Independent Risk Factor For Erectile Dysfunction Research Articles

Increased serum asprosin is correlated with diabetes mellitus-induced erectile dysfunction

ObjectiveAsprosin, a newly identified adipokine, is pathologically increased in type 2 diabetes. The aim of this study is to see whether serum asprosin concentrations are linked to diabetes mellitus-induced erectile dysfunction (DMED).Methods90 male patients with type 2 diabetes were included. According to the International Index of Erectile Function (IIEF-5) score, they were classified into two groups: 45 type 2 diabetes patients without erectile dysfunction (DM group) (IIEF-5 > 21),45 patients with diabetes induced erectile dysfunction (DMED group) (IIEF-5 ≤ 21)0.45 healthy male volunteers with normal blood glucose, IIEF-5 score > 21 points, and age matched with the DMED group were included as the control group. Anthropometric and biochemical variables were determined in all participants.ResultsWhen compared to the controls, T2DM ( Type 2 Diabetes Mellitus)patients had higher serum asprosin levels. The DMED group had significantly higher serum asprosin than the T2DM groups(p < 0.001). After adjusting for multiple variables considered traditional risk factors for ED(erectile dysfunction), Asprosin can still be used as an independent risk factor for ED; The ROC(Receive Operating Characteristic Curve) indicates that asprosin has good sensitivity (97.8%) and specificity (62.2%) in predicting ED, with an area under the curve of 0.843.Correlation analysis shows that asprosin is negatively correlated with SOD(superoxide dismutase ) and positively correlated with MDA (malondialdehyde).ConclusionSerum asprosin concentrations are increased in patients with DMED. Also, asprosin is correlated with oxidative stress indexes (MDA, SOD).

Risk of Sexual Dysfunction in Men Treated with Pelvic Radiation Therapy for Locally Advanced Rectal Cancer: 20 Years of Experience with 451 Patients

Radiation therapy (RT) is commonly used in the treatment of locally advanced rectal cancer (LARC), but data on its impact on men's sexual health is limited. Given the rising incidence of rectal cancer in younger men, sexual function is an important quality of life factor. We hypothesized that men with LARC treated with RT would be at increased risk of sexual dysfunction compared to men who did not receive RT. This is a single institution retrospective analysis of outcomes of men ≤50 years diagnosed with LARC between 1999 and 2019. Primary outcomes of erectile dysfunction (ED), ejaculatory dysfunction (EjD), and testosterone deficiency (TD) were assessed via ICD-9/10 codes, and TD was captured with free testosterone <300 ng/dL. Cumulative incidences were calculated with death as a competing risk and p values were calculated using Gray's test. Subdistribution hazard ratios from competing risk regression models were used. The combined study sample included 451 men: 347 received RT as part of their multimodality treatment, and 104 did not. Median time to last follow up was 5.6 years (IQR 3.3-8.7). Age at diagnosis, stage, and medical comorbidities for sexual dysfunction were similar between the two groups (p>0.05). Cumulative incidence estimates are shown in Table 1, showing a higher cumulative incidence of ED in the RT group, but no difference in EjD or TD between the 2 groups. On univariable analysis, RT, smoking, dyslipidemia, peripheral artery disease, depression, prostate cancer/hyperplasia, closed or current ileostomy, and undergoing rectal cancer surgery were all independent risk factors for ED (p<0.05). On multivariable analysis, RT maintained statistical significance as an independent risk factor for ED (HR 3.87, 95% CI 1.93-7.75, p<0.001). Within the RT group, IMRT compared to 3D (HR 1.54, 95% CI 1.02-2.32, p = 0.040) and groin RT (HR 2.60, 95% CI 1.21-5.59, p = 0.014) were independent risk factors for ED. Within the RT group, groin RT also approached significance as a risk factor for TD (HR 3.61, 95% CI 0.98-13.3, p = 0.054). No RT dose thresholds to external genitals or penile bulb were identified that increased risks of ED, EjD, or TD. RT for LARC independently increases risk of ED but not EjD or TD. IMRT might increase the risk of ED due to increased scatter dose to the genitals and including the inguinal nodes in the target volumes increases the dose to the genitals/testicles, which could translate into a higher risk for ED and TD. Future research on proton RT and prophylactic sildenafil is needed in men ≤50 to decrease the risk of ED.

Association between erectile dysfunction and Helicobacter pylori, folic acid, vitamin B12, and homocysteine: a cross-sectional study.

