Frequency Of Erectile Dysfunction Research Articles

Frequency of Erectile Dysfunction in Patients with Type 2 Diabetes Mellitus Presenting with Peripheral Neuropathy at a Tertiary Care Hospital

Background: Erectile dysfunction (ED) is notably prevalent among patients with type 2 diabetes mellitus (T2DM), especially those suffering from peripheral neuropathy. The condition significantly impacts the quality of life and is often exacerbated by diabetes-related complications. Objective: This study aims to ascertain the frequency and severity of ED among patients with T2DM and peripheral neuropathy, and to examine the association between ED and variables such as age, duration of diabetes, and glycemic control. Methods: A prospective cohort study was conducted at the Baqai Institute of Diabetology and Endocrinology, Karachi, from July 2021 to September 2022. We included 115 male patients aged 35-65 years with T2DM and diagnosed peripheral neuropathy. ED was assessed using the Urdu version of the International Index of Erectile Function-5 (IIEF-5) questionnaire. Demographic details, medical history, and laboratory results were collected and analyzed using SPSS version 25. Statistical tests included chi-squared and one-way ANOVA, with a significance level set at p<0.05. Results: The mean age of the participants was 50.97 ± 7.21 years, and the average duration of diabetes was 9.37 ± 6.56 years. The mean IIEF-5 score was 14.33 ± 6.0, indicating moderate ED. Severe ED was observed in 20% of the participants, moderate ED in 19.1%, and mild to moderate ED in 28.7%. The study found a significant association between the duration of diabetes and ED severity (p < 0.001), while age and HbA1c levels did not show a significant correlation with ED status. Conclusion: ED is highly prevalent and severe among patients with T2DM and peripheral neuropathy, with disease duration being a significant predictor of ED severity. These findings underscore the need for early screening and targeted interventions in this population.

(113) Investigating the Prevalence of Erectile Dysfunction in Patients with Non-Alcoholic Fatty Liver and Its Relationship with the Severity of Fatty Liver

Abstract Introduction Today, the relationship between erectile dysfunction in men and the pathogenesis process in the field of metabolic syndrome is of interest. Non-alcoholic fatty liver disease is one of the diseases related to metabolic syndrome, which has a high prevalence. This study was conducted with the aim of evaluating the prevalence of erectile dysfunction in men with non-alcoholic fatty liver disease and investigating the relationship between its severity and the grading of liver complications. Objective In this research, the frequency of erectile dysfunction and decreased libido and sexual satisfaction in patients with non-alcoholic fatty liver disease have been investigated and compared with the control group. Also, the relationship between the severity of sexual dysfunction and fatty liver grading has been investigated. Methods In this study, 1200 patients with non-alcoholic fatty liver disease were randomly selected and participated in this study between 2019 and 2022. In order to investigate sexual disorders, the standard male sexual performance questionnaire was used along with the demographic questionnaire. Results The results of this study showed that the indicators of male sexual dysfunction in patients with non-alcoholic fatty liver have a high prevalence (44.5%). Also, the severity of erectile dysfunction has a significant relationship with the severity of non-alcoholic fatty liver disease (pv=0.002). Conclusions A holistic view of the health category requires that in the treatment of medical disorders, the effective factors and consequences of the disorder should be considered. Paying attention to the diagnosis and treatment of sexual disorders in the treatment process will be one of the most important aspects of the patient's health; Because erectile dysfunction in men, apart from the effect on sexual relations, will have destructive consequences on their psychological indicators and quality of life. On the other hand, it is possible to improve the quality of patients' health by modifying the lifestyle and interdisciplinary cooperation. Disclosure No.

Состояние копулятивной функции у пациентов после эндовидеохирургической аденомэктомии.

Introduction. Benign prostatic hyperplasia is one of the most common diseases of elderly and senile men, for the treatment of which a large number of surgical methods of treatment have been developed, however, the dependence of the frequency of various disorders of copulative function on the type of surgical intervention is poorly reflected in the literature. Our study is devoted to assessing the effect of endovideosurgical adenomectomy on copulatory function. Materials and methods. The study involved 120 patients in whom copulatory function was assessed on the basis of IIEF-15, AMS and scale of evaluation of male copulatory function, bulbocavernosus reflex was also examined, performed actigraphy the content of total and free testosterone and sex hormone-binding globulin were determined. Patients were examined before surgery, 6 and 12 months after it. Results. A decrease in the frequency of erectile dysfunction was revealed 6 and 12 months after surgery. The frequency of retrograde ejaculation was lower compared to the preoperative value 12 months after surgery. Improvement of reflex and hormonal status in operated patients was noted. Conclusion. Endovideosurgical adenomectomy has a positive effect on the state of copulative function and hormonal background neuroreflex status in patients with benign prostatic hyperplasia, which is reflected in improving erectile function and reducing the frequency of retrograde ejaculation.

