Risk Factors For Erectile Dysfunction Research Articles

The 100 most influential manuscripts in andrology: a bibliometric analysis

BackgroundAs the specialty of Andrology expands it is important to establish the most important studies that have shaped, and continue to shape, current research and clinical practice. Bibliometric analysis involving a citation rank list is an established means by which to identify the published material within a given field that has greatest intellectual influence. This bibliometric analysis sought to identify the 100 most influential manuscripts in Andrology, as well as the key research themes that have shaped contemporary understanding and management of andrological conditions.MethodsThe Thompson Reuters Web of Science citation indexing database was interrogated using a number of search terms chosen to reflect the full spectrum of andrological practice. Results were ranked according to citation number and further analysed according to subject, first and senior author, journal, year of publication, institution and country of origin.ResultsThe Web of Science search returned a total of 24,128 manuscripts. Citation number of the top 100 articles ranged from 2819 to 218 (median 320). The most cited manuscript (by Feldman et al., The Journal of Urology 1994; 2819 citations) reported the prevalence and risk factors for erectile dysfunction (ED) in the Massachusetts Male Ageing Study. The Journal of Urology published the highest number of manuscripts (n = 11), followed by the New England Journal of Medicine (n = 10). The most common theme represented within the top 100 manuscripts was erectile dysfunction (n = 46), followed jointly by hypogonadism and male factor infertility (n = 24 respectively).ConclusionErectile dysfunction should be considered the most widely researched, published and cited field within andrological practice. This study provides a list of the most influential manuscripts in andrology and serves as a reference of what comprises a ‘highly citable’ paper for both researchers and clinicians.

Psoriasis and sexual dysfunction: links, risks, and management challenges.

According to the WHO, sexual health is not merely the absence of disease. Sexual dysfunction may be present in 40.8% of psoriasis patients, furthermore, 68% prevalence was found in Brazilian women with psoriasis. The moderate prevalence of psoriatic lesions in the genital area (35%–42%) does not explain the alarming prevalence of sexual dysfunction. Other factors, such as anxiety, depression, and also psoriasis treatment may contribute to its development. Likewise, atherosclerosis of the pelvic vasculature is involved in the pathogenesis of erectile dysfunction. Risk factors for erectile dysfunction tend to be confused with the comorbidities seen in psoriasis patients. We also highlight that it may serve as a marker of cardiovascular risk.

Dyslipidaemia as a risk factor for erectile dysfunction in type 2 diabetes mellitus patients

BackgroundDespite epidemiological studies worldwide have documented erectile dysfunction (ED) as a major complication of type 2 diabetes Mellitus (T2DM) in men, only limited research reported on determinants of ED in this population. The study aimed at examining the association of ED with dyslipidaemia in T2DM patients. MethodsThe study enrolled 813 consecutive eligible adult male T2DM patients attending the endocrinology departments of a tertiary teaching hospital in Bangladesh. Sexual function was assessed using modified International Index of Erectile Function (IIEF) in face-to-face interview and collected along with sociodemographic information. Diabetes and lipid profile and treatment history were collected from patient's treatment records. Association of ED with dyslipidaemia was assessed using multivariable logistic regression adjusting for potential confounders. ResultPrevalence of ED among the T2DM patients was very high (72.7%), of which around half had moderated-to-severe ED. Odds of having dyslipidaemia among T2DM patients with ED is 2.3 times higher than those without. The odds increased by approximately 3 fold for an abnormal High Density Lipoprotein level and by 2.7 fold for abnormal Low Density Lipoprotein. ConclusionDyslipidaemia was associated with increased ED risk among T2DM. Abnormal lipoprotein level particularly were found to pose greater risk.

Sexual and bladder dysfunction in male ketamine abusers: A large-scale questionnaire study