Previous studies have shown that Helicobacter pylori (Hp) infection is associated with erectile dysfunction (ED), but the mechanism is unclear. To assess the relationship between ED and Hp, folic acid (FA), vitamin B12 (B12), and homocysteine (HCY). This study included 84 patients with ED and 42 healthy men. We adopted an IIEF-5 score <21 (5-item International Index of Erectile Function) as the diagnostic criterion for ED, and the RigiScan monitoring device was used to preliminarily screen for and rule out psychogenic ED. Levels of Hp immunoglobulin G (Hp-IgG) titer, FA, B12, and HCY were compared between the ED group and the non-ED group, and the correlation between the indicators was evaluated. The median Hp-IgG titer was higher in the ED group than the control group (32.34 vs 20.88, P < .001). The ED group had lower median levels of B12 (195 vs 338, P < .001) and FA (4.66 vs 10.31, P < .001) and a higher median level of HCY (12.7 vs 8.1, P < .001). Multivariate logistic regression analysis showed that the level of FA (odds ratio,0.111; 95% CI, 0.031-0.399; P < .001) was an independent risk factor for ED. Specifically, FA level was significantly higher in the moderate ED group than the severe ED group, which had a higher median Hp-IgG titer and lower level of B12; although not significant, this was still a clinical trend. Hp-IgG titer was negatively correlated with levels of FA (r = -0.601, P < .001) and B12 (r = -0.434, P < .001) and with the IIEF-5 score (r = -0.382, P < .001) and positively correlated with HCY (r = 0.69, P < .001). The ED group had higher levels of Hp-IgG titer and HCY and lower levels of B12 and FA. This study is the first to link Hp infection, FA, B12, and HCY and further explain the relationship between these indicators and the underlying pathologic mechanisms that jointly cause ED. The limitation is that our study was based on Hp-IgG titers, which do not necessarily represent the full extent of Hp infection, despite the avoidance of invasive testing. Hp infection might lead to decreased FA and B12 and then increased HCY, which might be a mechanism leading to ED. Hp eradication or FA and B12 supplementation might have certain clinical value in the treatment of vascular ED.

The relationship between serum 25-hydroxy vitamin D and arteriogenic erectile dysfunction.

This study aimed to assess the relationship between 25(OH) levels and erectile dysfunction (ED), particularly arteriogenic ED (A-ED). From September 2020 to January 2022, 150 patients diagnosed with ED by the International Index of Erectile Function-5 (IIEF-5) questionnaire were included. All patients were classified as organic ED and psychological ED by nocturnal penile tumescence and rigidity (NPTR) examination. Organic ED patients were divided into A-ED and NA-ED by penile doppler ultrasound (PDU) examination. Finally, 150 patients complaining of ED were enrolled in our study. 25(OH)D levels were significantly lower in patients with organic ED (18.24 ± 6.04 ng/ml) than in patients with psychogenic ED (20.90 ± 8.79 ng/ml) (p=0.032). In A-ED and NA-ED, the mean of peak systolic flow velocity (PSV) values was 18.94 ± 5.28 cm/s and 51.57 ± 15.42 cm/s (p < 0.001), and the mean of 25(OH)D was 15.66 ± 5.86 ng/ml and 20.48 ± 5.90 ng/ml, respectively (p < 0.001). The results showed that 25(OH)D levels were positively correlated with IIEF-5 scores and the PSV values in A-ED patients. The 25(OH)D cut-off value differentiating between A-ED and NA-ED was 15.05 ng/ml. Low 25(OH)D levels may be an independent risk factor for ED, especially A-ED. ED patients should routinely undergo serum 25(OH)D level measurement, and 25(OH)D replacement therapy is necessary for patients with low vitamin D levels.

The Association Between Erectile Dysfunction and Sleep Parameters: Data from a Prospective, Controlled Cohort

Many studies have reported a possible strong relationship between poor sleep quality, sleep disruption, sleep disorders, and erectile dysfunction (ED). This study aimed to investigate the relationship between sleep quality and ED. Patients diagnosed with ED by the International Index of Erectile Function-5 (IIEF-5) questionnaire and 72 healthy adult men were included. Participants completed the questionnaire, underwent a detailed physical examination, and provided blood samples. All enrolled subjects then wore the Fitbit Charge 2 that monitored sleep throughout the night. Primary outcome measures included scores on the IIEF-5, General Anxiety Disorder-7 (GAD-7) scale, Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and sleep monitoring parameters obtained from Fitbit Charge 2. Finally, a total of 107 ED patients and 72 healthy adult men were enrolled in this study. Univariate analysis indicated that the GAD-7 (P < .001), PHQ-9 (P < .001), and PSQI scores (P < .001) significantly differed according to the presence/absence of ED. Further multiple logistic regression analysis showed that the PHQ-9 (odds ratio [OR]: 1.227, 95% confidence interval [CI]: 1.070-1.407; P=.003) and PSQI scores (OR: 1.220, 95%CI: 1.116-1.334; P < .001) were independent risk factors for ED. Analysis of objective sleep monitoring parameters showed that total sleep time (TST) (P=.001), sleep onset latency (SOL) (P=.026), deep sleep (N3) duration (P=.011) and rapid eye movement (REM) sleep duration (P < .001) were significantly differed between the 2 groups, with durations in the ED group significantly lower than those in the non-ED group. In addition, receiver operating characteristic (ROC) curve analysis indicated that the REM sleep duration had the highest area under the curve (AUC: 0.728) of all sleep parameters, with a P value < .001, a sensitivity of 72.2% and a specificity of 73.8%. Urologists and andrologists should be aware of impacted sleep quality and depression in ED patients. The strength of this study is that the relationship between sleep quality and ED was assessed with both a subjective scale and an objective sleep monitoring tool. However, our study only described an association between sleep quality and ED and did not establish a causal relationship. Sleep parameters are strongly associated with ED, indicating that poor sleep quality may increase the likelihood of ED. Wu X, Zhang Y, Zhang W, et al. The Association Between Erectile Dysfunction and Sleep Parameters: Data from a Prospective, Controlled Cohort. J Sex Med 2022;19:1387-1396.