Does Post-COVID-19 Erectile Dysfunction Improve over Time?

Some studies have shown that there may be an increase in the frequency of erectile dysfunction after COVID-19. However, no long-term study has investigated whether this is permanent or temporary. In this study, we aimed to examine whether there was an increase in the frequency of erectile dysfunction among individuals with a history of COVID-19, and, if there was, whether their condition improved over time. In this study, a total of 125 healthy male healthcare workers, 95 with and 30 without a history of COVID-19, were evaluated in terms of erectile function. Four study groups were formed. The first three groups consisted of individuals with a history of COVID-19 confirmed by the polymerase chain reaction (PCR) test at different times, who recovered from the disease (time elapsed since COVID-19 positivity: <6 months for Group 1, 6 to 12 months for Group 2, and >12 months for Group 3). The individuals in Group 4 did not have a history of COVID-19 diagnosis. In order to evaluate the erectile function of the participants, they were asked to complete the five-item International Index of Erectile Function questionnaire (IIEF-5). Then, statistical analyses were performed to evaluate whether there was a difference between the groups in terms of the IIEF-5 scores. There was a statistically significant difference between the groups in terms of the IIEF-5 scores (p < 0.001), and this difference was determined to be caused by the significantly higher IIEF-5 scores of Groups 3 and 4 compared to Group 1 (p = 0.004 and p < 0.001, respectively). In addition, the IIEF-5 score of Group 4 was statistically significantly higher than that of Group 2 (p < 0.001). However, the IIEF-5 scores did not statistically significantly differ between Groups 1 and 2, Groups 2 and 3, and Groups 3 and 4 (p > 0.999, p = 0.204, and p = 0.592, respectively). There may be deterioration in erectile function after COVID-19; however, this tends to improve over time, especially from the first year after active infection. Given that vascular, hormonal, and/or psychogenic factors may lead to the development of erectile dysfunction after COVID-19, we consider that in order to easily manage this process, it is important to determine the underlying cause, initiate appropriate treatment, and inform couples that this situation can be temporary.

A comparative study of sexual behavior, dysfunction, satisfaction, relationship, and sexual quality of life amongst treatment-naïve and abstinent men (buprenorphine-maintained) with Opioid (heroin) dependence syndrome.

Association between opioid use and sexual functioning is well-known. However, data evaluating the influence of treatment on different aspects of sexuality are lacking. To compare sexual behavior, functioning, relationship, satisfaction, and sexual quality of life (sQoL) among treatment naïve patients (GROUP-I) with Opioid (heroin) dependence syndrome (ODS-H) with those maintained on buprenorphine (GROUP-II). Married adult males diagnosed with ODS-H, currently sexually active, and living with their partner were recruited. They were assessed for their sexual practices and high-risk sexual behavior (HRSB) through a semi-structured questionnaire and sexual functioning, relationships, satisfaction, and sQoL through structured questionnaires. A total of 112 individuals (GROUP-I: 63; GROUP-II: 49) were recruited from the outpatient settings. Mean age and employment in GROUP-II were higher (p < 0.05) than in GROUP-I (37 vs 32 years; 94% vs 70%, respectively). Other sociodemographic variables and the age of onset of heroin use were comparable. The current practice of HRSB (e.g., engaging in casual partner sex, sex with commercial sex workers, and sex under intoxication) was higher in GROUP-I while almost no differences were seen in lifetime HRSB. The frequency of erectile dysfunction and premature ejaculation in the two groups were: 78% vs 39% (p < 0.001), and 30% vs 6% (p = 0.001), respectively. GROUP-II had significantly higher scores in all the scales (p < 0.05) as compared to GROUP-I, indicating better sexual satisfaction, quality of life, and sexual relationship. Heroin use is associated with HRSB, poorer sexual functioning, overall satisfaction, and sQoL. Maintenance of Buprenorphine helps with improvement in all these parameters. Comprehensive management for substance use should target sexual problems as well.

