Prevalence Of Erectile Dysfunction In Patients Research Articles

High prevalence of erectile dysfunction in men with hyperthyroidism: a meta-analysis

ObjectiveThe objective of this study was to evaluate the association between hyperthyroidism and the risk of developing erectile dysfunction (ED).MethodsA comprehensive search of multiple databases, including PubMed, Embase, Cochrane, and Web of Science, was conducted to identify relevant studies investigating the relationship between hyperthyroidism and ED in men. The quality of the included studies was assessed using the Newcastle‒Ottawa Quality Rating Scale, and a meta-analysis was performed using Stata 16.0 and RevMan 5.3 software.ResultsA total of four papers encompassing 25,519 study subjects were included in the analysis. Among these, 6,429 individuals had hyperthyroidism, while 19,090 served as controls. The overall prevalence of ED in patients with hyperthyroidism was determined to be 31.1% (95% CI 0.06–0.56). In patients with uncomplicated hyperthyroidism, the incidence of ED was 21.9% (95% CI 0.05–0.38). The combined odds ratio (OR) for the four studies was 1.73 (OR: 1.73; 95% CI [1.46–2.04]; p < .00001).ConclusionOur findings demonstrate a higher incidence of ED in patients with hyperthyroidism. These results provide valuable information for healthcare professionals and can facilitate discussions surrounding appropriate treatment options for ED in patients with hyperthyroidism.

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

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

S964 Impact of Biologics Therapy on the Prevalence of Erectile Dysfunction Among Patients With Inflammatory Bowel Disease: A Nationwide Population-Based Study

Introduction: Erectile dysfunction (ED) is a well-established comorbidity of Inflammatory bowel disease (IBD). However, the connection between the two diseases remains unclear. Previous studies have suggested that chronic inflammation resulting in endothelial dysfunction maybe a contributing factor in the pathology of ED. Biologics have been shown to decrease inflammation among IBD patients. Therefore, we sought to investigate the prevalence of ED among individuals with IBD in a large national claims database and assess if biologics therapy may affect the risk of ED in patients with IBD. Methods: We used the IBM Explorys clinical database which includes over 74 million de-identified unique patients across 300 hospitals in the United States. Patients were identified using SNOMED and ICD codes. We identified all male patients (age >18 years) who were diagnosed with either Crohn’s disease (CD) or ulcerative colitis (UC). We investigated the prevalence of ED in IBD patients compared to patients with no IBD. Also, we compared the prevalence of ED between IBD patients with and without biologics therapy. Odds ratios with 95% confidence intervals were calculated to evaluate the risk of ED. Results: In this male-only cohort, we identified 100,020 patients with CD and 86,340 patients with UC, of whom 7,060 (7.06%) and 7,430 (8.61%) developed ED, respectively compared to 2.89% in individuals without IBD, p< 0.0001 to all. Both CD [OR: 2.54; 95% CI: 2.48-2.61] and UC [OR: 3.16; 95%CI: 3.08-3.23] patients had a significant higher risk of ED compared to patients without IBD. 20,040 (20.0%) patients with CD and 10,980 (12.7%) patients with UC received biologics therapy. The biologics-treated cohort was not significantly associated with a lower risk of developing ED in both CD [OR: 1.02; 95%CI: 0.96-1.09] and UC [OR: 0.99; 95%CI: 0.92-1.07], respectively (Figure). Conclusion: In this large retrospective study, we found that the prevalence of ED in patients with IBD was significantly higher than the general population. Overall, treatment with biologics was not associated with a significant decline in ED among IBD patients. These findings suggest that ED among patients with IBD may be driven by a different pathology besides chronic inflammation. Further studies are needed to determine the etiology behind ED among IBD patients.Figure 1.: Logistic Regression of Erectile Dysfunction Risk in IBD, IBD; inflammatory bowel disease. Immunomodulators included Azathioprine, Methotrexate and Mercaptopurine. Other biologics included Natalizumab, Ustekinumab and Vedolizumab. TNF-a Blockers; tumor necrosis factor-alpha blocker. Table 1. - Demographics of patients with IBD and ED Variable Patients with ED With IBD Without IBD No ED N 12,780 % 903,480 % 30532290 % Age 18 - 64 5,760 45.1% 434,850 48.1% 21,038,710 68.9% Age >65 7,070 55.3% 472,220 52.3% 9,126,770 29.9% Caucasian 10,640 83.3% 663,680 73.5% 16,599,190 54.4% Smoker 2,810 22.0% 151,670 16.8% 1,791,870 5.9% Alcohol abuse 980 7.7% 52,640 5.8% 674,360 2.2% T2DM 4,150 32.5% 270,010 29.9% 2,627,640 8.6% Hyperlipidemia 9,350 73.2% 639,150 70.7% 5,077,870 16.6% HTN 4,330 33.9% 255,660 28.3% 1,366,290 4.5% CAD 3,780 29.6% 196,350 21.7% 2,027,450 6.6% Depressive disorder 4,590 35.9% 213,260 23.6% 2,010,190 6.6% Colectomy 3,190 25.0% 89,640 9.9% 488,020 1.6% Small intestinal repair/resection 1,880 14.7% 16,560 1.8% 473,250 1.6% PDE5 inhibitor use 4,620 36.2% 337,800 37.4% 342,420 1.1% IBD; inflammatory bowel disease, ED; erectile dysfunction, T2DM; type 2 diabetes mellitus, HTN; essential hypertension, CAD; coronary artery disease, PDE5; phosphodiesterase type 5 inhibitor.

