profile of men with ED is timely and indispensable for the efficient care of these men. METHODS: A cross-sectional analysis of the MarketScan® administrative claims database from 2008 to 2019 was performed. Inclusion criteria were men 18 to 64 years of age with a diagnosis of ED or phosphodiesterase type 5 inhibitor (PDE5i) prescription with ≥1 year of enrollment, as well as age-matched controls without an ED diagnosis or related prescription. Comorbidities were extracted by ICD-9/10 diagnosis codes and categorized by the Elixhauser Comorbidity Index. The trends in prevalence of comorbidities and odds of comorbidity diagnosis, overall and by age group, were analyzed. RESULTS: The prevalence of all comorbidities in men with and without ED increased over the study period. The five most prevalent comorbidities (and percentage increase) among men with ED were hypertension (108%), diabetes (78%), obesity (357%), chronic pulmonary disease (124%), and depression (164%). The association of ED with comorbidities such as complicated diabetes and paralysis was more pronounced among younger men (age 18-45 years vs 46-64 years). CONCLUSIONS: The comorbidity profile of men with ED has evolved since its initial characterization nearly 30 years ago. Increases in diseases associated with obesity and metabolic syndrome, as well as mental health disorders, are particularly notable. The findings illustrate the complex interplay of chronic health conditions in men with ED, and serve to justify the comprehensive evaluation of all men who present with ED. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e326 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Garrick Greear More articles by this author Tristan Nicholson More articles by this author Sarah Holt More articles by this author Marah Hehemann More articles by this author Hunter Wessells More articles by this author Thomas Walsh More articles by this author Expand All Advertisement PDF DownloadLoading ...

Sexual Function, Quality of Life and Depression in Left Ventricular Assist Device Supported Patients

<h3>Purpose</h3> Left ventricular assist device (LVAD) therapy is associated with improved survival and quality of life (QoL) in advanced heart failure (HF) patients. Sexual dysfunction is common among HF patients and considered an important hamper to QoL. The aim of the study was the evaluation of prevalence of erectile dysfunction (ED) in LVAD recipients and its association with QoL and depression. <h3>Methods</h3> This is a prospective, single-center, cross-sectional study. We included male LVAD patients who were clinically stable after at least 3 months post-implantation. Erectile function was assessed with the International Index of Erectile Function (IIEF-5) with a score of ≤ 21 being confirmatory for ED. QoL and depression were estimated with the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Patient Health Questionnaire depression scale (PHQ-8), respectively. Association between binary variables was estimated by the <i>x²</i> test. Pearson's correlation was run to assess the relationship between IIEF-5, KCCQ, and PHQ-8 scores. <h3>Results</h3> We included 52 patients on continuous-flow LVAD. Mean age was 57 years and bridge to transplant was the therapeutic goal in 79% of patients. Median time on device support was 707 days. HeartMate III was the most common device type (69%) followed by HeartWare (31%). According to IIEF-5 assessment, 78% of all study patients had ED. Mean IIEF-5 score was 11.9 ± 8.8, KCCQ 79.7 ± 5.5 %, and PHQ-8 score 6.3 ± 5.7. There was no significant association between ED and common comorbidities (chronic kidney disease, diabetes, peripheral arterial disease, coronary artery disease, hypertension, atrial fibrillation, stroke). ED was not associated with the intake of beta blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, sacubitril/valsartan, aldosterone antagonists, sodium-glucose co-transporter 2 inhibitors, or phosphodiesterase-5 inhibitors (PDE5i). There was a statistically significant negative correlation between IIEF-5 score and depression severity scale (r = -0.44, p < 0.014) while no significant correlation between IIEF-5 and KCCQ score was observed (r = 0.19, p = 0.25). <h3>Conclusion</h3> ED is highly prevalent among LVAD recipients and is associated with severity of depressive symptoms. There is no association of ED with HF drugs and major comorbidities and PDE5i use is not associated with the prevalence of ED in this cohort.