Frequency of Erectile Dysfunction after Transurethral Resection of Prostate

Background: The most effective treatment for symptomatic benign prostatic hyperplasia is surgery. When a patient is diagnosed with BPH and surgery is scheduled, the urologist will usually do transurethral resection of the prostate (TURP) to alleviate symptoms due to its positive results. The effect of TURP on sexual function, on the other hand, is yet unknown and debated.Objective: The purpose of this study was to determine the incidence of ED in sexually active adult males.Materials and Methods: The following are the materials and procedures that were used to complete this project. A total of 165 individuals between the ages of 40 and 65 years old with LUTS symptoms were included in the study. Patients with uncontrolled diabetes, a big prostate, bladder stones, or complicated urethral illness, such as corrected hypospadia or repaired urethral stricture disease, were excluded from the study. Every patient had TURP surgery and was cared for according to our ward routine until he was discharged. Results: The study's participants ranged in age from 40 to 65, with a mean age of 57.50 3.10 years. The majority of the 114 patients (69.09%) were between the ages of 56 and 65. Pre-operative IIEF-5 scores were 18.53 5.24, while post-operative IIEF-5 scores were 15.06 2.50. Patients with ED following TURP were observed in 29 (17.58%) of sexually active adult males, with mild ED in 13 (44.83%), moderate ED in 09 (31.03%), and severe ED in 07 (24.14%).Keywords: benign prostatic hyperplasia, transurethral resection of prostate, erectile dysfunction.

The Effect of Sleep Disorders on Sexual Function in Bipolar Disorder in the Remission Period

IntroductionBipolar Disorder(BD) is a common,severe and recurrent disease with significant effects on functionality. Residual symptoms such as sleep disturbance and sexual dysfunction are defined as predictors of poor functioning in remission.ObjectivesThe aim of this study was to investigate the correlation between sleep disorder and severity of sexual dysfunction in patients with BD in remission.MethodsThe study was conducted with 100 female and 100 male BD patients in remission. The sociodemographic and clinical characteristics were recorded by interview with the patients and the patients were given the Young Mania Rating Scale(YMRS),Hamilton Depression Rating Scale(HAM-D),Pittsburg Sleep Quality Index(PSQI),Epworth Sleepiness Scale(ESS),Female Sexual Function Scale(FSFI) and International Index of Erectile Function(IIFF-15)for the assesment of symptom severity.ResultsThe frequency of “sleep disorder” was 45.5% and the frequency of ’’daytime sleepiness’’ was 5.5%.In women the mean FSFI score was 26.06±5.14 and sexual dysfunction frequency was 48%.In men,the mean IIEF score was 59.63±8.34 and erectile dysfunction frequency was 56%. There was a statistically significant negative correlation between total FSFI score with HAM-D(r=-0.592, p &lt;0.001),ESS (r=-0.330, p=0.001)and PSQI(r=-0.557, p&lt;0.001)and between total IIEF score with HAM-D(r=-0.509, p&lt;0.001),ESS(r=-0.361, p&lt;0.001)and PSQI(r=-0.511,p&lt;0.001). Sexual function scores in both women and men with sleep problems were significantly lower than those without sleep problems(23.56±4.71vs.28.56±4.31and53.88±7.10vs.63.80±6.56 respectively). Multiple linear regression analysis also showed that total sleep quality scores were an effective factor on sexual function in women(OR:2.74,%95CI[0,799-0,127];p=0,007) and men(OR:2.45, %95CI[1.577-0.164];p=0,016) with BD.ConclusionsThere was an increased incidence of sexual dysfunction in bipolar patients with sleep disorders.Treatment of sleep disorders is important for improving sexual function in bipolar patients for both genders.DisclosureNo significant relationships.

Predictors of erectile dysfunction and hypogonadism in men with types 2 diabetes mellitus