PurposeTo evaluate the prevalence of lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in the illicit male ketamine abusers (KA).Materials and methodsThe male street KAs caught by policemen and patients visiting urologic clinics were invited to answer a structured questionnaire including demographic data, illicit drug use related details (duration, frequency, dosage and abstinence status), international prostate symptoms score (IPSS), interstitial cystitis symptoms and problem index (ICSI and ICPI) and International index of erectile function (IIEF-5). Erectile dysfunction was defined as IIEF-5 ≦21.ResultsFinally, we included 1056 participants (993 street, 63 hospital KAs) with a mean age of 27.4 ±6.2 years. ED presented in 30.8% of all KAs. and Hospital KAs were more subject to having ED than street KAs (69.6% vs. 28.0%, p<0.01). Multi-variate analysis revealed that risk factor for male ED were age ≧30 years (OR = 1.765). Subgroup analysis on male street KAs disclosed that abstinence ≧3 months is a protective factor for ED. Lower urinary tract symptoms (ICSI+ICPI ≧12) was prevalent in KAs and multivariate analysis disclosed that significant risk factors for LUTS (ICSI+ICPI ≧12) were age ≧30 years, duration ≧24 months and co-use of other illicit drugs.ConclusionsMale ED and LUTS were frequently observed in the ketamine abusers. We suggested that street ketamine abuse should be considered in young men presented with ED and LUTS in the clinics.

602. Factors Associated With Erectile Dysfunction Diagnosis in HIV-Infected Individuals: A Case–Control Study

BackgroundHIV-infected men have increased incidence of erectile dysfunction (ED) compared with men without HIV infection. Risk factors for ED among HIV-positive individuals have not been widely described.MethodsA retrospective cohort study was completed evaluating participants in the US Military HIV Natural History Study, a cohort of HIV-infected active duty members and beneficiaries. Men with a diagnosis of ED after HIV diagnosis were included (n = 488). Cohort controls (n = 976) without ED diagnosis were matched 2:1 by age at HIV diagnosis. Multivariate logistic regression model was used to identify risk factors for ED.ResultsAt HIV diagnosis, the median CD4 count was similar for cases (523 cells/μL, IQR 396–675) and controls (508 cells/μL, IQR 366–673; P = 0.310) and the overall median age was 32 years. At ED diagnosis, cases had a median age of 43 years (IQR 37.0–49.0) and 445 (92.3%) were on antiretroviral therapy (ART). The median time from HIV diagnosis to ART start was longer for cases (5.0 years, IQR 2.0–9.0) compared with controls (3.0 years, IQR 1.0–6.0; P < 0.001). Cases had a higher proportion of the following diagnoses compared with controls (P < 0.001 for all): depression (33.4% vs. 21.7%), hypertension (37.9% vs. 20.4%), hyperlipidemia (54.3% vs. 32.4%), tobacco use (31.1% vs. 23.1%), sleep apnea (14.8% vs. 4.2%) and diabetes/cardiovascular disease (CVD)(10.5% vs. 4.7%). Multivariate logistic regression model is reported below (table).Logistic Regression Model to Predict ED Characteristic Odds Ratio 95% CI P-value Sleep apnea2.621.69–4.05<0.001Time from HIV diagnosis to ART start > mean2.071.58–2.71<0.001African-American race1.760.90–3.420.096Diabetes/cardiovascular disease1.611.01–2.580.048Tobacco use1.420.99–2.040.057Hypertension1.361.02–1.820.034Hyperlipidemia1.260.96–1.640.092Depression1.240.94–1.630.130CD4 count <200 cells/μL at HIV diagnosis0.630.32–1.250.184Prior protease inhibitor use0.430.31–0.60<0.001ConclusionDelay in ART initiation as well as risk factors for and presence of CVD were associated with ED in HIV-infected persons. Mitigating risk factors and optimizing comorbidities is important to improve sexual health and reduce ED in HIV-infected persons.Disclosures All authors: No reported disclosures.

High prevalence of erectile dysfunction in men with psoriasis: evidence from a systematic review and meta-analysis.

Psoriasis is a common skin disease with the global prevalence of about 2%. Mounting evidence has emerged indicating that there was an association between psoriasis and increased susceptibility to erectile dysfunction (ED). We aimed to assess whether psoriasis was a risk factor for ED through a comprehensive literature review and meta-analysis. The MEDLINE (PubMed), EMBASE, and the Cochrane Library were systematically searched for all studies investigating the erectile function in psoriatic patients. The association between psoriasis and risk of ED was summarized using the odds ratios (OR) with a 95% confidence interval (CI). The protocol for this meta-analysis is available from PROSPERO (CRD42018093025). Overall, 1829449 participants (the mean age ranged from 44 years to 56.3 years) were included from 8 studies (6 cross-sectional, 1 cohort, and 1 case-control study); 39490 of whom were patients with psoriasis, with the mean disease duration from 6 months to 19.9 years. The methodological quality of the 8 included studies was considered to be either moderate or high quality. Synthesis results from the included studies revealed that psoriasis was significantly associated with an increased risk of ED in psoriatic patients (OR = 1.62, 95%CI: 1.37-1.91, P < 0.001; heterogeneity: I2 = 62.6%, P = 0.009). The results were consistent after multivariable adjustment (6 studies; combined OR = 1.5, 95%CI: 1.31-1.72, P < 0.001; heterogeneity: I2 = 53.5%, P = 0.056). Evidence from this meta-analysis indicates that patients with psoriasis have a significantly elevated risk of ED.