Association of erectile dysfunction with tinnitus: a nationwide population-based study

With many previous studies indicating a higher prevalence of sexual problems in patients with tinnitus, the association between tinnitus and erectile dysfunction (ED) has become an interesting topic that warrants further research. In our study, we hypothesized that tinnitus may be associated with ED and aimed to further explore the relationship between these two medical conditions using a nationwide population-based database. After retrieving data of 19,329 patients with ED and 19,329 propensity score-matched patients without ED (controls) from Taiwan’s National Health Insurance Dataset, we defined the diagnosis date (the date of the first ED claim) for patients with ED as the index date for cases, and the date of the first utilization of ambulatory care by patients without ED during the index year of their matched case as the index date for controls. We found that 1247 out of 38,658 sampled patients (3.23%) had received a tinnitus diagnosis within the year before the index date, with 792 (4.10%) from cases and 455 (2.35%) from controls. We then utilized multiple logistic regression analysis and observed that cases were more likely to have had a prior tinnitus diagnosis compared to controls (OR 1.772; 95% CI 1.577–1.992; p < 0.001). Lastly, we adjusted the data for co-morbid medical disorders and social economic factors, with the end results showing that cases were more likely than controls to have a prior diagnosis of tinnitus (OR 1.779, 95% CI 1.582–2.001, p < 0.001). Through our investigation, we have ultimately detected a novel association between ED and tinnitus and urge physicians to be alert to the possibility of the development of ED in patients treated for tinnitus.

Association of erectile dysfunction and cardiovascular disease: an umbrella review of systematic reviews and meta-analyses.

ObjectivesTo present an overall picture of the evidence regarding the association of erectile dysfunction (ED) with cardiovascular disease (CVD).MethodsSystematic reviews and meta‐analyses that studied the association of ED with any CVD were included in this umbrella review. We did not restrict the population to a particular group or age. PubMed, Embase, the Joanna Briggs Institute (JBI) Database of Systematic Reviews and Implementation Reports, the Cochrane Database of Systematic Reviews, the Database of s of Reviews of Effects, and the PROSPERO register were searched to find relevant systematic reviews, with or without meta‐analyses, from inception to April 2020. The JBI Checklist for Systematic Reviews and Research Syntheses was used for the critical appraisal. Only studies with acceptable quality were included. Two independent reviewers extracted the data using the JBI data extraction tool for qualitative and quantitative data extraction.ResultsThe summary estimate showed a higher risk of CVD (relative risk [RR] 1.45, 95% confidence interval [CI] 1.36–1.54; P < 0.001), coronary heart disease (RR 1.50, 95% CI 1.37–1.64; P < 0.001), cardiovascular‐related mortality (RR 1.50, 95% CI 1.37–1.64; P < 0.001), all‐cause mortality (RR 1.25, 95% CI 1.18–1.32; P < 0.001), myocardial infarction (RR 1.55, 95% CI 1.33–1.80; P < 0.001) and stroke (RR 1.36, 95% CI 1.26–1.46; P < 0.001) in patients with ED than in other patients.ConclusionsOur results confirm that ED is an independent predictor of CVD and their outcomes. ED and CVD are two presentations of the same physiological phenomenon. ED normally precedes symptomatic CVD, providing a window of opportunity for healthcare practitioners to screen and detect high‐risk patients early to prevent avoidable morbidity and mortality.

Heart Rate Variability and Erectile Function in Younger Men: A Pilot Study.

Erectile dysfunction (ED) in younger men is an increasing concern. In middle aged and older men, ED was related to lower resting heart rate variability (HRV), but research in younger men is lacking. The present study examined, in a nonclinical sample of 105 men between 18 and 39years, the association of ED with several parameters of resting HRV. Scores of the 5-item version of the International Index of Erectile Function (IIEF-5) below 22 were considered as indicating ED. Eighteen men (17.1%) reported ED (mild in 16, mild to moderate in 2). Welch's tests revealed that ED was associated with lower low-frequency power (LF), lower high-frequency power (HF), lower standard deviation of interbeat intervals, and lower standard deviation of the heart rate, which is influenced by both sympathetic and parasympathetic activity. After removing outliers, ED was unrelated to HF. In younger men, erections might be facilitated by a combination of higher parasympathetic tone and relatively higher sympathetic tone in the heart, as indicated by LF and greater standard deviation of the heart rate, a largely overlooked parameter in HRV research.