Associations between exposure to different heavy metals and self-reported erectile dysfunction: a population-based study using data from the 2001-2004 National Health and Nutrition Examination Survey.

Heavy metals are ubiquitous and nonbiodegradable pollutants that are widely distributed in the environment. Heavy metal exposure can damage various biological tissues and cause several diseases. This study aimed to investigate the association between blood and urinary cadmium, lead, and mercury levels and erectile dysfunction (ED) based on data from the 2001-2004 National Health and Nutrition Examination Survey. In total, 3681 participants were included in the analysis. Results showed that participants with ED had high blood cadmium, mercury, creatinine, urinary lead, cadmium levels, low blood lead, serum cotinine, and urinary mercury levels. Multivariate logistic regression analysis showed that only blood cadmium level was an independent risk factor of ED (tertile [T]2 vs T1: odds ratio = 1.495, 95% confidence interval: 1.181-1.892, p = 0.001; T3 vs T1: odds ratio = 2.089, 95% confidence interval: 1.554-2.809, p < 0.001). The dose-response curve showed a positive nonlinear association between blood cadmium and lead levels and ED and a negative nonlinear association between blood and urinary mercury levels and ED after propensity score matching. In conclusion, heavy metal exposure is closely correlated with the development of ED, and a high blood cadmium level is an independent risk factor of ED.

PD47-01 LOW SOCIOECONOMIC STATUS IS A RISK FACTOR FOR ERECTILE DYSFUNCTION: AN ANALYSIS OF NHANES DATA

You have accessJournal of UrologyCME1 May 2022PD47-01 LOW SOCIOECONOMIC STATUS IS A RISK FACTOR FOR ERECTILE DYSFUNCTION: AN ANALYSIS OF NHANES DATA Eric Macdonald, Joseph Kim, and Darius A. Paduch Eric MacdonaldEric Macdonald More articles by this author , Joseph KimJoseph Kim More articles by this author , and Darius A. PaduchDarius A. Paduch More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002615.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Socioeconomic status (SES) plays a critical role in an individual’s overall health. However, little is known about the relationship between SES and erectile dysfunction (ED), a condition that affects millions of men in the United States. We analyzed nationally representative survey data to determine the effect of SES on ED. METHODS: Data was obtained from the National Health and Nutrition Examination Survey (NHANES). Demographic, medical, laboratory, and social factors were collected. Age matching was performed due to significantly different mean ages among men of different races. SES was estimated using the poverty income ratio (PIR), a ratio of family income to established poverty levels. Low SES was defined by PIR <2. Erectile function was assessed from a single survey question: “How would you describe your ability to get and keep an erection adequate for satisfactory sexual intercourse?” Responses were divided into two groups: normal (always and usually able to maintain an erection) and ED (sometimes or never able to maintain an erection). Weighted prevalence comparisons were performed using Chi-squared and t-tests at p=0.05. Multivariate logistic regression was subsequently used to characterize the interplay between well-established risk factors for ED and SES. RESULTS: 3,898 men responded to the ED survey question. After age matching, 3,679 men (mean age 48.14±17.41) were included. 975 men (26.5%) reported ED. Weighted prevalence comparisons are reported in Table 1 with many factors showing a significant association (p <05) with ED. Multivariate logistic regression showed that patients with a low income (PIR <2) were significantly more likely to report ED; AOR=2.02 (1.33-3.07; p <0.001). Only diabetes had a similar AOR of 2.52 (1.57-4.05, p <0.001). Other social factors, such as private insurance coverage and education level, did not maintain significance during multivariate regression analysis. CONCLUSIONS: This study provides strong evidence that low SES is an independent risk factor for ED. Physicians must consider SES when evaluating patients with ED and forming a treatment plan. Our data suggest that future urological outcome studies must include SES as an important modifying factor to ensure accurate analysis. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e793 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eric Macdonald More articles by this author Joseph Kim More articles by this author Darius A. Paduch More articles by this author Expand All Advertisement PDF DownloadLoading ...

