Impact Of Erectile Dysfunction Research Articles

(098) The Impact of Erectile Dysfunction and Urinary Incontinence on the Mental Health of Prostate Cancer Patients

Abstract Introduction Prostate cancer (PCa), erectile dysfunction (ED), and urinary incontinence (UI) can all independently increase a person’s risk of mental health (MH) disorders. However, the relationship between ED and UI on the MH of PCa patients is poorly understood. Objective Our objective is to assess the impact of ED and UI on MH in PCa patients at different stages of diagnosis and treatment. Methods We performed a retrospective cohort study using the insurance claims database, IBM MarketScan, between 2011-2020. Using ICD9/10 and CPT codes, we identified all patients with a diagnosis of PCa and matched each to a control without PCa by age and CCI, which was modified to exclude cancer diagnoses. PCa status was categorized into four groups based on where patients were in their prostate cancer timeline: pre-cancer (PCa patients prior to diagnosis), watching (patients with a diagnosis of PCa without treatment), radiation and prostatectomy. We also noted the first diagnosis of UI and ED for each patient. Patients were followed throughout their enrollment period and any MH diagnoses were recorded, including depressive disorders, anxiety disorders, psychotic disorders, substance abuse disorders and self-harm/suicide attempts. Multivariable cox proportional hazard models were used to assess the relationship between PCa, ED or UI, and MH diagnoses. Models additionally controlled for age, rurality and comorbidities. Patients were censored when their enrollment ended. Interaction terms between PCa status and ED or UI were included to test for differential responses to urologic comorbidities between cancer patients and cancer-free controls. Results A total of 1,253,618 patients were included in the analysis. All patients in the pre-cancer, watching, prostatectomy, and radiation groups without ED or UI showed a decreased risk of being diagnosed with a MH condition compared to controls [HR: 0.86 (0.84-0.88), 0.93 (0.92-0.94), 0.77 (0.74-0.81), and 0.89 (0.86-0.93), respectively; p<0.001]. MH diagnosis was significantly increased in controls with ED [HR: 1.13 (1.10-1.15); p<0.001]. Though the effect of ED was increased in the pre-cancer group [HR: 1.05 (1.00-1.11); p<0.05] compared to controls, the effect was significantly ameliorated in the watching, prostatectomy and radiation groups [HR: 0.88 (0.85-0.90), 0.91 (0.85-0.98) and 0.88 (0.82-0.95), respectively; p<0.01]. UI also significantly increased the likelihood of a MH diagnosis in controls [HR: 2.07 (2.00-2.15); p<0.001], but the effect was significantly dampened for men in the pre-cancer, watching, prostatectomy and radiation groups [HR: 0.83 (0.76-0.91), 0.67 (0.64-0.71), 0.54 (0.50-0.58), and 0.69 (0.62-0.77), respectively; p<0.001). Conclusions Compared to age and CCI-matched controls, PCa patients with ED in watching, prostatectomy and radiation groups and PCa patients with UI have a decreased risk of being diagnosed with a MH condition compared to controls with the same urologic comorbidities. This relationship between PCa groups and MH disorders has been observed in other cancer patient populations and is sometimes referred to the “cancer paradox” or “post-traumatic growth” since these patients with cancer experience a lower incidence of MH compared to those without cancer. Possible reasons for this phenomenon include enhanced resilience, a reevaluation of life priorities and/or a greater appreciation for life due to a shift in perspective of cancer patients. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Inherent bio, Paterna bio, Firmtech, Turtle health, Maximus, Carrot.

Men's perceptions of the impact of the physical consequences of a radical prostatectomy on their quality of life: a qualitative systematic review.

To identify men's perceptions of the impact of the physical consequences of a radical prostatectomy on their quality of life. Prostate cancer is the most common male cancer and second most common cause of cancer death of men in the Western world. Compared to other prostate cancer treatments, trials report worse urinary incontinence and sexual function and similar bowel function among men with prostate-specific antigen detected prostate cancer who underwent radicalized prostatectomy. This review included men of all ages and nationalities who had undergone a radical prostatectomy as treatment for any stage of prostate cancer. It considered studies that investigated:Any setting where the topic was addressed with participants meeting the inclusion criteria was included. The review considered studies that focused on qualitative data including, but not limited to: phenomenology, grounded theory, ethnography and action research. Studies were included if they reported results relating to one or more of the phenomena of interest. Studies not written in English were excluded. The search strategy aimed to find published studies from six databases from database inception to November 2017. Methodological quality of studies was independently assessed by two reviewers using the standardized JBI Critical Appraisal Checklist for Qualitative Research. For data extraction, the standardized Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI) data extraction tool was used. A meta-aggregation was undertaken and the final synthesis of the findings was reached through discussion. Results are presented as five aggregated qualitative syntheses. Nineteen qualitative studies were included in the review. The five synthesized findings were: CONCLUSIONS:: Urinary incontinence and erectile dysfunction are significant side-effects of radical prostatectomy which have a negative impact on men's quality of life for which they feel ill prepared, and physical and psychosocial support is essential.