ABSTRACT Background It is increasingly apparent that erectile dysfunction (ED), male hypogonadism (MHG) and type 2 diabetes mellitus (T2D) are interlinked. ED occurs in up to 75% of men with T2DM and has complex pathogenesis owing to a combination of micro vascular, macro vascular, endocrine and neuropathic disease. But its prevalence is still debated. On the other hand, hypogonadism in male is characterized by low serum testosterone (Low T) levels along with clinical symptoms and is very frequent in diabetes mellitus (DM). The association between T2D and hypogonadism is not clearly known in the Bangladeshi population. Objectives The key objective of the study was to find out the frequency of erectile dysfunction, hypogonadism predictors and serum status of newly detected male patients with T2D. Materials and Method A cross-sectional study encompassing1940 newly detected T2D male patients were carried out in the out-patient department of endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. The sociodemographic and disease related data were obtained by face-to-face interview and were recorded in the pretested case record form from patients who signed the informed written consent form by knowing all the study related information. A blood sample was taken and serum total testosterone (TT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH) and follicle stimulation hormone (FSH) were measured by chemiluminescent technology. Results Among hypogonadal patients, according to calculated free testosterone (cFT) and androgen deficiency in aging male (ADAM) criteria, frequency of hypogonadotropic hypogonadism was 80% which on the basis of TT and ADAM criteria was 92.5%. There was no significant difference for hypogonadism among either the glycosylated hemoglobin (HbA1c) categories (p=0.23) or age groups (p=0.9). Hypogonadal and eugonadal groups significantly differed both according to TT and ADAM (81.5% vs 43.4%; p=0.01) and cFT and ADAM (93.3% vs 47.7%, p=&amp;lt;0.001) criteria for ED. There was a significant difference between the groups for SHBG (21.7±11.6 vs 30.71±22; p=0.05) by TT and ADAM criteria. Similarly, cFT and ADAM criteria also revealed statistically significant difference for SHBG (38.04±19.90 vs 25.28±19.37 nmol/l; p=0.03) and Total Cholesterol (211.40±44.7 vs 191.3 ± 32.64 mg/dl p=0.04). However, in both groups, LH, FSH, HbA1c, fasting blood sugar, 2hrs after 75gm glucose, Triglyceride, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) did not differ significantly. cFT significantly correlated with age (r=-0.3503, p=001) and SHBG (r=-0.37, p=&amp;lt;0.01) while TT with SHBG (r=0.58, p=0.01). In multiple regressions analysis, erectile dysfunction and SHBG were found to be significant predictors for hypogonadism (p=0.01, 0.03 respectively). Conclusion This study demonstrated the significant relationship between d T2DM, hypogonadism and ED presence in men. Many of newly detected male with T2D have symptoms of hypogonadism judged on the basis of TT, cFT and ADAM score. Thus, it should be considered while diagnosing T2D in men. Disclosure Work supported by industry: no, by BSMMU.

Bhagwat Award Abstracts for Journal

Background:Association between opioid use and sexual functioning is well-known. However, data evaluating the influence of treatment on different aspects of sexuality are lacking.Aim:To compare sexual behaviour, functioning, relationship, satisfaction, and sexual quality of life (sQoL) among treatment naïve patients(GROUP-I) with Opioid(heroin) dependence syndrome (ODS-H) with those maintained on buprenorphine(GROUP-II).Methods:Married adult males diagnosed with ODS-H, currently sexually active, and living with their partner were recruited. They were assessed for their sexual practices and high-risk sexual behaviour(HRSB) through a semi-structured questionnaire and sexual functioning, relationships, satisfaction, and sQoL though structured questionnaires.Results: A total of 112 individuals (GROUP-I:63; ODS-H:49) were recruited from the out-patient settings. Mean age and employment in GROUP-II was higher (p<0.05) than GROUP- I (37vs32 years; 94%vs70%, respectively). Other sociodemographic variables and age of onset of heroin use were comparable. Current practice of HRSB (e.g., engaging in casual partner sex, sex with commercial sex workers, and sex under intoxication) was higher in GROUP-I while almost no differences were seen in lifetime HRSB. Frequency of erectile dysfunction and premature ejaculation in the two groups were: 78%vs39% (p<0.001), and 30%vs6% (p=0.001), respectively. GROUP-II had significantly higher scores in all the scales (p<0.05) as compared to GROUP-I, indicating better sexual satisfaction, quality of life, and sexual relationship.Conclusion: Heroin use is associated with HRSB, poorer sexual functioning, overall satisfaction, and sQoL. Maintenance on Buprenorphine helps with improvement in all these parameters. Comprehensive management for substance use should target sexual problems as well.

Prevalence of erectile dysfunction (ED) in patients on hemodialysis.