Prevalence and Associated Factors of Sexual Dysfunction in Patients With Inflammatory Bowel Disease.

BackgroundSexual dysfunction (SD) in patients who suffer from inflammatory bowel disease (IBD) has not attracted widespread attention, and thus research studies are scarce.ObjectiveThis study aims to evaluate the rates of SD in IBD compared with healthy individuals and elucidate the associated factors.MethodsIn this cross-sectional study, the Female Sexual Function Index (FSFI) and the simplified version of the International Index of Erectile Function (IIEF-5) were filled by IBD patients, as well as healthy control individuals.ResultsA total of 208 IBD patients, including 133 with Crohn’s disease (CD) and 75 with ulcerative colitis (UC), and 190 healthy individuals filled out the questionnaires. In women, SD rates were 61.9% in the patients with IBD vs. 24.4% in the healthy controls (p < 0.01). In men, the rates of erectile dysfunction (ED) were 43.5% in the patients with IBD vs. 12.5% in the healthy controls (p < 0.01). Anxiety (OR, 3.092; 95%CI: 1.033-9.252, p = 0.044) and active perianal disease (OR, 4.481; 95%CI: 1.055-19.029, p = 0.042) were independent risk factors for SD in female IBD patients. age (OR, 1.050; 95%CI: 1.007-1.095, p = 0.022), depression (OR, 5.763; 95%CI: 1.864-17.821, p = 0.002) and active perianal disease (OR, 7.117; 95%CI: 1.747-28.983, p = 0.006) were independent risk factors for ED in male patients.ConclusionsIn the IBD patients, 62% of women reported having SD, and 44% of men reported having ED. These higher rates, as compared to the healthy controls, are mostly driven by active perianal disease and psychological factors.

Comparative study of tamsulosin versus tadalafil in benign prostatic hyperplasia patients with lower urinary tract symptoms. A prospective randomized study.

Introduction:Benign prostatic hyperplasia (BPH) is one of the common causes of lower urinary tract symptoms (LUTS) in aging men. Men with LUTS have a higher incidence of erectile dysfunction (ED), and LUTS themselves represent an independent risk factor for ED, triggering a significant negative impact on quality of life.Materials and Methods:A total of 92 patients were randomly assigned to two groups. Groups I and II had 45 and 47 patients, two patients from Group I and three patients from Group II did not follow and were excluded from the study. Patients in Group I received 0.4 mg of tamsulosin and Group II patients received 5 mg tadalafil. Patients were assessed at baseline, 3 months, and at 6 months after receiving treatment. Treatment efficacy was measured by a change in Qmax, post void residual urine (PVR), International Prostate Symptom Score (IPSS), and Sexual Health Inventory for Men (SHIM) score at 3 months and 6 months.Results:Baseline parameters between the two groups were similar. Mean Qmax improved by 7 ml/s at 3 months to 9.44 ml/s at 6 months in Group I versus 4.73 ml/s at 3 months to 6.46 ml/s at 6 months in Group II (P = 0.739). Mean PVRU decreased by 35.53 ml at 3 months to 47.23 ml at 6 months in Group I versus 44.98 at 3 months to 58.28 ml at 6 months in Group II (P = 0.102). IPSS score improved by 4.24 points at 3 months to 7.22 points at 6 months in Group I versus 4 points at 3 months to 5.02 points at 6 months in Group II (P = 0.336). SHIM score improved by 0.7 points 16.2 at 3 months to 0.8 points at 6 months in Group I versus 6.12 points at 3 months to 6.3 points at 6 months (P < 0.001).Conclusion:When both groups were compared, tadalafil showed statistically similar improvements in Qmax, PVRU, and IPSS score, but statistically significant improvement was observed with tadalafil in SHIM score compared with tamsulosin in treating LUTS secondary to BPH. Our study provides evidence that once daily tadalafil 5 mg is well tolerated and can be considered for the treatment of LUTS secondary to BPH especially in patient with ED.

A systematic review and meta-analysis of the relationship between erectile dysfunction and the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios.