Managing erectile dysfunction in diabetes

Nasima Moussa, Marie C Hill, Anne Claydon and Alison Klufio examine the impact of erectile dysfunction on patients with diabetes and the importance of recognition and support

What Is The Psychological Impact Of Erectile Dysfunction As a Side Effect Of Radiation Therapy Treatment For Prostate Cancer Patients?

What Is The Psychological Impact Of Erectile Dysfunction As a Side Effect Of Radiation Therapy Treatment For Prostate Cancer Patients?

Erectile dysfunction and pcsychoemotional state in ischemic heart disease patients undergone coronary artery bypass grafting

The impact of erectile dysfunction on psychoemotional state of patients undergone coronary artery bypass graft surgery was evaluated. The International Index of Erectile Function, postcompression cavernous artery dilation test, nocturnal penile tumescence recording and psychophysiological exam were used. It was found that ischemic heart disease patients have higher incidence of associated psychoemotional and erectile dysfunctions.

The Impact of Erectile Dysfunction on the Quality of Life of Men Undergoing Hemodialysis and Its Association with Depression

Erectile dysfunction (ED) is highly prevalent among men undergoing hemodialysis. This study was performed to identify the influence of ED on the patient's quality of life (QoL) and to evaluate the influence of depression on erectile function of these patients. For this multicenter cross-sectional study, 275 patients were interviewed through questionnaires: the five-item version of the International Index of Erectile Function was used for diagnosing and classifying ED; the Medical Outcomes Study Questionnaire 36-Item Short Form Health Survey (SF-36) for scoring QoL; and the Hospital Anxiety and Depression Scale (HADS) to evaluate depressive symptoms. Linear regression was used to examine the associations between some of the variables and ED. Predialytic biochemical and hematological parameters were determined during the longer interdialytic period. Patients had a mean age of 48.6 ± 12.8 years, and the ED prevalence was 72.3%. Advanced age, diabetes and depression score were independent risk factors for the development of ED as confirmed by linear regression (P < 0.001, P = 0.002, and P < 0.001, respectively). QoL was worse among patients with any degree of ED, and the scores were statistically significant for overall health rating (P = 0.016), physical composite score (P = 0.003), bodily pain (P = 0.042), physical functioning (P < 0.001), and vitality (P = 0.005). Furthermore, more severe forms of ED were associated with a lower QoL. After adjustment for some variables, such as age, time under dialysis, hemoglobin, albumin, parathyroid hormone, Kt/V, and depression, linear regression showed that domains related to poorer physical functioning (P = 0.047) and decreased vitality (P = 0.009) were significantly related to ED. Depression is an important trigger for the development of ED in hemodialysis patients, and this sexual condition is an independent risk factor for their poor QoL.

The impact of erectile dysfunction on female partners: a qualitative investigation

Sexual dysfunction research has primarily focused on understanding and treating problems of erectile dysfunction (ED) in men. Research has paid little attention to the impact of ED on women. The current study reports on an investigation of women's perception of their partners' ED, what they had tried to do about the problem and the impact of ED on them and their relationship. In-depth interviews were conducted with 51 women who were currently in a heterosexual relationship with a man with ED. The findings provide detailed information on women's experience of their partners' ED. They also demonstrate the need for educational resources on sexual difficulties for both the lay public and their medical practitioners. In the clinical situation, the study demonstrated the value of involving the female partner in the treatment process in improving a couple's sexual satisfaction.

The impact of the use of PDE5 inhibitors for erectile dysfunction on the lives of Australian men

This article presents findings from a recent cross-sectional study that was designed to evaluate both the impact of erectile dysfunction (ED) on the lives of Australian men, and explore whether the use of PDE5 inhibitors was able to alter this impact. The sample comprised 410 men with ED, and 242 men who did not have ED. All men were primarily recruited over the internet via men's health web sites. Participants completed a questionnaire to assess their self-esteem, masculinity, quality of life, sexual satisfaction, relationship satisfaction and usage of oral ED medication. The results demonstrated that men with ED experienced deficits on all of the psychosocial areas when compared to men without ED. Moreover, treatment with ED medication did not alleviate this deficit. Implications of these findings for the treatment of men with ED are discussed in the context of the biopsychosocial model of health and the need for a multidisciplinary approach to ED management is highlighted.