Genetic variation in the SIM1 locus is associated with erectile dysfunction

Erectile dysfunction affects millions of men worldwide. Twin studies support the role of genetic risk factors underlying erectile dysfunction, but no specific genetic variants have been identified. We conducted a large-scale genome-wide association study of erectile dysfunction in 36,649 men in the multiethnic Kaiser Permanente Northern California Genetic Epidemiology Research in Adult Health and Aging cohort. We also undertook replication analyses in 222,358 men from the UK Biobank. In the discovery cohort, we identified a single locus (rs17185536-T) on chromosome 6 near the single-minded family basic helix-loop-helix transcription factor 1 (SIM1) gene that was significantly associated with the risk of erectile dysfunction (odds ratio = 1.26, P = 3.4 × 10-25). The association replicated in the UK Biobank sample (odds ratio = 1.25, P = 6.8 × 10-14), and the effect is independent of known erectile dysfunction risk factors, including body mass index (BMI). The risk locus resides on the same topologically associating domain as SIM1 and interacts with the SIM1 promoter, and the rs17185536-T risk allele showed differential enhancer activity. SIM1 is part of the leptin-melanocortin system, which has an established role in body weight homeostasis and sexual function. Because the variants associated with erectile dysfunction are not associated with differences in BMI, our findings suggest a mechanism that is specific to sexual function.

Role of folic acid deficiency as a possible risk factor for erectile dysfunction

Background: erectile dysfunction (ED) is the persistent inability to attain or maintain an erection. ED affects millions of men worldwide. The pathophysiology of ED includes vasculogenic, neurogenic, hormonal, anatomical, drug-induced and psychogenic causes. Endothelial dysfunction (EDys) is an important pathophysiologic factor underlying vasculogenic erectile dysfunction. The pathogenesis of both EDys and ED are linked through decreased expression and activation of endothelial nitric oxide synthase (NOS) which is responsible for formation of Nitric Oxide (NO). NO is a relaxing factor which plays a major role in activation and maintenance of the erection process. Aim of the work: this study aimed to detect the possible relationship between serum folic acid and erectile dysfunction by measuring serum FA concentration in patients with erectile dysfunction and comparing them with the healthy controls. Methodology: our study has been carried out on 90 individuals who were categorized into two groups. Group 1: 60 married males complained of ED. Group 2: 30 married potent males as a control.All participants were subjected to : personal history, past history of medical diseases and operations, sexual history, general examination, genital examination and evaluation of erectile function according to the International Index of Erectile Function (IIEF-5) Questionnaire). Fasting serum samples were collected from all participants and assayed for serum total testosterone, serum prolactin, serum cholesterol, serum triglycerides (TG), HbA1c and serum folic acid.Results: results of the current study showed a significant relation between folic acid and ED. FA level was declined as ED severity increased. It is thought that ED severity was related to HHcy which was related to the severity of FA deficiency.Conclusion: a significant association between serum FA level and ED severity was detected in the current study. Serum FA level decreased as the severity of ED increased. These results suggest that FA deficiency might reflect the severity of ED. Recommendations: serum folic acid assessment as a part of the routine investigations for patients complaining with erectile dysfunction. Additional experimental and clinical studies are needed to determine whether FA supplementation may be beneficial for patients having ED.