Objective: To find out the frequency of erectile dysfunction in patients who are on hemodialysis. Study Design: Cross Sectional study. Setting: Department of Urology and Kidney Transplantation, Allied Hospital/Faisalabad Medical University, Faisalabad. Period: November 2015 to May 2016. Material &amp; Methods: Patients enrolled for study included indoor admitted patients, patients presenting in outdoor and patients being admitted in Department of Urology and Renal Transplantation, Allied Hospital/Faisalabad Medical University, Faisalabad for purpose of Arterio-Venous Fistula (AVF) surgery. ED assessed and graded using the questionnaire of International Index of Erectile Function (IIEF-5). Results: 60 patients enrolled and out of 60 cases, 27 (45%) were of age 25-35 years while 33 (55%) were between 36-45 years and mean+SD age was 36.15+5.47 years. 49 (81.67%) were having ED while 11 (18.33%) were not suffering from ED. Out of 49 patients having ED, results showed that 32 patients were having severe erectile dysfunction while 11 patients having moderate disease, 4 with mild to moderate disease and only 2 with mild ED. Conclusion: Based upon results, a conclusion has been made that the frequency of erectile dysfunction is significantly higher in patients of renal failure who are on hemodialysis. It is recommended that every patient undergoing hemodialysis should be sort out for erectile dysfunction.

Frequency of Erectile Dysfunction in Patients Receiving Pegylated Interferon and Ribavirin for the Treatment of Chronic Hepatitis C

Objective: The purpose behind this study was to determine the frequency of erectile dysfunction in patients receiving pegylated interferon and ribavirin for the treatment of chronic hepatitis C.&#x0D; Study Design: Prospective observational study.&#x0D; Setting: Department of Gastroenterology and Hepatology, Medical Unit III, Services Hospital, Lahore.&#x0D; Period: Six months from 10st July 2017 to 9th January 2018.&#x0D; Materials and Methods: We have evaluated a total of 130 patients through a consecutive sampling technique who were admitted or visited Out-Patient-Department (OPD) with an underlying diagnosis of hepatitis C virus infection and advise to take anti viral regime (Pegylated interferon and ribavirin combination therapy) for HCV treatment and followed after 12 weeks and 24 weeks for erectile dysfunction.&#x0D; Results: A total of 130 patients with HCV infection were included. The overall mean age of the patients was 37.4±9.6 years. The overall frequency of erectile dysfunction was 83.07%. Among them, equal percentage of patients at 12 and at week 24 did not have erectile dysfunction (N = 76, 58.5%). While severe erectile dysfunction was surprisingly more common at week 12 (14.61%, N = 19) than at week 24 (13.07%, N = 17) of treatment. Significant association of severe erectile dysfunction was only observed at week 12 in age group 40 – 60 years (p &lt;0.05).&#x0D; Conclusion: Erectile dysfunction is more common and potential side effect of patients being treated with pegylated interferon and ribavirin but duration of therapy did not affect the prevalence of sexual impairment although with increasing age, the prevalence of sexual dysfunction is significantly increased.

Erectile Dysfunction in Chronic Hemodialysis Patients at the University Hospital Center of Point-G in Mali

Introduction: Erectile Dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient for sexual intercourse. The frequency of erectile dysfunction in patients with kidney failure is estimated at 50% to 70%. The objective of this work was to determine the frequency of sexual dysfunction in chronic hemodialysis patients, to evaluate the psycho-social impact and to describe hormonal disturbances. Patients and Methods: This was a descriptive prospective study carried out from 3 April to 31 August 2017 in the nephrology and haemodialysis department of the Point G University Hospital. She has been interested in men over the age of 18 who have been on chronic hemodialysis for more than a year. Sexual dysfunction was assessed using the questionnaire: International Index of Erectile Function (IIEF-5). Results: Sixty-five patients were included. Forty-six (70.8%) had severe (30.8%), moderate (13.8%) and mild (26.2%) ED. 56.9% of patients had libido disorders, with decreased sexual desire (38.5%); absent sexual desire (18.5%). Sexual desire was normal in 43.1% of patients. Sexual activity was absent in 20 patients (30.8%). Sexual rigidity was reduced in 28 patients (43.1%) and normal in 24 patients (36.9%). The mean age of our patients was 42.55 years with a median age of 40 years and extremes of 23 and 74 years. Eighty percent were married. Nine patients (13.8%) were using sildenafil-based medications. Antihypertensives were prescribed in 93.9% and erythropoietin in 30.8% of patients. The main impact groups were anxiety (53.8%), fear of failure (27.7%), insomnia (7.7%) and anxiety (6.1%). And defence mechanisms included: understanding (54.7%); isolation (24.6%); repression (7.7%); quarrel (7.7%); and divorce in 1 case (1.5%). The occurrence of ED was related to hypotestosterolemia (p = 0.030), and between low libido and testosterone (p = 0.001). Nutritional status was satisfactory in 78.4% of our patients. Moderate and at and severe undernutrition was found in equal proportions (10.8%) in our patients with a statistically significant relationship with the occurrence of erectile dysfunction (p = 0.015). There was no correlation between ED and duration of dialysis (p = 0.715), the existence of inflammatory syndrome (p = 0.870), age (p = 0.249) and diabetes, hypertension, smoking (p = 0.442). Sexual activity was decreased in 41 patients with Hb 10 g/dl (p = 0.340). Conclusion: Sexual disorders are common in hemodialysis patients. Psychological support of the patient is essential throughout the therapeutic sequence of erectile dysfunction, whatever the molecule or physical means considered.