Impact of Erectile Dysfunction on Confidence, Self-Esteem and Relationship Satisfaction After 9 Months of Sildenafil Citrate Treatment

Impact of Erectile Dysfunction on Confidence, Self-Esteem and Relationship Satisfaction After 9 Months of Sildenafil Citrate Treatment

Impact of Erectile Dysfunction on Confidence, Self-Esteem and Relationship Satisfaction After 9 Months of Sildenafil Citrate Treatment

The first double-blind, placebo controlled trial in the United States of the Self-Esteem And Relationship questionnaire revealed that treatment with sildenafil citrate improves erectile function and measures of quality of life in men with erectile dysfunction. We investigated long-term improvement, and correlations between improved erectile function and confidence, self-esteem and sexual relationship satisfaction in men with erectile dysfunction. This was a 36-week open label extension of the double-blind, placebo controlled trial. The blind was not broken. Patients were 18 years or older with clinically diagnosed erectile dysfunction. Erectile function was assessed using the International Index of Erectile Function. Self-esteem, confidence and relationship satisfaction were assessed using the Self-Esteem And Relationship questionnaire. Correlations were determined using Pearson's product moment coefficients. A total of 204 participants were enrolled in the open label extension, including 108 on placebo and 96 on sildenafil. In men who received placebo in the double-blind, placebo controlled phase mean erectile function scores and self-esteem, confidence and relationship satisfaction scores were increased significantly at week 36 of the open label extension (p < 0.0001). Men who received sildenafil in the double-blind, placebo controlled phase maintained high scores in the open label extension. Correlations between improved erectile function, and self-esteem, confidence and relationship satisfaction were strong and positive (p < 0.0001). Open label extension sildenafil after double-blind, placebo controlled placebo significantly improved erectile function, self-esteem, confidence and relationship satisfaction. Following an initial 12 weeks of double-blind, placebo controlled sildenafil therapy for erectile dysfunction improvements were sustained an additional 9 months. Positive correlations between erectile function, and self-esteem, confidence and relationship satisfaction suggest that improved erectile quality can improve long-term psychosocial quality of life.

The impact of erectile dysfunction and its treatment with phosphodiesterase type‐5 (PDE5) inhibitors in patients with diabetes

AbstractMen with diabetes are prone to cardiovascular and neurological complications that can result in a higher incidence of erectile dysfunction (ED) than in the general population. Management of ED is similar to that in men without diabetes, with the goal of restoring the sex life the patient had previously enjoyed. Treatments for ED must be suitable for patients with diabetes with or without comorbidities and should not interfere with metabolic control or existing medications.The oral phosphodiesterase type‐5 (PDE5) inhibitors are the first‐line treatment for most causes of ED in men with diabetes. They promote smooth muscle relaxation by blocking the hydrolysis of cyclic guanosine monophosphate (cGMP). All commercially available PDE5 inhibitors (sildenafil, vardenafil and tadalafil) are effective with minimal side effects in both the general ED population and patients with diabetes. Tadalafil has pharmacokinetic properties different from those of sildenafil and vardenafil. Tadalafil, however, has a long half‐life producing a broad period of responsiveness and its pharmacokinetics are not altered by food. These properties give patients with diabetes and ED, and their partners, further freedom in choosing when to have sex. Copyright © 2004 John Wiley &amp; Sons, Ltd.

Psychological Impact of Erectile Dysfunction: Validation of a New Health Related Quality of Life Measure for Patients With Erectile Dysfunction

Psychological Impact of Erectile Dysfunction: Validation of a New Health Related Quality of Life Measure for Patients With Erectile Dysfunction

Impact of erectile dysfunction on quality of life: patient and partner perspectives.

Quality of life (QoL) has become one of the important parameters in the evaluation of treatment and assessment of medical conditions, and it may be an important tool in determining the urgency of the need for therapeutic intervention for erectile dysfunction (ED). It is important to evaluate QoL of the couple, because men and women alike will suffer because of male erectile disability. Future drug trials, as well as studies of sexological intervention programs, should involve both partners. International Journal of Impotence Research (2000) 12, Suppl 4, S144-S146.