Several studies were conducted to explore the association between haematological parameters and erectile dysfunction (ED), but the conclusions were contradictory with small sample size. The extensively search was conducted in PubMed, Cochrane Library and Web of science from inception to August 2021. Studies comparing the haematological parameter (at least NLR, PLR) between ED patients and healthy controls were eligible for the present meta-analysis. The differences in NLR and PLR between ED patients and healthy controls were assessed by calculating the standardised mean difference (SMD) and 95% confidence interval (95% CI). Eventually, 7studies were remained for our meta-analysis, with a total of 929 ED patients and 737healthy controls. For the methodological quality based on NOS, 5studies were of high quality, scored 7, and 8. 2studies were of moderate quality, scored 6. There were statistically significant differences in NLR values between ED patients and healthy controls, based on the pooled results (SMD: 0.53, 95% CI: 0.24-0.82). Pooled results from the 6studies revealed that ED patients had higher PLR values than healthy controls (SMD: 0.70, 95%CI: 0.12-1.28). Our meta-analysis solidly confirmed the association between NLR, PLR and ED. Increased NLR and PLR should be independent risk factors for ED.

The association between uric acid and erectile dysfunction: A systematic review and Meta-analysis.

The main purpose of this systematic review and meta-analysis was to explore the association between uric acid (UA) and erectile dysfunction (ED). Databases including PubMed, Cochrane Library and Web of Science were retrieved to identify studies published in English up to 31June 2021. We preregistered this meta-analysis in the PROSPERO (registration number CRD42021267035). Two independent authors extracted the relevant data from all enrolled articles. We evaluated the quality of enrolled studies using the Newcastle-Ottawa Scale (NOS). The standardized mean difference (SMD), as well as the corresponding 95% confidence intervals (95% CIs), was used to assess the difference between ED patients and healthy subjects. A total of five studies were enrolled for our meta-analysis to explore the association of UA with ED. The pooled SMD of the UA level difference between ED patients and healthy subjects was 0.42 (95% CI:0.09, 0.74, p<0.001). There were no individual data that significantly influenced the pooled SMDs in the sensitivity analysis. There was no evidence of publication bias. This novel meta-analysis confirmed that UA was an independent risk factor for ED, which suggested that the erectile function of patients with elevated uric acid should be evaluated by clinicians.

Association between folic acid, homocysteine, vitamin B12 and erectile dysfunction-A cross-sectional study.

To evaluate the relationship between serum levels of folic acid (FA), homocysteine (HCY), vitamin B12 (B12) and erectile dysfunction (ED) and to explore their internal relationships. The study included 134 ED patients and 50 healthy controls. ED was assessed using IIEF-5 scores. ED group had lower median FA (6.08 versus 10.21; p<.001) and B12 (256.0 versus 337.5; p<.001) levels, and higher median HCY (11.4 versus 7.95; p<.001) levels, and these differences seemed to be more pronounced in the younger participants (age<35yr). FA decreased with the severity of ED (7.52 versus 6.15 versus 5.49 versus 3.97; p<.001), while HCY increased (10.35 versus 11.8 versus 12.9 versus 15; p<.001). Smoking and shift work were associated with lower FA levels. Multivariate analysis showed that serum FA and HCY revealed significant relation with ED. ROC analysis showed that FA≤8.84 and HCY≥10.35 were the best cut-off values for ED diagnosis. Both FA (r=-0.703, p<.001) and B12 (r=-0.576, p<.001) were negatively correlated with HCY. In conclusion, low FA levels and high HCY levels might be independent risk factors for ED. Low serum FA and B12 levels might co-cause high HCY levels and lead to ED.

A Mid-to-Long Term Comprehensive Evaluation of Psychological Distress and Erectile Function in COVID-19 Recovered Patients

BackgroundThe psychological and sexual health of different populations are negatively affected during the coronavirus disease 2019 (COVID-19) pandemic. However, little is known about psychological distress and erectile function of male recovered patients with COVID-19 in the long term. AimWe aimed to evaluate psychological distress and erectile function of male recovered patients with COVID-19 in the mid-to-long terms. MethodsWe recruited 67 eligible male recovered patients with COVID-19 and followed them up twice within approximately 6 months of recovery time. The psychological distress and erectile function were assessed by validated Chinese version of paper questionnaires. OutcomesThe primary outcomes were Symptom Checklist 90 questionnaire for psychological distress and International Index of Erectile Function-5 for erectile function. ResultsIn the first visit, COVID-19 patients with a median recovery time of 80 days mainly presented the following positive symptoms: Obsessive-Compulsive, additional items (ADD), Hostility, Interpersonal Sensitivity, Depression, and Somatization; while the dimension scores in Somatization, Anxiety, ADD, and Phobia were higher than Chinese male norms. Besides, the prevalence of erectile dysfunction (ED) in the first-visit patients was significantly higher than Chinese controls. In the second visit, the primary psychological symptoms of COVID-19 patients with a median recovery time of 174 days were Obsessive-Compulsive, ADD, Interpersonal Sensitivity, and Hostility, while all dimensions scores of Symptom Checklist 90 were lower than Chinese male norms. Moreover, second-visit patients had no significant difference with Chinese controls in ED prevalence. In addition, it suggested that GSI was the independent risk factor for ED in the regression analysis for the first-visit patients. Clinical ImplicationsThe study showed the changes of psychological symptoms and erectile function in COVID-19 recovered patients, and provided reference on whether psychological and sexual supports are needed after a period of recovery. Strengths and LimitationsTo our knowledge, it is the first study to comprehensively evaluate the psychological distress and erectile function of COVID-19 recovered patients in the mid-to-long terms. The main limitations were the low number of analyzed participants, and the psychological distress and erectile function of healthy Chinese men over the same period were not evaluated, and the psychological and sexual related data of participants prior to COVID-19 were not available. Additionally, there was a selection bias in comparing COVID-19 patients with healthy controls. ConclusionWith less impact of COVID-19 event, the impaired erectile function and psychological distress improved in COVID-19 recovered patients with a recovery time of nearly half a year.Hu B, Ruan Y, Liu K, et al. A Mid-to-Long Term Comprehensive Evaluation of Psychological Distress and Erectile Function in COVID-19 Recovered Patients. J Sex Med 2021;18:1863–1871.