Male Sexual Health and Cardiovascular Disease

To provide an updated review on the association of erectile dysfunction (ED), male hypogonadism, and testosterone therapy with cardiovascular disease (CVD). Direct evidence links male sexual dysfunction to CVD, including higher coronary artery calcium scores, carotid narrowing, and more severe coronary artery disease. While questions about the role of ED in predicting cardiovascular risk independent of shared comorbidities have lingered, the most recent analyses favor a diagnosis of ED as a strong independent predictor of adverse cardiac events. ED has now been incorporated into the widely used QRISK3 calculator for cardiovascular risk assessment and may influence clinical decision-making about primary prevention interventions. Controversy also surrounds changes in testosterone labeling that highlight potential cardiovascular risks. While continuing to remain contentious, the most extensive meta-analyses conclude that low endogenous testosterone is independently associated with increased cardiovascular risk and that testosterone therapy does not appear to carry increased risk in most populations. The assessment of ED is an effective tool in predicting cardiovascular risk and may influence clinical decision-making with regard to primary prevention interventions. The associations between endogenous testosterone levels, testosterone therapy, and cardiovascular risk remain controversial.

Association of erectile dysfunction and type II diabetes mellitus at a tertiary care centre of south India

Background and aimsErectile Dysfunction (ED) is more common in diabetic men and, unfortunately, occurs at an earlier age in diabetic patients when compared with the general population. The study aims to evaluate the independent predictors of ED in adult men with type 2 diabetes mellitus (DM) at a tertiary care center of South India. MethodsA total of 720 men aged 30–70 years who had been diagnosed with type 2 DM were enrolled for the study from January 2017 to January 2020 from the outpatient diabetes clinic of the Hospital. All patients completed the abridged version of the International Index of Erectile Function (IIEF-5) questionnaire. ResultsThe mean age of the patients was (58.4 ± 7.8 years). 68.6% of subjects had varying degrees of erectile dysfunction, of which 54.6% had moderate to severe ED. 55.8% had poor glycemic control (HbA1c ≥ 7%). Subjects with ED had a longer duration of DM than those without ED (mean DM duration was 8.1 ± 4.9 years versus 4.4 ± 3.5 years; p < 0.001). Longer duration of DM, poor glycemic control, hypertension, peripheral arterial disease, testosterone deficiency were all independent predictors ED (p < 0.05). ConclusionsA high incidence of erectile dysfunction was observed in type 2 DM patients attending the diabetic clinic, and over half of the people affected were of moderate-to-severe in intensity. Poor glycemic control, testosterone deficiency, peripheral arterial disease were the modifiable risk factors for ED in diabetic subjects. At the same time, a longer duration of type 2 DM was noticed as a glaring non-modifiable risk factor, according to our study.

Re: Association of Erectile Dysfunction with Incident Atrial Fibrillation: the Multi-Ethnic Study of Atherosclerosis (MESA).

Re: Association of Erectile Dysfunction with Incident Atrial Fibrillation: the Multi-Ethnic Study of Atherosclerosis (MESA).

Association of Erectile Dysfunction with Incident Atrial Fibrillation: The Multi-Ethnic Study of Atherosclerosis (MESA)

PurposeErectile dysfunction has been associated with atrial fibrillation in cross-sectional studies, but the association of erectile dysfunction with incident atrial fibrillation is less well established. This study aimed to determine whether erectile dysfunction is independently associated with incident atrial fibrillation after adjusting for conventional risk factors. MethodsWe studied 1760 male participants (mean age 68 ± 9 years) from the Multi-Ethnic Study of Atherosclerosis (MESA), who completed self-reported erectile dysfunction assessment at MESA exam 5 (2010-2012). Cumulative incidence of atrial fibrillation was estimated by Kaplan-Meier analysis. Cox proportional hazards regression was used to calculate the unadjusted and adjusted hazard ratios (HR) using 3 models in which variables were added in a stepwise manner. In model 3, HR was adjusted for age, race and ethnicity, education, smoking status, alcohol use, systolic blood pressure, body mass index, diabetes, anti-hypertensive medication use, lipid-lowering medication use, total cholesterol, and estimated glomerular filtration rate. ResultsDuring the median follow-up of 3.8 (interquartile range, 3.5-4.2) years, 94 cases of incident atrial fibrillation were observed. There was a significant difference between males with and without erectile dysfunction for cumulative incident atrial fibrillation rates at 4 years (9.6 vs 2.9%, P < .01). In the fully adjusted model, erectile dysfunction remained associated with incident atrial fibrillation (model 3; HR, 1.66; 95% confidence interval 1.01-2.72, P = .044). ConclusionsAmong older male participants in this prospective study, we found that self-reported erectile dysfunction was associated with incident atrial fibrillation.

