Risk Factors For Erectile Dysfunction Research Articles

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.

Low Serum 25-Hydroxyvitamin D Level as a Potential Risk Factor of Erectile Dysfunction in Elderly Men with Moderate to Severe Lower Urinary Tract Symptoms.

PurposeTo evaluate the correlation between vitamin D level and erectile dysfunction (ED) in male lower urinary tract symptoms (LUTS) patients.Materials and MethodsWe analyzed data from 534 male patients who were tested for LUTS from 2014 to 2017. LUTS severity was classified into mild (≤7) or moderate to severe (≥8) based on total IPSS scores. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D [25(OH)D] level of less than 20 ng/mL. The severity of ED was dichotomized into mild (≥17 points) or moderate to severe (≤16 points) depending on total IIEF-5 scores. The association of the serum 25(OH)D level with moderate to severe ED was assessed using logistic regression analysis.ResultsIn the entire cohort, moderate to severe ED was significantly associated with age ≥60 years (odds ratio [OR], 1.762; 95% confidence interval [CI], 1.011–3.073) and moderate to severe LUTS (OR, 2.075; 95% CI, 1.134–3.789), but not with serum 25(OH)D level (OR, 1.001; 95% CI, 0.979–1.023). Whereas, in the subgroup consisting of moderate to severe LUTS patients over 60 years (n=223), either low serum 25(OH)D level (OR, 0.944; 95% CI, 0.903–0.986) or vitamin D deficiency (OR, 2.949; 95% CI, 1.118–7.782) was the independent risk factor of moderate to severe ED as a result of each multivariate analysis.ConclusionsLow vitamin D status closely correlated with moderate to severe ED in elderly men with moderate to severe LUTS.

Erektil Disfonksiyonlu Hiperlipidemik Hastalarda Penil Doppler Bulgularının Serum Lipit Parametreleri ile Karşılaştırılması

Objective: The aim of this study is to investigate the effect of hyperlipidemia on the development of erectile dysfunction (ED) in hyperlipidemic patients with ED. Materials and Methods: Twenty-five patients who applied to the radiology clinic were included in the study. All patients have only hyperlipidemia as a risk factor of ED. The patients were evaluated in terms of ED by using International Index of Erectile Function (IIEF) form. Before and after oral treatment with daily doses of 10 mg atorvastatin, all parameters were measured. Paired t-test was used to compare vascular velocities between lipid profiles and Erectile Function Domain Scores (EFDS) and IIEFs, before and after treatment separately. Results: Cholesterol levels of 96% of patients were higher than 200 mg/dl and 52% of them had abnormal penile Doppler ultrasonography (PDU) findings. Patients with abnormal PDU findings had lower cholesterol levels than those with normal PDU findings. Significant differences existed between patients with normal and abnormal PDU in the high triglyceride group as for pre-, and post-treatment values . Pre-, and post-treatment EFD and IIEF scores were comparable. Conclusion: It can be said that a relationship exists between hyperlipidemia and erectile dysfunction. Therefore, lipid profile of a patient admitted with ED may be analyzed routinely

Comparison of the Prevalence of Erectile Dysfunction Between Hypertensive and Normotensive Participants: A Case-Control Study

IntroductionHypertension is a very common risk factor for erectile dysfunction (ED). In recent time, changes in lifestyle has led to an increase in the prevalence of hypertension, which has increased the risk of ED. The purpose of this study is to assess the prevalence of ED in hypertensive patients and compare various domains of sexual activity between hypertensive and normotensive participants.MethodsThis case-control study was conducted in an outpatient department of a tertiary health care hospital in Pakistan from March 2019 to September 2019. Two hundred and twelve clinically diagnosed hypertensive patients were enrolled and were identified as case group. Control group consisted of 212 people, without any history of hypertension. Sexual function was assessed with the International Index of Erectile Function (IIEF).ResultsThe prevalence of erectile dysfunction in hypertensive group was 61.79%, compared to 20.28% in normotensive group. Erectile weakness (OR = 4.32, CI 2.64-7.05), impaired morning erection (OR = 5.02, CI 2.98-8.47), complete erectile failure (OR = 2.32, CI 1.14-4.75), impaired spontaneous erection (OR = 5.45, CI 3.28-9.03), ejaculatory disturbances (OR = 5.20, CI 2.96-9.12) and reduced sexual interest (OR = 5.12, CI 3.04-8.64) were found to be significantly higher in patients with hypertension compared to normotensive participants.ConclusionThis study has found ED to be prevalent in hypertensive patients. Identifying and acknowledging hypertension as a risk factor may help identify patients with ED and reinforce the clinician's importance of asking sexual history of hypertensive patients.