State of copulative function in patients after the holmium laser enuсleation of benign prostatic hyperplasia

The effect of holmium laser enucleation of BPH (HoLEP) on the copulative function of 79 patients was evaluated. The copulative function was assessed by means of the IIEF, AMS scores, ICF scale questionnaires. The bulbocavernous reflex, total and free testosterone and sex hormone-binding globulin were also examined. Patients were examined before surgery, 3 and 6 months later. A decrease in the frequency of erectile dysfunction after 3 and 6 months after surgery was revealed. The frequency of retrograde ejaculation was higher compared with the preoperative value after 3 and 6 months after surgery. An improvement in the reflex and hormonal status of the operated patients was noted. Thus, HoLEP has a dual effect on the state of copulative function in patients with BPH, which results in improved erectile function and increased frequency of retrograde ejaculation.

Lower MPV Can Independently Predict Erectile Dysfunction in T2DM

Objectives: To find out the frequency of erectile dysfunction in diabetic patients and the association between erectile dysfunction and various clinical and laboratory parameters such as diabetic neuropathy, diabetes control, and cardiovascular risk factors. Subjects and methods: 91 type 2 diabetic patients were screened for erectile dysfunction. Clinical data were collected and included body mass index (BMI), blood pressure (BP), heart rate, duration of diabetes and diabetes complications mainly peripheral diabetic neuropathy (PDN). Laboratory data included testosterone, pituitary gonadotropins, fasting plasma glucose (FPG), HbA1c, complete blood count (CBC), serum creatinine and lipid profile. Associations of testosterone and erectile dysfunction with various clinical and biochemical parameters were studied. Results: Erectile dysfunction (ED) was present in 56% of our patients. No significant difference in total testosterone level, LH, FSH or Prolactin level between patients with and those without erectile dysfunction. Patients with peripheral diabetic Neuropathy were significantly at higher risk for erectile dysfunction (ED) [p=0.008]. High HbA1c, Low MPV and low MCH were significant and independent predictors for ED (p= 0.033, 0.033, 0.004 respectively, OR= 1.651, 5.562, 9.524 respectively). Testosterone level was negatively and significantly associated with BMI, heart rate and RDW (p= <0.005, 0.047, 0.028 respectively). Conclusion: Erectile dysfunction is very common among type 2 diabetic patients. It is strongly and directly associated with peripheral diabetic neuropathy (PDN) so, questionnaire and patient examination for PDN and further interrogation of patients complaining of PDN for erectile dysfunction (ED) is of utmost significance. This disorder can be easily predicted by the low MPV and low MCV which are found to be independent predictors in our study population. ED in T2DM is not related to serum testosterone level. Proper control of blood glucose and reaching the target HbA1c can protect diabetic patients from development of such disorder as HbA1c is also found to be a significant independent predictor of it.

Frequency of Erectile Dysfunction in Males with Central Serous Chorioretinopathy

ABSTRACTObjectives: To evaluate the frequency of sexual dysfunction and associated factors in patients with central serous chorioretinopathy (CSCR). Material and methods: Fifty-eight CSCR patients who met the inclusion criteria and 99 age- and sex-matched healthy controls were prospectively investigated for sexual dysfunction and associated factors. All participants were investigated using the Beck Depression Inventory (BDI), Beck Anxiety Scale (BAS), and the15-question Index of Erectile Function-15 (IIEF-15) and by extensive examination of CSCR, associated factors, and confounding factors. Results: The mean ages of the patient and control groups were 46.95±11.27 and 45.3±10.93 years, respectively (p=0.370). The erectile function, orgasmic function, sexual desire, sexual satisfaction, and overall sexual satisfaction scores of the patient group were significantly lower than those of the control group (p<0.001). Severe erectile dysfunction (ED) was diagnosed in 3 (5.2%), moderate ED in 10 (17.2%), mild-to-moderate ED in 7 (12.1%), and mild ED in 15 (25.9%) patients in the patient group, whereas no severe or moderate ED was diagnosed in the control group. The erectile function score was found to be negatively correlated with age and BMI. No sexual parameters were found to be correlated with choroidal thickness (CT) in either the patient or control group. Conclusion: CSCR patients experience a higher incidence of sexual dysfunction compared to healthy individuals without CSCR. The exclusion of confounding factors suggests that factors involved in CSCR pathogenesis may also play a role in ED.