The Relationship Between Gait Function and Erectile Dysfunction: Results from a Community-Based Cross-Sectional Study in Japan

IntroductionAlthough physical activity is associated with a decreased risk of erectile dysfunction (ED), the association of ED with physical function remains unclear. AimTo investigate the relationship between gait function and ED in a community-dwelling population. MethodsThis cross-sectional study analyzed 324 men who participated in the Iwaki Health Promotion Project in 2015 in Hirosaki, Japan. ED was assessed with the 5-Item International Index of Erectile Function (IIEF-5). The participants were divided into 2 groups: low IIEF-5 score (≤16) and high IIEF-5 score (>16). We evaluated physical function, including gait function and grip strength. Gait function was evaluated by 10-meter gait speed and 2-step score (the ratio of the maximum length of 2 strides to height). We assessed daily physical activity, comorbidities, mental status, and laboratory data. The association between physical function and a low IIEF-5 score was analyzed by multivariate logistic regression analysis. Main Outcome MeasureThe main outcome measure was to assess whether gait function was an independent indicator for erectile dysfunction. ResultsOf 324 men, 154 (48%) had a low IIEF-5 score. Grip strength, 2-step score, and 10-meter gait speed in the low IIEF-5 group were significantly inferior to those in the high IIEF-5 group. Multivariate analysis showed that the 2-step score (odds ratio = 0.08), age, and total testosterone were independently associated with a low IIEF-5. Clinical ImplicationsThis study may motivate clinicians to investigate predictive values of physical function for ED. Strengths & LimitationsThe strength of this study was the use of simple, objective, and feasible tests for gait function to assess its association with ED. The limitations of this study were selection bias, regional bias, and nature of the cross-sectional study. ConclusionsOf the gait functional tests, not the 10-meter gait speed but 2-step score was an independent indicator for the presence of ED.Okamoto T, Hatakeyama S, Imai A, et al. The Relationship Between Gait Function and Erectile Dysfunction: Results from a Community-Based Cross-Sectional Study in Japan. J Sex Med 2019; 16:1922–1929.

Erectile dysfunction and risk of cardiovascular and all-cause mortality in the general population: a meta-analysis of cohort studies.

Studies on the association of erectile dysfunction (ED) with cardiovascular or all-cause mortality have yielded conflicting findings. We conducted this meta-analysis to evaluate the association of ED with cardiovascular or all-cause mortality in the general population. Pubmed and Embase databases were searched for prospective studies that evaluated the association of ED with cardiovascular or all-cause mortality in the general population up to 15 December, 2017. The overall combined risk ratio (RR) and 95% confidence intervals (CI) were pooled for the men with or without ED. A total of 7 studies involving 111,440 participants were included in the meta-analysis. When compared to the men with or without ED, the overall pooled RR was 1.24 (95% CI 1.11-1.39) for all-cause mortality and 1.11 (95% CI 0.92-1.35) for cardiovascular mortality. Subgroup analyses indicated that only men with severe ED significantly increased all-cause mortality risk (RR 1.58; 95% CI 1.37-1.82), but not in the mild (RR 1.07; 95% CI 0.93-1.24) ED and the moderate (RR 1.16; 95% CI 1.00-1.35) ED. This meta-analysis suggests that severe ED is significantly associated with increased all-cause mortality in the general population. However, the association of ED with cardiovascular mortality should be further investigated.