Increasing access to erectile dysfunction treatment via pharmacies to improve healthcare provider visits and quality of life: Results from a prospective real-world observational study in the United Kingdom.

ObjectivesThe Medicines and Healthcare Products Regulatory Agency in the United Kingdom (UK) formally reclassified sildenafil citrate 50 mg tablets as a pharmacy medicine (sildenafil‐P) in 2017 for adult men with erectile dysfunction (ED). A 1‐year prospective real‐world observational study was conducted to track men's health behaviour, particularly their healthcare resource utilisation (HCRU) and quality of life (QoL) before and after the availability of sildenafil‐P.MethodsAdult men with ED aged ≥18 years provided data at baseline (prior to launch of sildenafil‐P) and every 3 months after the launch. Demographics, health characteristics, treatments at baseline and HCRU, including number of pharmacist and physician/nurse practitioner visits over time are reported. QoL‐related outcomes were assessed via the Self‐Esteem and Relationship Questionnaire (SEAR), 2‐Item Patient Health Questionnaire and ratings of sexual satisfaction. Generalised linear models were used to assess the association of sildenafil‐P use with total physician/nurse practitioner and pharmacist visits and QoL‐related outcomes at 12 months.ResultsOverall, 1162 men completed the survey at all 5 time points. The mean ± SD age was 59.02 ± 12.06 years; 55.42% reported having a moderate‐to‐severe ED. Hypertension (37.52%) and hypercholesterolaemia (31.50%) were the most common risk factors for ED. At baseline, 62.99% were not using any ED treatment. After adjusting for baseline visits/other covariates, mean physician/nurse practitioner (3.68 vs 2.87; P = .003) and pharmacist visits for any reason (2.10 vs 1.34; P < .001) at 12 months were significantly higher among sildenafil‐P users than those who never used sildenafil‐P. Sildenafil‐P users also had significantly higher SEAR total and domain (sexual relationship and self‐esteem) scores at 12 months.ConclusionFollowing the reclassification to a pharmacy medicine in the UK, sildenafil‐P was associated with a higher number of physician/nurse practitioner and pharmacist visits for any reason. Sildenafil‐P use was also associated with better QoL, although group differences were small in magnitude.

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.

Novel predictive risk factor for Erectile Dysfunction: Serum folic acid.

The purpose of this study was to compare the serum Folic Acid (FA) levels in patients with Erectile Dysfunction (ED) and healthy controls and whether levels vary with its severity.The study was carried out on 77 sexually active individuals, out of which 41 complained of ED and 36 were apparently normal.Patients were excluded if they hadany diseasesknown to cause ED.The severity was further categorised based on IIEF-5 scores. Blood serum levels of testosterone, lipid profile, random blood sugar, liver function test, renal function test and FA levels were obtained in each patient. Independent-samples t test of significance was used when comparing between two means. Pearson's correlation coefficient (r) test was used for correlating data. All clinical and biochemical parameters except FA were comparable in both the groups. FA levels were significantly decreased in ED group (5.29 vs. 10.8; p value=.004). Smoking habits were comparable between the groups, and FA levels did not vary among smokers and nonsmokers (p value=.46). Serum FA levels significantly declined with increasing severity of ED (8.28 vs. 5.56 vs. 4.37 vs. 3.5; p value<.001). Thus, decreased FA might possibly be one of the novel risk factors for ED.

Sexual Adverse Effects and Erectile Dysfunction During Buprenorphine/Naloxone Combination Treatment for Opioid Use Disorders.