P35-1 Erectile dysfunction in patients with metastatic prostate cancer treated with androgen-deprivation therapy

Sexual function is affected by treatment for both localized and advanced prostate cancer (PC). Erectile dysfunction (ED) has been studied in localized PC but rarely in advanced or metastatic disease. This study aimed to establish the prevalence of ED in patients with metastatic PC treated with androgen-deprivation therapy (ADT), and to determine the differences in the severity of ED in patients who have received different ADT: bilateral orchiectomy, hormonal therapy, androgen inhibitor, or their combination.

Prevalence of Erectile Dysfunction in Patients With Abdominal Aortic Aneurysm: An Exploratory Study.

IntroductionErectile dysfunction (ED) is defined as the recurrent inability to achieve and maintain a satisfactory erection for sexual intercourse. Many studies have highlighted that ED shares common cardiovascular risk factors with cardiovascular disease. No data are reported about the prevalence of ED in patients with the abdominal aortic aneurysm (AAA). The aim of our study was to investigate the preoperative information given about sexual functions of patients undergoing endovascular aneurysm repair (EVAR) and to compare it with the presence and severity of steno-occlusive atherosclerotic lesions of the pelvic arterial tree at pre-operative Computed Tomography Angiography (CTA).MethodsWe prospectively enrolled all men patients who underwent elective EVAR from September to November 2021. Preoperative ED was evaluated using the International Index of Erectile Function (IIEF-5) questionnaire. Preoperative imaging was routinely performed with CTA scan of the abdominal aorta and iliac-pelvic district. An innovative score of pelvic arterial disease associated to AAA was defined, dividing the iliac district in 4 zones attributing a grading of severity for each zone bilaterally (score ranges 0–24). Linear regression analysis was used to correlate IIEF-5 score to anatomical score of pelvic arterial steno-occlusive disease.ResultsA total of 25 patients were enrolled. Median age was 74 ± 5.3 years. IIEF-5 average score was 14.8 ± 7.1. Eight cases (32%) had severe ED; one case (4%) had moderate, five patients (20%) had mild to moderate ED; five patients (20%) had mild ED, and 6 (24%) patients had no ED. CTA evaluation revealed an average anatomical score of 7.9 ± 4.5. Pelvic disease was considered moderate-severe in 20 cases (80%) and not significant in 20% (five cases). Linear regression analysis confirmed the hypothesis that a more diseased pelvic arterial tree was correlated to a more severe ED (Y = −1.531* × + 26.35 [slope CI: −1.946 to −1.117, p < 0.0001]).ConclusionAlthough typically unreported, the prevalence of ED associated to AAA was found to be high. A vasculogenic origin of ED in patients with AAA is plausible and may be easily confirmed by the evaluation of pelvic arterial distribution at angio-CT performed for EVAR planning. Our proposed “MAPPING AND SCORING SHEET” may help to identify the vasculogenic origin of ED in AAA patients.

INFLUENCE OF THE DURATION OF DIABETES AND VIBRATION PERCEPTION THRESHOLD ON THE SEVERITY OF ERECTILE DYSFUNCTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS.