Inflammatory bowel disease is an independent risk factor for male erectile dysfunction

Background and objective: Inflammatory bowel diseases (IBD) are chronic diseases involving the gastrointestinal system, including ulcerative colitis (UC) and Crohn's disease (CD). Studies have shown a relationship between inflammatory bowel diseases and sexual dysfunction in men but it has been reported that this is due to surgery or the patient's psychological state. In our study, we aimed to assess the impact of IBD on the sexual functioning of male patients who has no previous pelvic surgery by evaluating the depression status of the patients. Materials and methods: The 334 patients who were followed up in our gastroenterology outpatient clinic between January 2021 and March 2021 were included in the study and they were divided into 2 groups as with (n = 146) and without IBD (n = 188). None of the patients had a history of pelvic surgery or pelvic radiotherapy due to IBD or any other disease. The two groups were compared in terms of demographic data, comorbidities, sexual function, depression status and blood tests. International Index of Erectile Function (IIEF) was used in the evaluation of sexual functions, and the Beck Depression Inventory (BDI) was used in the evaluation of depression. Risk factors for erectile dysfunction (ED) were determined. Results: The mean Beck depression test scores of the two groups were found to be similar (p = 0.361). ED was detected in 52.7% of patients with IBD and 32.4% of patients without IBD (p &lt; 0.0001). In multivariate regression analysis, age (p = 0.008), smoking (p &lt; 0.001), presence of diabetes mellitus (p = 0.02) and presence of IBD (p &lt; 0.001) were determined as independent risk factors for ED. Conclusion: Inflammatory bowel diseases can cause ED regardless of the pelvic surgery performed and the psychological status that occur in these patients.

The Relationship Between Hematologic Parameters and Erectile Dysfunction.

IntroductionCertain hematologic parameters related to blood cells, known as the biomarkers that predict cardiovascular disease, might be potential predictors of erectile dysfunction (ED) due to the shared pathophysiology between ED and cardiovascular disease .AimTo investigate the relationship between ED and these hematologic parameters and the clinical significance of hematologic parameters for the diagnosis of ED.MethodsA total of 113 male patients diagnosed with ED were included in this study. Blood samples were collected before 10:00 AM for blood cells examination, biochemical tests, and sex hormone analysis. Another 212 healthy controls without ED from the health management center was included as the control group. The relationship between hematologic parameters and ED was assessed by comparing differences in body mass index (BMI), biochemical indexes and hematologic parameters between the 2 groups, and the diagnostic value of hematologic parameters for ED was also examined and compared.Main outcome measuresInternational Index of Erectile Function, hematologic parametersResultsThe neutrophil count (NC), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in ED patients were significantly higher than those in healthy controls, whereas the lymphocyte count (LC) was significantly lower than that in healthy controls. After adjusting for age, BMI, uric acid (UA), fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), increases in the NC, NLR, and PLR and a decrease in the LC were shown to be independent risk factors for ED. Receiver operating characteristic (ROC) curve analysis showed that the NLR exhibited better diagnostic performance for ED than the other parameters.ConclusionIncreases in the NC, NLR, and PLR and a decrease in the LC significantly increased the risk of ED. The NC, LC, NLR and PLR could contribute to the diagnosis and assessment of ED. Zhangcheng L, Yuxin T, Xiucheng L and Dongjie L, et al. The Relationship Between Hematologic Parameters and Erectile Dysfunction. Sex Med 2021;9:100401.

Serum Folic Acid and Erectile Dysfunction: A Systematic Review and Meta-Analysis.