ASCENDE-RT: An Analysis of Treatment-Related Morbidity for a Randomized Trial Comparing a Low-Dose-Rate Brachytherapy Boost with a Dose-Escalated External Beam Boost for High- and Intermediate-Risk Prostate Cancer

Toreport the genitourinary (GU) and gastrointestinal (GI) morbidity and erectile dysfunction in a randomized trial comparing 2 methods of dose escalation for high- and intermediate-risk prostate cancer. ASCENDE-RT (Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy) enrolled 398 men, median age 68years, who were then randomized to either a standard arm that included 12months of androgen deprivation therapy and pelvic irradiation to 46Gy followed by a dose-escalated external beam radiation therapy (DE-EBRT) boost to 78Gy, or an experimental arm that substituted a low-dose-rate prostate brachytherapy (LDR-PB) boost. At clinic visits, investigators recorded GU and GI morbidity and information on urinary continence, catheter use, and erectile function. Exclusion of 15 who received nonprotocol treatment and correction of 14 crossover events left 195 men who actually received a DE-EBRT boost and 188, an LDR-PB boost. Median follow-up was 6.5years. The LDR-PB boost increased the risk of needing temporary catheterization and/or requiring incontinence pads. At 5years the cumulative incidence of grade 3 GU events was 18.4% for LDR-PB, versus 5.2% for DE-EBRT (P<.001). Compared with the cumulative incidence, the 5-year prevalence of grade 3 GU morbidity was substantially lower for both arms (8.6% vs 2.2%, P=.058). The 5-year cumulative incidence of grade 3 GI events was 8.1% for LDR-PB, versus 3.2% for DE-EBRT (P=.124). The 5-year prevalence of grade 3 GI toxicity was lower than the cumulative incidence for both arms (1.0% vs 2.2%, respectively). Among men reporting adequate baseline erections, 45% of LDR-PB patients reported similar erectile function at 5years, versus 37% after DE-EBRT (P=.30). The incidence of acute and late GU morbidity was higher after LDR-PB boost, and there was a nonsignificant trend for worse GI morbidity. No differences in the frequency of erectile dysfunction were observed.

Evaluation of Erectile Function and Quality of Life in Patients Undergoing Methadone Maintenance Treatment

The controversial data for erectile function and quality of life of patients undergoing methadone maintenance treatment (MMT) and lack of questionnaire-based studies, providing information about these bio-psycho-social issues, in Bulgaria motivated the investigators to examine the frequency of erectile dysfunction among patients on methadone maintenance treatment, and to identify quality of life among these subjects. For these needs cross-sectional, observational with no intervention, case-control, questionnaire-based study was performed which included participants from 18 to 40 years of age undergoing MMT for at least six months and clinically healthy people. A total of 91 patients from 5 clinical programs for MMT in Bulgaria took part in the study and 27 clinically healthy people from the same age and without a history of drug abuse, psychiatric and somatic diseases which served as a control group. All participants signed informed consent. For evaluating erectile function International Index of Erectile Function survey was used. SF 36 v.2 quality of life survey was used for assessing the quality of the participants. When comparing results of the quality of life survey in Patient and Control group significant differences were found in all of the components of the survey (p<0.05) with lower results in the Patient group. When analysing results from the IIEF survey significantly lower total scores were present for all components of the survey in the patient as compared to the group of healthy men (p<0.05).

Sexuality of 26 - 36-Year-Old Lithuanian Healthy and Type-1 Diabetic Males (Comparison with Older than 40 Years Men Sexuality of 8 European Countries)