Erectile dysfunction(ED) in men is a frequent under-reported complication of diabetes mellitus, which is becoming significant health problem worldwide. The study aims to determine the prevalence and risk factors for development of ED in North Indian patients with type 2 diabetes mellitus. We used international index of erectile function (IIEF-5) for the assessment of ED in 796 patients with type 2 diabetes mellitus. We recorded the age, duration of diabetes, glycemic status, body mass index, diabetes medications, microvascular and macrovascular complications. The mean age of patients in the study was 49.38 ± 9.52 years. The prevalence of ED in patients with type 2 diabetes mellitus was 79.4%. Logistic regression analysis revealed that age, body mass index, glycemic control, insulin therapy, retinopathy and nephropathy was not significantly associated with erectile dysfunction in patients with type 2 diabetes mellitus. Duration of diabetes (OR = 1.054, 95% CI 1.007 to 1.102, P=0.023) and vibration perception threshold (OR = 1.071, 95% CI 1.042 to 1.102, P=0.000) were identified as key risk factors for development of ED. Duration of diabetes and peripheral neuropathy emerged as significant risk factors for development of severe erectile dysfunction.

Erectile Dysfunction as a Cardiovascular Risk Factor: Time to Step Up?

Erectile dysfunction (ED) is a major health problem that affects a significant proportion of the general population, and its prevalence is even higher in patients with CV risk factors and/or disease. ED and cardiovascular (CV) disease share several common pathophysiological mechanisms, and thus, the potential role of ED as a predictor of CV events has emerged as a significant research aspect. The purpose of this review is to present and critically discuss data assessing the relation between ED and CV disease and the potential predictive value of ED for CV events. A comprehensive review of the literature has been performed to identify studies evaluating the association between ED and CV disease. Several cross-sectional and prospective studies have examined the association between ED and CV disease and found an increased prevalence of ED in patients with CV disease. ED was shown to independently predict future CV events. Importantly, ED was found to precede the development of overt coronary artery disease (CAD) by 3 to 5 years, offering a "time window" to properly manage these patients before the clinical manifestation of CAD. Phosphodiesterase type 5 inhibitors are the first-line treatment option for ED and were shown to be safe in terms of CV events in patients with and without CV disease. Accumulating evidence supports a strong predictive role of ED for CV events. Early identification of ED could allow for the optimal management of these patients to reduce the risk for a CV event to occur.

Prevalence of Erectile Dysfunction in Patients with Diabetes Mellitus and Its Association with Body Mass Index and Glycated Hemoglobin in Africa: A Systematic Review and Meta-Analysis.

Background Mortality and morbidity in patients with diabetes mellitus (DM) are attributed to both microvascular and macrovascular complications. However, there is a significant amount of variation in the primary studies on DM regarding the prevalence of erectile dysfunction (ED) in Africa. Therefore, this study was aimed to estimate the pooled prevalence of ED patients with DM and its association with body mass index (BMI) and glycated hemoglobin in Africa. Methods PubMed, Web of Science, Cochrane Library, Scopus, PsycINFO, African Journals Online, and Google Scholar were searched for studies that looked at ED in DM patients. A funnel plot and Egger's regression test were used to determine publication bias. The I2 statistic was used to check heterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size. The subgroup and meta-regression analyses were conducted by country, sample size, and year of publication. Sensitivity analysis was deployed to see the effect of a single study on the overall estimation. STATA version 14 statistical software was used for the meta-analysis. Result A total of 13 studies with 3,501 study participants were included in this study. We estimated that the pooled prevalence of ED in patients with DM in Africa was 71.45% (95% CI: 60.22–82.69). Diabetic patients whose BMI was ≥30 kg/m2 were 1.26 times more likely to develop ED (AOR = 1.26; 95% CI: 0.73–2.16) and whose glycated hemoglobin was <7% were 7% less likely to develop ED (AOR = 0.93; 95% CI: 0.5–5.9), although they were not significantly associated with ED. Conclusions The prevalence of ED in DM patients in Africa remains high. Therefore, situation-based interventions and country context-specific preventive strategies should be developed to reduce the prevalence of ED among patients with DM.