Role of folic acid deficiency as a possible risk factor for erectile dysfunction

Background: erectile dysfunction (ED) is the persistent inability to attain or maintain an erection. ED affects millions of men worldwide. The pathophysiology of ED includes vasculogenic, neurogenic, hormonal, anatomical, drug-induced and psychogenic causes. Endothelial dysfunction (EDys) is an important pathophysiologic factor underlying vasculogenic erectile dysfunction. The pathogenesis of both EDys and ED are linked through decreased expression and activation of endothelial nitric oxide synthase (NOS) which is responsible for formation of Nitric Oxide (NO). NO is a relaxing factor which plays a major role in activation and maintenance of the erection process. Aim of the work: this study aimed to detect the possible relationship between serum folic acid and erectile dysfunction by measuring serum FA concentration in patients with erectile dysfunction and comparing them with the healthy controls. Methodology: our study has been carried out on 90 individuals who were categorized into two groups. Group 1: 60 married males complained of ED. Group 2: 30 married potent males as a control.All participants were subjected to : personal history, past history of medical diseases and operations, sexual history, general examination, genital examination and evaluation of erectile function according to the International Index of Erectile Function (IIEF-5) Questionnaire). Fasting serum samples were collected from all participants and assayed for serum total testosterone, serum prolactin, serum cholesterol, serum triglycerides (TG), HbA1c and serum folic acid.Results: results of the current study showed a significant relation between folic acid and ED. FA level was declined as ED severity increased. It is thought that ED severity was related to HHcy which was related to the severity of FA deficiency.Conclusion: a significant association between serum FA level and ED severity was detected in the current study. Serum FA level decreased as the severity of ED increased. These results suggest that FA deficiency might reflect the severity of ED. Recommendations: serum folic acid assessment as a part of the routine investigations for patients complaining with erectile dysfunction. Additional experimental and clinical studies are needed to determine whether FA supplementation may be beneficial for patients having ED.

AB027. New progress in the study of erectile dysfunction in the American Urological Association’s 2018 Annual Meeting

It is estimated that 150 million men worldwide are affected by erectile dysfunction (ED). In terms of risk factors, independent risk factors for ED include age, smoking, diabetes, hypertension, dyslipidemia, depression, obesity, and sedentary lifestyle. Besides, sleep disorders are potential risk factors for ED, so men who are troubled with loss of diurnal rhythm have significant worse erection. In addition, serum cadmium levels can be used as an independent predictor of erectile function. In terms of diagnosis and evaluation, penile color Doppler ultrasound can effectively evaluate the presence of vascular factors in patients with ED, and has a good correlation with angiographic results, which can be used as a non-invasive examination before angiography. As for treatment, penile prosthesis can effectively improve the erectile function of patients, and posttreatment score is higher on the quality of sexual life and satisfaction of sexual performance. In addition, it is reported that diabetes is an important factor affecting the quality of sexual life after the first penis implant. What’s more, prosthesis implantation will not lead to complications such as shortening of the penis length and decreased sensitivity. However, studies such as extracorporeal shock wave therapy, recovery of erectile function after prostate cancer surgery (sural nerve grafting, intraoperative tissue sealing sheets, application of low dose of sildenafil after surgery), autologous adipose tissue derived stromal vascular fraction injection, gene therapy have the small sample size, and some of them still stay in the basic research stage. Their therapeutic effect needs further study.

Is lower low-density lipoprotein cholesterol associated with lower androgen and erectile dysfunction in men?

Background and aimsTherapeutic possibilities now exist to lower low-density lipoprotein cholesterol (LDL-C) to very low levels. However, substantial controversy remains in clinical practice with regard to its safety, and the question of whether low LDL-C levels per se may provoke adverse effects in humans arises. We aimed to explore the association of LDL-C with androgen and erectile dysfunction (ED) in a general population of men. Methods and resultsA total of 4203 men without hormone replacement therapy were enrolled from 22 sites in East China. Total testosterone (T) and Free T were assessed. Free androgen index (FAI) was calculated. The IIEF-5 questionnaire was used to assess ED. We found that free T and FAI gradually and markedly increased with increasing LDL-C levels. Using linear regression, after adjusting for age, educational level, economic status, smoking status, drinking status, BMI, diabetes, and use of lipid-lowering medication, LDL-C was positively associated with free T (B = 0.175, 95% CI: 0.084, 0.266) and FAI (B = 0.064, 95% CI: 0.016, 0.112). Meanwhile, there was a U-shaped curvilinear relationship between LDL-C and prevalence of ED. In the logistic regression analysis, compared to those with LDL-C among the 10th–90th percentile, the ORs of ED in men in the lowest and highest deciles were 1.938 (95% CI: 1.121, 3.349) and 1.804 (95% CI: 1.117, 2.916), respectively. ConclusionLower LDL-C levels were significantly associated with lower free T and lower FAI in a general population of men. Moreover, both low and high levels of LDL-C might be risk factors for ED.