IntroductionThe association between folic acid (FA) and erectile dysfunction (ED) was contradictory in the published original articles, and no meta-analysis was conducted to pool these data.AimTo verify the role of FA in the pathology of ED and explore the treatment efficacy of FA for ED patients.MethodsAn extensive search was performed on PubMed, Cochrane Library, and Web of Science to obtain all relevant studies published up to October 31, 2020. Studies comparing the serum FA level between ED patients and healthy controls, or comparing the score of the IIEF-5, or IIEF before and after folic acid therapy alone or combination in ED patient were eligible for our meta-analysis. The Newcastle-Ottawa Scales (NOS) was used to qualify included studies.Main Outcome MeasuresThe standardized mean differences (SMD) and their corresponding 95% confidence intervals (95% CIs) were calculated to pool our data.ResultsNine studies were eligible for our meta-analysis to verify the association between FA and ED, and to explore the treatment efficacy of FA for ED patients. The pooled SMD of the FA level difference between ED patients and healthy subjects was -0.94 (95% CI: -1.59, -0.30, P = .004). Moreover, the level of folic acid in healthy subjects, Mild ED patients, Moderate ED patients and Severe ED patients was 11.847 (95%CI = 9.671, 14.022), 9.496 (95%CI = 8.425, 10.567), 6.597 (95%CI = 5.187, 8.007) and 5.623 (95%CI = 3.535, 7.711) respectively. The SMD of changes in score of IIEF-5 was 1.89 with 95%CI (1.60, 2.17) after FA administration in ED patients. Our analysis also showed that combination therapy of FA plus tadalafil changed the score of IIEF with 0.90 (95%CI = 0.44, 1.36) comparing to combination of placebo plus tadalafil.ConclusionThis novel meta-analysis demonstrated that FA was an independent risk factor for ED and FA supplement may have potentially positive effects in the treatment of ED patients.Zhang Y, Zhang W, Dai Y, et al. Serum Folic Acid and Erectile Dysfunction: A Systematic Review and Meta-Analysis. Sex Med 2021;9:100356.

Prevalence of erectile dysfunction among Egyptian male patients with type 2 diabetes mellitus

Background and aimsThe relation between type 2 diabetes mellitus (T2DM) and erectile dysfunction (ED) has been identified in multiple studies. The aim of this cross-sectional study was to estimate the prevalence and to determine some associated factors of ED among a sample of adult Egyptian male patients with T2DM. MethodsThis cross-sectional study included 150 adult male patients with T2DM (aged 40–60 years) who attended the outpatient clinic of Diabetes in Alexandria Main University hospital. They were evaluated for the presence of ED which was assessed by the validated Arabic-translated five-item version of the International Index of Erectile Function-5 (IIEF-5) questionnaire. Fasting blood glucose (FBG), HbA1c, total serum cholesterol, HDL-C, total serum testosterone (TT) and urinary albumin creatinine ratio (uACR) were measured for all study subjects. ResultsThe prevalence of ED was 80% among the studied sample. Significant negative correlation was found between IIEF-5 score and age, duration of diabetes, FBG and urinary ACR; while there was a significant positive correlation between IIEF-5 score and serum total testosterone. On performing multiple linear regression analysis for the parameters affecting IIEF-5 questionnaire score, TT, urinary ACR, age and FBG were the independent predictors of ED. ConclusionED was a common finding in our sample of Egyptian men with T2DM. Poor glycemic control and albuminuria may be considered as independent risk factors for ED.

Male erectile function after treatment for colorectal cancer: a population-based cross-sectional study.

The aim of this work was to determine the knowledge gap in the field of erectile function (EF) after colorectal cancer surgery and investigate and compare long-term male EF in colon and rectal cancer survivors in a national population. Danish male patients alive without evidence of recurrence who were treated for colon or rectal cancer between May 2001 and December 2014 were invited to participate. Using the International Index of Erectile Function (IIEF) score the derived dichotomized erectile dysfunction (ED) was defined as moderate/severe or no/mild. Patients were grouped based on type of surgery [colon resection, rectal resection (RR) or local resection] and stratified for stoma, preoperative radiotherapy (RT), age and American Society of Anesthesiologists (ASA) score. Of 10037 eligible patients, 4334 responded (43.18%). The EF score was significantly lower for RR (mean 12.14) compared with both colon resection (mean 15.82) and local resection (mean 14.81) (p<0.0001). No significant difference between colon resection and local resection was found (p=0.29). Both a stoma and the use of RT were independent risk factors for ED. After excluding patients with stoma and RT and adjusting for age and ASA score, RR still had a higher risk of ED (OR 1.42, CI 1.20-1.67) compared with colon resection. RR has a negative affect on EF. No difference between patients who underwent colon resection and local resection was found. RT and stoma were independent risk factors for ED.

A correlation study of ischiocavernosus muscle injury with different types of pelvic fractures and erectile dysfunction after pelvic fracture.