MP81-10 ERECTILE DYSFUNCTION IN 45–YEAR–OLD GERMAN MEN IN ASSOCIATION WITH RISK FACTORS AND COMORBIDITIES; RESULTS OF THE GERMAN MALE SEX–STUDY

You have accessJournal of UrologySexual Function/Dysfunction: Basic Research & Pathophysiology II1 Apr 2017MP81-10 ERECTILE DYSFUNCTION IN 45–YEAR–OLD GERMAN MEN IN ASSOCIATION WITH RISK FACTORS AND COMORBIDITIES; RESULTS OF THE GERMAN MALE SEX–STUDY Kathleen Herkommer, Jacqueline Hallanzy, Martina Kron, F.-M. Köhn, Maximilian Schmautz, Peter Albers, Christian Arsov, Boris A. Hadaschik, Markus Hohenfellner, Florian Imkamp, Martin Kuczyk, and Jürgen E. Gschwend Kathleen HerkommerKathleen Herkommer More articles by this author , Jacqueline HallanzyJacqueline Hallanzy More articles by this author , Martina KronMartina Kron More articles by this author , F.-M. KöhnF.-M. Köhn More articles by this author , Maximilian SchmautzMaximilian Schmautz More articles by this author , Peter AlbersPeter Albers More articles by this author , Christian ArsovChristian Arsov More articles by this author , Boris A. HadaschikBoris A. Hadaschik More articles by this author , Markus HohenfellnerMarkus Hohenfellner More articles by this author , Florian ImkampFlorian Imkamp More articles by this author , Martin KuczykMartin Kuczyk More articles by this author , and Jürgen E. GschwendJürgen E. Gschwend More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2536AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We analyzed erectile dysfunction (ED) in a representative sample of 45-year-old German men and assessed the association with lifestyle risk factors and ED-related comorbidities. METHODS Data was collected within the German Male Sex-Study (part of the PROBASE prostate cancer screening trial) between April 2014 and April 2016. 45-year old men living in four German regions (Dusseldorf, Hannover, Heidelberg, Munich) were invited within a screening trial. 10.135 Caucasian, heterosexual and sexually active men were included in this analysis. An anamnesis interview was obtained for all men including information on comorbidities and medication. Weight and waist circumference were measured on site. Erectile function was evaluated using the International Index of Erectile Function (IIEF-EF(6)). The presence of ED was defined as IIEF-EF-Score <=25. Association of ED and comorbidities/risk factors were analyzed by logistic regression. RESULTS The prevalence of ED was 25.2% (IIEF-EF: 6-10: 3.1%, 11-16: 9.2%, 17-21: 4.2%, 22-25: 8.7%). We ascertained a baseline risk of 14.4% for men without ED-related comorbidities and with healthy lifestyle factors: no smoking, waist circumference <94cm, physical activity >=4 days a week, IPSS=0. In multiple logistic regression with backward elimination the following factors associated with ED were identified: Comorbidities: Depression [OR 1.87], lower urinary tract symptoms (defined as International Prostate Symptom Score >7) [OR 1.68], diabetes mellitus [OR 1.38], hypertension [OR 1.22].Risk factors: Poor general health status (first question of SF12) [OR 1.72], waist circumference (>=102cm) [OR 1.31], physical activity (<2 days a week minimum 30 minutes per day mild exercise) [OR 1.27], smoking regularly [OR 1.15]. The only factor eliminated during variable selection was BMI even though this factor showed a crude OR of 1.42. ED-prevalence increased with the number of risk factors (0 factors: 21.9%; 3 factors: 33.4%) and number of comorbidities (0 comorbidities: 22.4%; 3-4 comorbidities: 64.3%). CONCLUSIONS ED was found in every fourth 45-year-old German man. Prevalence increased significantly with the number of risk factors and comorbidities. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1092-e1093 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Kathleen Herkommer More articles by this author Jacqueline Hallanzy More articles by this author Martina Kron More articles by this author F.-M. Köhn More articles by this author Maximilian Schmautz More articles by this author Peter Albers More articles by this author Christian Arsov More articles by this author Boris A. Hadaschik More articles by this author Markus Hohenfellner More articles by this author Florian Imkamp More articles by this author Martin Kuczyk More articles by this author Jürgen E. Gschwend More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

P-03-017 Severity and associations of erectile dysfunction in a sample of type 2 diabetic men

P-03-017 Severity and associations of erectile dysfunction in a sample of type 2 diabetic men