Erectile Dysfunction and Obstructive Sleep Apnoea-What is the Link and What can We do about it? A Descriptive Review of the Current Literature

Erectile dysfunction (ED) and obstructive sleep apnoea (OSA) are increasingly common conditions seen in primary and secondary care. With shared risk factors and associated comorbidities men often suffer with both. The aim of this study is to review the literature to consider why there is a correlation, and clinically how assessment and management of such patients could be adjusted. A structured review of current literature was performed using search terms ‘erectile dysfunction' or 'erectile function' or 'Erection' or 'Sexual dysfunction' AND 'Sleep apnoea/apnea' or 'sleep disorder'. Descriptive analysis categorized results into: The association between OSA and ED; the pathophysiological hypotheses; the role of OSA treatment; and the role of ED treatment. Higher prevalence of ED in patients with OSA is demonstrated, particularly in men with more severe OSA disease, reaching 80% in some studies. However, the pathophysiological explanation remains unclear with a number of hypotheses researched. CPAP is the mainstay of treatment for OSA, and short and long-term benefits to sexual function are demonstrated in men with severe OSA from it’s use. Further improvement in ED and quality of life can be achieved by additional PDE5 inhibitor therapy. With the increasing evidence base showing higher rates of ED in OSA patients there is certainly a role for clinicians in both OSA and ED clinics to enquire about each condition. A referral to their counterpart for consideration of combination treatment with CPAP and a PDE5 inhibitor for both of these problematic, life changing diseases is recommended-particularly in those with severe disease. Further investigation is needed to try and establish any pathophysiological link, and the impact of treatment in less severe cases.

Tadalafil, a Phosphodiesterase-5 Inhibitor, Improves Erectile Dysfunction in Patients With Liver Cirrhosis

Erectile dysfunction(ED) is common in patients with chronic liver disease(CLD). Although it significantly worsens the quality of life, caregivers and researchers often neglect it. Evaluating the prevalence of ED in patients with CLD, associated factors, and response to therapy with tadalafil, a phosphodiesterase-5 inhibitor. A total of 60 males with Child-Pugh score between 5 and 10 and no overt hepatic encephalopathy were studied. ED was assessed based on the 15-question International Index of Erectile Function (IIEF) questionnaire. Patients were classified as ED+ if score was <25. Patients with ED were given 10mg of tadalafil for 4 weeks. The mean age was 45.2 he7.8 years. The mean Child-Turcotte-Pugh (CTP) score was 6.4 sc1.7, and model for end-stage liver disease (MELD) score was 12.1 sc4.5. Twenty-seven (45%) patients had compensated cirrhosis, and 45(75%) had alcohol as etiology. Twenty-five (42%) had an IIEF score <25, suggestive of ED. The IIEF score had significant correlation with the presence of ascites(r=-0.27, P 0.04) and serum creatinine (r -0.26, P=0.05); however, there was no correlation with CTP, MELD, or alcohol as etiology. Among ED group, IIEF scores improved significantly with 4 weeks of tadalafil therapy (15.1 ±5.6 vs 22.0 ±3.4, P<0.001), and 11(44%) had resolution of ED. ED is common in patients with cirrhosis. Tadalafil administration significantly improves ED in these patients.

Prevalence and correlates of erectile dysfunction in type 2 diabetic men: a population-based cross-sectional study in Chinese men.

The aim of this study was to estimate the prevalence and correlates of erectile dysfunction (ED) in a sample of Chinese type 2 diabetic men. Between October 2016 and April 2017, male patients with type 2 diabetes mellitus treated in our diabetes outpatient clinic were recruited in this study. The participants were asked to complete a short version of the International Index of Erectile Function (IIEF-5), which was a validated and self-administered questionnaire for the diagnosis and grading of ED severity. All patients screened for erectile function also underwent detailed physical examination, and interviewed for demographic and medical history. A total of 550 men were recruited in this study, of whom 20 patients were excluded and 35 did not complete all scheduled study procedures, leaving 495 patients in the final analysis. As determined by IIEF-5 score, 318 (64.2%) patients had ED. Among the 318 patients with ED, mild, mild-to-moderate, moderate, and severe were 37 (11.6%), 65 (20.4%), 95 (29.9%), and 121 (38.1%), respectively. The prevalence of ED in patients with high education, secondary education, and less than secondary education were 83.3%, 60.2%, and 35.4%, respectively (P < 0.0001). The prevalence of ED was 64.2% in Chinese type 2 diabetic men. Increased age, longer duration of diabetes mellitus, and worse glycemic control may promote the progression of ED among Chinese type 2 diabetic men. We also found that the higher education levels may increase the risk of ED in men with type 2 diabetes mellitus.