Erectile dysfunction in obstructive sleep apnea patients: A randomized trial on the effects of Continuous Positive Airway Pressure (CPAP).

ObjectivesObstructive sleep apnea (OSA) is among the least studied risk factors for erectile dysfunction (ED). We aimed to determine ED prevalence in newly-diagnosed OSA patients, describe their main characteristics and assess continuous positive airway pressure (CPAP) effects on ED.MethodsCross-sectional study assessing ED prevalence in OSA patients and open-label, parallel, prospective randomized controlled trial evaluating 3-month CPAP treatment effects on sexual function, satisfaction, and psychological, hormonal and biochemical profiles. Male patients newly diagnosed with moderate/severe OSA (apnea-hypopnea index >20 events·h−1), aged 18–70 years, attending the sleep unit of a Spanish hospital during 2013–2016 were considered. A total of 150 patients were recruited (75 randomized ED patients). ED was defined as scores <25 on International Index Erectile Function 15 test. Wilcoxon’s matched-pairs signed-ranks and rank-sum tests were used.ResultsED prevalence was 51%. Patients with ED were older (p<0.001), had greater waist-to-hip ratios (p<0.001), were more frequently undergoing pharmacological treatment (p<0.001) and had higher glucose levels (p = 0.024) than non-ED patients. Although significant increases in erectile function (mean(SD) change: +4.6(7.9); p = 0.002), overall satisfaction (+1(2.2); p = 0.035), and sexual satisfaction (+2.1(4.3); p = 0.003) were found after CPAP treatment, only differences in sexual satisfaction (p = 0.027) and erectile function (p = 0.060) were found between study arms. CPAP treatment did not impact psychological, hormonal or biochemical profiles.ConclusionsThis study confirmed the relationship between OSA and ED, suggesting the potential usefulness of ED screening in OSA patients, but could not determine conclusively whether CPAP is an effective stand-alone ED treatment, regardless of positive results on sexual satisfaction.Trial registrationClinicalTrials.gov NCT03086122

Gout and the Risk of Incident Erectile Dysfunction: A Body Mass Index-matched Population-based Study.

Gout is the most common inflammatory arthritis. Erectile dysfunction (ED) is common in the general population; however, evidence regarding ED among patients with gout is limited. Our purpose was to study the association between incident gout and the risk of incident ED in the general population. We conducted a cohort study using The Health Improvement Network, an electronic medical record database in the United Kingdom. Up to 5 individuals without gout were matched to each case of incident gout by age, enrollment time, and body mass index (BMI). Multivariate HR for ED were calculated after adjusting for smoking, alcohol consumption, comorbidities, and medication use. We identified 2290 new cases of ED among 38,438 patients with gout (mean age 63.6 yrs) and 8447 cases among 154,332 individuals in the comparison cohort over a 5-year median followup (11.9 vs 10.5 per 1000 person-years, respectively). Univariate (matched for age, entry time, and BMI) and multivariate HR for ED among patients with gout were 1.13 (95% CI 1.08-1.19) and 1.15 (95% CI 1.09-1.21), respectively. In our sensitivity analysis, by restricting gout cases to those receiving anti-gout treatment (n = 27,718), the magnitude of relative risk was stronger than the primary analysis (multivariate HR 1.31, 95% CI 1.23-1.39). This population-based study suggests that gout is associated with an increased risk of developing ED, supporting a possible role for hyperuricemia and inflammation as independent risk factors for ED.

564 Do socioeconomic factors influence the pathogenesis of erectile dysfunction through modifiable risk factors?

Analysis of the connection of socioeconomic status (SES) and modifiable risk factors for erectile dysfunction (ED) as well as the evaluation of their influence on the presence of ED in patients with coronary artery disease (CAD). 808 patients with the mean age of 59,61±9,43 and recognized CAD were recruited for the study. An own questionnaire as well as the IIEF5 were used for assessment. The own questionnaire included questions about the socioeconomic situation such as marital status (married, single), education (basic, vocational, secondary, higher), net income per capita in family per month – as percentage of the mean pension in industry in the year 2015 (<34,7%, >34,7% <69,41%, >69,41% <104,12%, >104,12%)and the character of work (physical, intellectual, decision-making position –managing). Furthermore the questionnaire included questions regarding the presence of modifiable risk factors for erectile dysfunction. The analysis of the presence of modifiable risk factors for erectile dysfunction included tobacco smoking, hypertension, dyslipidemia, diabetes, inadequate body weight (overweight and obesity) as well as a sedentary lifestyle (low intensity of health-promoting physical activity).