Objective:To explore the correlation between ischiocavernosus muscle injury (ICMI) with different types of pelvic fractures and erectile dysfunction (ED) after pelvic fracture.Design:Retrospective analysis of a prospective database.Setting:The study was carried out at the affiliated hospital of Zunyi Medical University.Patients/participants:A total of 776 male patients with pelvic fracture, aged 18 to 67 years, were recruited for this study by retrospective analysis, and based on the diagnosis of ED and the presence of ICMI, the participants were divided into ED and non-ED groups as well as ICMI and non-ICMI groups.Intervention:No.Main outcome measurements:ICMI, the type of pelvic fracture, International Index of Erectile Function-5 scores. Computed tomography/magnetic resonance imaging scans, electromyography (motor unit potential) was used to diagnose ICMI.Results:The International Index of Erectile Function-5 score was 19.7 ± 5.9. The incidence of ED was 27.3%, the duration time of ED was 30 ± 23 months, and the incidence of reversible ED was 39.6% and of irreversible ED was 60.4%. The incidence of ICMI was 29.4%, among which the incidence of unilateral injury was 57.9%, and the incidence of bilateral injury was 42.1%. Among all pelvic fractures, the incidence of pubic ramus fracture was 88.1%. Bilateral pubic ramus fractures, bilateral fractures of the ischial ramus, and ICMI were independent risk factors for ED after pelvic fracture. Bilateral pubic ramus fractures and pubic symphysis separation were independent risk factors for ICMI. Unilateral ICMI was an independent risk factor for reversible ED, while bilateral ICMI was an independent risk factor for irreversible ED.Conclusions:ICMI is associated with ED and may be a cause for ED, while pubic ramus fracture, ischial ramus fracture, and pubic symphysis separation may be the main causes of ICMI. Unilateral ICMI may be the main risk factor for transient ED, and bilateral ICMI may be the main risk factor for permanent ED.

Can High Visceral Adiposity Index Be a Risk Factor for Sexual Dysfunction in Sexually Active Men?

BackgroundTo our knowledge, there is no study in the literature that has investigated a cutoff value of the visceral adiposity index (VAI) for erectile dysfunction (ED) in men. AimTo show a possible relationship between ED and VAI levels representing adipose tissue dysfunction and to identify a cutoff value of the VAI for ED. MethodsThis prospective cross-sectional study included 276 participants in 5 groups: non-ED, mild ED, mild-moderate ED, moderate ED, and severe ED. The VAI was calculated. Fasting glucose, triglyceride, high-density lipoprotein, testosterone (T), prolactin, and estradiol were measured. Erectile function, sexual satisfaction, orgasm, desire, and general satisfaction scores were recorded using the International Index of Erectile Dysfunction 1–15 questionnaire. The participants were divided into BMI1 (<25.0), BMI2 (25–29.9), and BMI3 (>30.0) categories based on body mass index (BMI) and WC1 (<94 cm), WC2 (94–102 cm), and WC3 (>102 cm) categories based on waist circumference (WC). OutcomesThe VAI was investigated as an independent risk factor for ED, compared with BMI and WC. ResultsThe median VAI progressively increased, but a marked increase was recorded in groups 4 and 5 (P = .001). A significant increase in ED was observed for a VAI score higher than 4.33 (P = .001). Each integer increase of the VAI was associated with a 1.3-fold increased risk of ED. The odds ratio of ED for the VAI = 4.33 was 4.4 (P < .001). The WC and BMI significantly increased as the degree of ED increased (P = .001), but statistical analysis showed a significant decrease only in moderate and severe ED groups (P < .05). Starting from non-ED patients, serum triglyceride increased and high-density lipoprotein decreased progressively in all ED groups (P = .001). T/E2 slightly reduced as the severity of ED increased (P > .05). T decreased in ED groups (P = .022). Regardless of the ED level, other sexual subdomains decreased in ED patients (P = .001). The ED rates in 3 increasing BMI and WC categories were similar (P > .05). For VAI = 4.33, BMI ≥ 30.0 kg/m2, and WC > 102 cm, sensitivity and specificity were 61.2% and 73.8%, 31.6% and 90.5%, and 54.3% and 69.0%, respectively. Clinical ImplicationsThe VAI should be considered as a reliable independent risk factor for ED as a predictor of visceral adipose dysfunction. Strengths & LimitationsThe main strength is that this is the first study to investigate the association between the VAI and sexual dysfunction in men. The low number of participants is the limiting factor. ConclusionThe findings suggest that the VAI can be used as a reliable independent risk factor marker for ED as a predictor of visceral adipose dysfunction.Bolat MS, Kocamanoglu F, Ozbek ML, et al. Can High Visceral Adiposity Index Be a Risk Factor for Sexual Dysfunction in Sexually Active Men? J Sex Med 2020;17:1926–1933.