Prevalence and risk factors of erectile dysfunction in patients with hepatitis B virus or hepatitis C virus or chronic liver disease: results from a prospective study.

Consecutive patients with HCV and HBV chronic infection were enrolled. In total, 89 out (49 with cirrhosis, 21 with HBV and 68 with HCV infection) were included in this study. ED was diagnosed in 76.4% of patients. The use of phosphodiesterase type 5 inhibitors was reported by 21.3% of patients. Patients with ED were older and had a higher rate of cirrhosis and diabetes mellitus compared with patients without ED. At multivariate analysis, diabetes mellitus and stage of liver disease (cirrhosis vs chronic hepatitis) were the only independent predictors of ED. Due to the high rate of ED in outpatients with viral-related liver disease and the underuse of phosphodiesterase type 5 inhibitors, a larger study focussed on these patients is needed.

Erectile dysfunction as a predictor of two-year prognosis in acute myocardial infarction.

Erectile dysfunction (ED) is a predictor or marker of coronary artery disease in patients at high risk of cardiovascular diseases. The aim of this study was to investigate the prevalence of ED in patients with acute myocardial infarction (AMI) and after 2 years of follow-up, and to determine the association between ED and the concentrations of the markers of inflammation, endothelial dysfunction and oxidative stress which were measured on the third day after hospital admission. The study included 80 patients aged 62.25 ± 10.47 years. The primary endpoints of interest were re-hospitalization due to cardiovascular causes and death during the 2 year period after hospital-ization. The Sexual Health Inventory for Men (SHIM) was assessed at the point of hospital discharge and 24 months thereafter. 40.1% of patients had some degree of ED. The percentage of patients without ED increased (13.2%), while the percentage of patients with severe ED significantly decreased (14.7%) after 2 years. Patients with ED had significantly higher B-type natriuretic peptide (BNP) levels and decreased levels of nitric-oxide. During the 2 years of follow-up, 9 patients died (6.5% without ED, 68.6% with ED) (c2 = 7.19, p = 0.015). During the same time period, 22 (27.5%) patients were re-hospitalized due to cardiovascular causes, of whom 59.1% had ED at hospital admission (p < 0.05). Low levels of nitric-oxide were the best predictors of ED during AMI and after 2 years. ED predicted the worst outcomes of AMI: death and re-hospitalization. Lifestyle changes and nitric- -oxide donors could assist in the treatment of ED and in the improvement of long-term prognosis for AMI. (Cardiol J 2017; 24, 4: 393-402).

Erectile dysfunction in patients with nonalcoholic fatty liver disease

Background and study aimsThere is a lack of studies on erectile dysfunction (ED) in patients diagnosed with nonalcoholic fatty liver disease (NAFLD). The present study aimed to estimate the prevalence of ED in patients with NAFLD and to determine the independent predictors of ED in these patients. Patients and methodsWe conducted a prospective, hospital-based study of 192 consecutive male patients with NAFLD. All patients underwent clinical evaluation; abdominal ultrasonography; test for viral hepatitis markers; and estimation of liver chemistry panel, complete blood count, prothrombin time, serum lipids panel, serum testosterone, and fasting serum levels of glucose, insulin, and C-peptide. ResultsThe mean age of the study population was 42.4±7.7years (79.1%≥40years). Of the 192 patients with NAFLD, 88 (45.8%) had ED, 28 (14.6%) had metabolic syndrome, 25 (13%) had type-2 diabetes mellitus (DM), and 131 (68.2%) had insulin resistance (IR). The mean level of serum testosterone was 3.17±2.94ng/mL, while the mean insulin resistance index was 2.9±1.7. Mild ED (38.6%) was the most frequent grade of ED. Age≥40years (odds ratio [OR] 6.4; 95% confidence interval [CI] 1.7–24.1; p- 0.006), IR (OR 5.9; 95% CI 1.7–20.6; p- 0.005), and low serum testosterone (OR 5.1; 95% CI 1.5–17.1; p- 0.009) were the predictors of ED. ConclusionsED is a common disorder in male patients with NAFLD; both IR and low serum testosterone contribute to its development. Treatment of IR may carry a dual benefit of improving erectile function and decreasing the grade of hepatic steatosis.