443 Risk factors for erectile dysfunction among young men – findings of a real-life cross-sectional study

443 Risk factors for erectile dysfunction among young men – findings of a real-life cross-sectional study

045 The Fertility quality of life and Sexual dysfunction in men seeking fertility treatment

To investigate the fertility quality of life (FertiQoL) and the prevalence of erectile dysfunction (ED) and premature ejaculation (PE) in infertile men. In a cross-sectional study, a total of 351 men seeking fertility treatment completed a questionnaire about sexual experiences and quality of life. ED was evaluated through the simplified International Index of Erectile Function (IIEF-5), ejaculation status was determined by the PE diagnostic tool (PEDT), and the quality of life was measured using the FertiQoL tool. Reliability analyses for the FertiQoL tool demonstrate a sufficiently strong fit (Cronbach’s alpha=0.891). Social and relational domains of FertiQoL were lower in infertile men compared with that reported in other countries. ED and PE were found in 125 (35.6%) and 90 (25.6%) subjects respectively. The emotional, mind/body, relational and social domain scores of FertiQoL were positively associated with the IIEF-5 score whereas the scores were negatively associated with the PEDT score. In a logistic multivariate model, emotional, relational and social domains were significantly associated with ED, while only the emotional domain was related to PE. Furthermore, our data suggested that overweight, extended family, smoking, male factor infertility and primary infertility are risk factors for ED and PE, while the duration of infertility only affect erectile function. However, the education level, family income and the treatment of infertility had no significant effect on sexual experience.

Prevalence of erectile dysfunction in Egyptian males with metabolic syndrome

Objectives: Determination of the potential effect of metabolic syndrome (MetS) on erectile function in Egyptian men and description of the sociodemographic characteristics of these men.Materials and methods: A cohort of 615 patients presenting to urology department aged between 30 and 75 years were prospectively assessed and divided into two groups. Group I (n = 325) diagnosed with MetS and mean age of 56.07 ± 8.51 years. Group II (n = 290) subjects with no MetS and mean age 54.97 ± 8.14 years. Patients filled the IIEF questionnaire, medical, personal history, and BMI data were tabulated. Metabolic syndrome was determined when three or more of the five risk factors were present according to the NCEP.Results: In Group I (79.4%) of the patients had erectile dysfunction (ED). Of these, 20.3% had mild, 22.5% had moderate, and 36.6% had severe ED and 30% of patients without MetS had ED. Of these, 17.2% had mild, 5.9% had moderate, and 6.9% had severe ED (p < .001; odds ratio 5.549; 95% CI 3.101–9.928). Patients with metabolic syndrome had lower IIEF-EF domain scores. Logistic regression analysis revealed that DM, dyslipidemia, age, and HTN were the most important criteria for ED in the MetS group (p < .01). While in the group without MetS, DM, HTN, HDL, and age were the most important risk factors (p < .01), and TG and BMI were less important.Conclusions: MetS is a potential risk factor for ED in Egyptian men. Patients with MetS should be questioned about ED. The diabetic patients are most risky for ED.

Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies.

IntroductionThe leading cause of erectile dysfunction (ED) is arterial dysfunction, with cardiovascular disease as the most common comorbidity. Therefore, ED is typically linked to a web of closely interrelated cardiovascular risk factors such as physical inactivity, obesity, hypertension, and metabolic syndrome. Physical activity (PA) has proved to be a protective factor against erectile problems, and it has been shown to improve erectile function for men affected by vascular ED. This systematic review estimated the levels of PA needed to decrease ED for men with physical inactivity, obesity, hypertension, metabolic syndrome, and/or manifest cardiovascular diseases.AimTo provide recommendations of levels of PA needed to decrease ED for men with physical inactivity, obesity, hypertension, metabolic syndrome, and/or cardiovascular diseases.MethodsIn accord with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was performed of research articles specifically investigating PA as a possible treatment of ED. The review included research on ED from physical inactivity, obesity, hypertension, metabolic syndrome, and/or cardiovascular diseases. All available studies from 2006 through 2016 were checked for the predetermined inclusion and exclusion criteria to analyze the levels of PA needed to decrease ED.Results10 articles met the inclusion criteria, all suggesting various levels of PA needed to decrease ED for men with relevant risk factors for ED. The results of the review provided sufficient research evidence for conclusions regarding the levels of PA necessary to decrease ED.ConclusionRecommendations of PA to decrease ED should include supervised training consisting of 40 minutes of aerobic exercise of moderate to vigorous intensity 4 times per week. Overall, weekly exercise of 160 minutes for 6 months contributes to decreasing erectile problems in men with ED caused by physical inactivity, obesity, hypertension, metabolic syndrome, and/or cardiovascular diseases.Gerbild H, Larsen CM, Graugaard C, Areskoug Josefsson K. Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies. Sex Med 2018;6:75–89.