Objective: To determine the relation of the European Male Ageing Study (EMAS) Sexual function questionnaire (SFQ) parameters in the groups of healthy (H) and type 1 diabetic (T1D) males and in groups of different ages and different centers of EMAS. Design and Method: The evaluation of EMAS SFQ of 204 persons: 82 H and 122 T1D patients was performed. The answers to the questions characterizing various domains of sexual activity were analyzed. Results: Results. Eight sexual parameters were counted. The ratio of H males (%) /40 - 49-year-old EMAS males (%) was above 1, except the frequency of erectile dysfunction which is very low in the group of H males and extremely high in the group of T1D males. The results were similar when the 50 - 59-year-old EMAS group was taken in comparison to H males. The H males group shows even more clear predominance while T1D males are similar to 50 - 59-year-old EMAS males. Comparing the results of H males and EMAS males from various centers the rarity of H erectile dysfunction and higher frequency of masturbation become apparent. Other parameters do not show difference in comparison to EMAS centers. Conclusions: Conclusions. The sexuality of H males is above the one of EMAS 40 - 49-year-old males, while the sexuality of T1D males is similar to the sexuality of EMAS 50 - 59-year-old males. The erectile dysfunction is rare and the frequency of masturbation is higher when H males are compared to the various ages EMAS males from different centers.

Predictors of Erectile Dysfunction in Men with Type 2 Diabetes Mellitus Referred to a Tertiary Healthcare Centre

Background. The frequency of erectile dysfunction (ED) complicating diabetes mellitus (DM) is reportedly high. However, its risk factors have not been well studied. Methods. This was a cross-sectional study of 160 male type 2 DM adults, aged 30–70 years, attending a tertiary healthcare clinic. Demographic and relevant clinical information was documented. Erectile function was assessed using an abridged version of the International Index of Erectile Function (IIEF-5). All subjects were evaluated for central obesity, glycemic control, peripheral arterial disease (PAD), autonomic neuropathy, dyslipidemia, and testosterone deficiency. Results. 152 (95%) patients with a mean age of 60.3 ± 8.8 years completed the study. 71.1% had varying degrees of ED, while 58.3% suffered from a moderate-to-severe form. Independent predictors of ED [presented as adjusted odds ratio (95% confidence interval)] were longer duration of DM, 1.14 (1.02–1.28), PAD, 3.87 (1.28–11.67), autonomic neuropathy, 3.51 (1.82–6.79), poor glycemic control, 7.12 (2.49–20.37), and testosterone deficiency, 6.63 (2.61–16.83). Conclusion. The prevalence of ED and its severe forms was high in this patient population. Poor glycemic control and testosterone deficiency were the strongest risk factors for ED, making it possibly a preventable condition.

Evaluation of relationship between sexual functions, depression and quality of life in patients with chronic kidney disease at predialysis stage

Aim: The relation of chronic kidney disease (CKD) with metabolic, psychiatric and endocrinologic disorder is well-known. Depressive mood and sexual dysfunction are frequently observed as renal functions deteriorate. We aimed to analyze the relationship of sexual dysfunction, depressive mood and life quality in patients with CKD at predialysis stage. Patients and methods: Fifty-three patients; 27 female and 26 male with CKD who had estimated glomerular filtration rate (eGFR) between 15 and 90 mL/min and followed up in the Nephrology Department, Bursa Sevket Yılmaz Education and Research Hospital, were enrolled. Age- and sex-matched 20 female and 20 male healthy control subjects were assigned to the control group. Detailed medical and sexual history was obtained by using Female Sexual Function Index (FSFI), Erectile Function International Evaluation Form (IEFF), Short form (SF) 36 Form and Beck Depression Questionnaire (BDI). Biochemical and hormonal parameters including urea, creatinine, uric acid, sedimentation rate, c-reactive protein, total testosterone, DHEA-S, FSH, LH, TSH, estradiol and prolactin were analyzed. Findings: Depression was observed in 12 male (46%) and 14 female (51%) patients. The frequency of depression among male patients and control subjects was similar, however, significantly higher in female patients than female controls (p = 0.036). Physical function score, physical role score and pain score in SF 36 of entire patients were significantly lower than controls (p = 0.0001, 0.0001, 0.001, respectively). The frequency of depression was similar between patients and controls (p > 0.05). When SF 36 tests of male and female patients were compared, general health status, vitality and mental health status were significantly better in male patients (p = 0.005, 0.016, 0.035, respectively). SF 36 scores of female patients were significantly lower than female controls (p = 0.0001). The frequency of erectile dysfunction (ED) was similar between male patients (84%) and controls (75%) (p = 0.62). On the other hand, sexual dysfunction was significantly higher in female patients when compared to female controls (92% vs. 30%; p = 0.0001). Conclusion: We showed that sexual dysfunction and depression are more frequent among female patients with CKD at predialysis stage; however, it does not have significant impact on life quality. When life quality of female and male patients was compared, general health status, vitality and mental health status of female patients were poorer. We failed to demonstrate a relationship between sexual dysfunction and sex hormone level.