Erectile dysfunction in anterior urethral strictures after urethroplasty with reference to vascular parameters

BackgroundRelation of erectile dysfunction (ED) with urethroplasty has long been a subject of debate. Very few studies on subcontinent population are available in this regard and still rarer are studies assessing vascular parameters of ED following urethroplasty. The objective of the study was to assess the incidence and prevalence of ED in patients of urethral stricture disease, and to find out effect of urethroplasty on ED after six months of operation including vasculogenic aetiology after operation. MethodsFrom January 2014 to December 2015, 35 subjects underwent urethroplasty. They were assessed pre- and postoperatively by International Index of Erectile Function (IIEF-5) and Pharmacological Colour Doppler Ultrasonography (PCDU) for a period of 6 months. ResultsPreoperative prevalence of ED assessed by IIEF was found to be 82.8%. Postoperative incidence of ED was 28.5% and new onset ED is 50%. There was no significant change in IIEF values and values of peak systolic velocity and resistive index of cavernosal artery over time. ConclusionThere is significant prevalence of ED with urethral stricture. Despite significant postoperative incidence of ED after urethroplasty, the surgical procedure per se does not result in ED.

Tadalafil, a Phosphodiesterase-5 Inhibitor, Improves Erectile Dysfunction in Patients with Liver Cirrhosis

Background and aim: Erectile dysfunction (ED) is common in patients with liver cirrhosis. Though ED leads to a significant deterioration in the quality of life, it is often neglected by most caregivers as well as researchers. This study evaluates the prevalence of ED in patients with cirrhosis, associated factors, and response to treatment with Tadalafil, a phosphodiesterase-5 inhibitor. Methods: Sixty male patients with Child-Turcotte-Pugh (CTP) score between 5 and10 and no evidence of overt hepatic encephalopathy (HE) were studied. ED was assessed by International Index of Erectile Function (IIEF) questionnaire, and the patients were divided into 2 groups on the basis of presence (ED+) or absence (ED-) of ED. Minimal HE was diagnosed by Psychometric Hepatic Encephalopathy Score (PHES ≤ −5). Patients who had IIEF score < 25 were given Tadalafil, a Phosphodiesterase-5 inhibitor, 10 mg daily for 4 weeks. Results: The mean age of the participants was 45.2 ± 7.8 yrs. Mean CTP score was 6.4 ± 1.7 and median MELD score was 11 (Range 7–30). 27 (45%) patients had compensated cirrhosis and 45 (75%) patients had alcohol as etiologic factor. 21 (35%) patients were found to have minimal HE. 25 (41.7%) patients had an IIEF score of <25, suggestive of ED. Patients with ED were more likely to be smokers (P = 0.07), had ascites (P = 0.04), had more use of diuretics (P = 0.03) and had a higher serum creatinine (P = 0.03). Multivariable analysis demonstrated that only smoking (P = 0.04, OR 3.75) was independently associated with the presence of ED (Table). There was a significant improvement in IIEF scores after the treatment for 4 weeks with Tadalafil (baseline 15.1 ± 5.6, 4 weeks 22.0 ± 3.4; P < 0.001; Figure); 11(44%) patients demonstrated resolution. There was no significant difference in the testosterone levels between patients with or without ED.TableMultivariable analysis.PredictorsOdds ratio95% CIp-valueCTP score1.440.93–2.240.10Ascites0.700.14–3.610.67Serum Sodium1.100.91–1.340.35Serum Creatinine0.120.01–1.090.06Diabetes2.930.47–18.050.24Smoking3.751.27–11.100.04Use of Beta blocker7.350.58–91.750.12Use of Diuretics2.080.35–12.350.49 Open table in a new tab Conclusion: ED is common among patients with liver cirrhosis. Tadalafil is effective in improving ED in these patients. The authors have none to declare.

Hormonal determinants of erectile dysfunction and lower urinary tract symptoms in middle-aged and elderly men with prediabetes

Objectives: Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) are common in diabetic men. The aim of this study was to investigate hormonal determinants, the prevalence and severity of ED and LUTS in middle-aged and elderly men with prediabetes (PD).Methods: We investigated 176 men with PD and 184 healthy peers. PD was defined according American Diabetes Association. ED according IIEF scale and LUTS according IPSS scale were assessed. Total testosterone (TT), calculated free testosterone (cFT), dehydroepiandrosterone sulfate (DHEAS) and insulin-like growth factor 1 (IGF-1) were measured.Results: The prevalence of ED in patients with PD was higher than in control group (30 versus 24%) as well as the prevalence and severity of ED and LUTS in elderly (60–80 years) and middle-aged (40–59 years) men with PD was higher than in healthy peers. In middle-aged pre-diabetic men, the more severe LUTS symptoms were associated with low TT and DHEAS, while in elderly men with low cFT and DHEAS. The higher prevalence of ED in middle-aged men with PD was associated with cFT and DHEAS, while in elderly pre-diabetic men with TT and IGF-1.Conclusions: The prevalence and severity of LUTS and ED symptoms were higher in pre-diabetic men than in healthy peers. Hormonal determinants of these symptoms are different in middle-aged and elderly patients with PD.