PD27-06 SHIFT WORK SLEEP DISORDER AND NIGHT SHIFT WORK SIGNIFICANTLY IMPAIR ERECTILE FUNCTION.

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation I1 Apr 2018PD27-06 SHIFT WORK SLEEP DISORDER AND NIGHT SHIFT WORK SIGNIFICANTLY IMPAIR ERECTILE FUNCTION. Katherine M. Rodriguez, Taylor P. Kohn, Jaden R. Kohn, E. Will Kirby, Stephen M. Pickett, Alexander W. Pastuszak, and Larry I. Lipshultz Katherine M. RodriguezKatherine M. Rodriguez More articles by this author , Taylor P. KohnTaylor P. Kohn More articles by this author , Jaden R. KohnJaden R. Kohn More articles by this author , E. Will KirbyE. Will Kirby More articles by this author , Stephen M. PickettStephen M. Pickett More articles by this author , Alexander W. PastuszakAlexander W. Pastuszak More articles by this author , and Larry I. LipshultzLarry I. Lipshultz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1357AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Non-standard shift workers, who regularly work hours outside a 7am-6pm workday, have been found to have worse general health when compared to men working standard shifts. Men working non-standard shifts are at increased risk for shift work sleep disorder (SWSD), a primary circadian rhythm disorder characterized by excessive daytime sleepiness associated with shift work. Here we examine the association between SWSD and erectile dysfunction (ED) in shift workers. METHODS Men presenting to a single andrology clinic between January 2014 - July 2017 completed validated questionnaires: IIEF, Patient Health Questionnaire (PHQ), and the SWSD Questionnaire. Men were also asked about shift work schedule, comorbidities, PDE5 inhibitor use, and testosterone use. Serum total testosterone values were determined for each visit. Linear regression was performed controlling for testosterone use, testosterone levels, PDE5-inhibitor use, age, and comorbidities to determine the effect of SWSD on erectile dysfunction as assessed using the IIEF-EF. RESULTS Of the 2,571 men completing questionnaires, 1,952 reported non-standard shift work and 196 were found to have SWSD. 802 men completed the IIEF-EF questionnaire. Non-standard shift work alone did not result in worse IIEF-EF scores (p = 0.31), but men with SWSD had IIEF-EF scores that were 2.8 points lower than men without SWSD (P<0.01). When assessing for the type of shift, we found that men who worked night shifts had IIEF-EF scores 7.58 points lower than men who worked during the day or evening (p < 0.01). Testosterone use improved IIEF-EF scores for men with SWSD by 2.90 points, ameliorating the effect of SWSD. Testosterone levels were not associated with worse erectile function. CONCLUSIONS Men with SWSD have statistically and clinically worse erectile function, and men who work night shifts have even worse ED. These findings suggest that circadian rhythm disturbance may significantly impact erectile function. Testosterone therapy may partly reverse the effects of SWSD. Shift work is a potential risk factor for ED and should be assessed for as part of the evaluation of men with ED. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e559 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Katherine M. Rodriguez More articles by this author Taylor P. Kohn More articles by this author Jaden R. Kohn More articles by this author E. Will Kirby More articles by this author Stephen M. Pickett More articles by this author Alexander W. Pastuszak More articles by this author Larry I. Lipshultz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

OP-556 - The Effect of Nebivolol on Erectile Dysfunction with Dipper and Non Dipper Hypertensive Patients

Erectile dysfunction (ED) is one of the common health problem and occurs at a higher incidence in men with hypertension. Hypertension (HT) is one of the most important risk factor for ED and could also show complex characteristics, especially subtypes which are introduced by nocturnal blood pressure alterations.