Efecto del trasplante renal en la percepción de la función sexual de los pacientes con insuficiencia renal terminal

ObjectiveDescribe the effect of renal transplantation on the perception of erectile function reported in patients with terminal renal failure. MethodsDatabase transplant The Hospital San José transplant data base was reviewed, finding 23 patients transplanted from November 2009 to November 2013. Women, patients with graft loss, and those who were unable to communicate, were exclude. A total of 20 patients with complete histories were obtained, who were asked to complete the International Index of Erectile Function (IIEF-5) questionnaire by telephone, in order to evaluate the degree of erectile dysfunction (ED) before and at least 6months after kidney transplantation. ResultsThe 20 patients surveyed were aged between 20 and 69 years, with a mean of 45.2years. Less than half (40%) of the patients had no ED before transplantation, with 25% reporting moderate ED, of which 60% improved, and 20% reported mild ED prior to transplantation, referred to an improvement in 50% of cases. Only 10% reported of mild-moderate, the remaining 5% severe, which remained unchanged after transplantation. ConclusionThe prevalence of ED in patients with terminal renal insufficiency in those who responded to the questionnaire is similar to that reported in the literature, and it is shown that the majority of patients with ED prior to transplantation improve with the graft.

A comprehensive review of metabolic syndrome affecting erectile dysfunction.

Metabolic syndrome (MetS) is the most important public health issue threatening the health of men and women all over the world. Its current prevalence (i.e., approximately 30%) is continuously increasing. MetS by itself is considered a risk factor for erectile dysfunction (ED). To focus on the definition epidemiology, pathogenesis, and possible mechanistic links between MetS and ED in order to provide guidelines for treating such individuals. The search strategies yielded total records screened from PubMed. Regardless of the definition, MetS consists of insulin resistance, hypertension, dyslipidemia, and obesity. MetS is not an end disease but is a disorder of energy utilization and storage. The prevalence of ED in patients with MetS is almost twice than in those without MetS, and about 40% of patients with ED have MetS. An important mechanism linking MetS and ED is hypogonadism. Recognizing through ED, underlying conditions such as hypogonadism, diabetes and MetS might be a useful motivation for men to improve their health-related choices. The clinical management of MetS can be done by therapeutic interventions that include lifestyle modifications, hormone replacement alone or in combination with phosphodiesterase 5 inhibitors, and other pharmacological treatments.

Erectile dysfunction in patients with diabetes mellitus: Its magnitude, predictors and their bio-psycho-social interaction: A study from a developing country

BackgroundPersons suffering from diabetes mellitus (DM) are at higher risk of developing erectile dysfunction (ED). Several factors contribute to ED in patients of DM. Only few studies have attempted to explore physical, psychological and social factors in a single study. The aim of the index study was to measure the prevalence of ED in patients of DM and to determine the contributory role of various socio-demographic, physical, and psychological variables. MethodOne hundred and thirteen (N=113) consenting consecutive male married diabetic patients were assessed on International Index of Erectile Function Questionnaire (IIEFQ-5), Dyadic Adjustment Scale (DAS) and Beck's Depression Inventory (BDI) to measure erectile performance, quality of marriage and depressive symptoms respectively. Pretested Bengali versions of these scales were used in the index study. ResultsPrevalence of ED was 38.94%. ED group significantly differed from non-ED group in current age, family type, type of treatment for diabetes, presence of micro/macrovascular complications, history of current tobacco use, quality of marriage, and presence of depressive symptoms. In logistic regression analysis current age, body mass index (BMI) and presence of depressive symptoms had significant predictive role on occurrence of erectile dysfunction. ConclusionPrevalence of ED among diabetic patients is high compared to general population. Both physical and psychosocial factors predict the occurrence of ED in this group. So, both physicians and psychiatrists should remain aware about the multi-faceted causative role of ED in DM.