Background and ObjectivesCompliance and maintenance of abstinence is a major issue in substance use disorders. Adverse effects of opioid maintenance treatments (OMT) include sexual dysfunctions. There is a vast amount of studies regarding sexual adverse effects of conventional OMTs; however, information regarding buprenorphine/naloxone (Bup/Nal) combination is limited, mostly evaluated in western populations and controversial. In this study, we aimed to assess the sexual adversities of Bup/Nal treatment in a Turkish alcohol and substance use disorder treatment center sample.Materials and MethodsWe recruited 100 subjects continuing sublingual Bup/Nal combination and 35 control subjects. Subjects were evaluated via the the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) for sexual dysfunction and for erectile dysfunction (ED) with the International Index of Erectile Function-5 (IIEF-5) as a comparison.ResultsThe mean dose of our treatment was 9.05. Overall sexual dysfunction scores were not significantly different in between groups with GRISS. ED and noncommunication scores were significantly higher in the Bup/Nal treatment group than the control group (p = 0.002, p = 0.02, respectively). Along with the increased ED scores in GRISS, IIEF-5 total scores also revealed more significant severity of the ED in the Bup/Nal group (p = 0.001).ConclusionBuprenorphine/naloxone combination lead to a higher degree of ED severity than the non-treatment controls. Noncommunication seems to play a role as a risk factor for ED in patients with opioid use disorder. Thus, effective communication can be a key factor for sexual assertivity and disclosing the sexual adverse effects to the clinicians as well as staying in the treatment.

Laparoscopic rectal dissection preserves erectile function after ileal pouch-anal anastomosis: a two-centre study.

Few studies have been published on erectile function after ileal pouch-anal anastomosis (IPAA) and, unlike in women, male fertility after IPAA has never been assessed. The primary objective was to assess the impact of IPAA on erectile function. The secondary objective was to assess the impact of IPAA on male fertility. All of the male patients who underwent IPAA in two university care centres between 2003 and 2017, aged 70years or less at the time of operation, were included. Forty-eight per cent of the patients responded to the international index of erectile function, the Jorge-Wexner score and a fertility questionnaire. All demographic and perioperative data were prospectively collected. Fertility results were compared with those of a control group undergoing appendectomy, matched for age at the time of operation, desire for paternity and length of follow-up. One hundred and thirty-nine patients were included, among which 46 (33%) presented with erectile dysfunction and 14 (10%) with severe erectile dysfunction. Age older than 50years (OR 0.27, 95% CI 0.12-0.62, P=0.002) and rectal dissection performed by open surgery (OR 4.16, 95% CI 1.62-10.65, P=0.003) were independent risk factors for erectile dysfunction. There was no infertility after IPAA compared with controls: indeed, 23 (16%) IPAA patients presented with pregnancy in their couple versus 27 (22%) controls (P=0.29), whereas 36 (26%) IPAA patients and 34 (28%) controls (P=0.80) expressed paternity desire. A total laparoscopic approach, including rectal dissection, should be preferred to preserve erectile function. Male fertility is not impaired after IPAA.

History of Prostatitis Is an Independent Risk Factor for Erectile Dysfunction: A Cross-Sectional Study.

Purpose To determine the role of history of prostatitis (HP) as an independent risk factor for erectile dysfunction (ED) in Chinese adult males. Methods We conducted an online survey using a crowd-sourced questionnaire in Chinese adult males. The participants were separated into two groups as adult participants with HP and with no history of prostatitis (NHP) according to the medical history record. As diagnosis criteria of ED, we used the 5 questions of the International Index for Erectile Function (IIEF-5). The general data including height, weight, monthly income, academic background, smoking history, alcohol drinking, marital status, conjugal affection, and other disease history was asked and recorded. The relationship between HP and ED using the chi-square test and logistic regression analyses was investigated and analyzed. Results In total, 1873 participants answered the questionnaire. 95 participants in the HP group and 1778 participants in the NHP group were included in this study. The rate of participants with HP was 5.343%. ED was found in 68.4% of the HP group and 43% of the NHP group (p < 0.001). Regression analysis showed that participants in HP were more likely to have ED (OR 2.135, 95% CI 1.266–3.60) after adjusting for the participant's age, body mass index (BMI), monthly income, academic background, smoking history, alcohol drinking, marital status, conjugal affection, BPH, hypertension, and diabetes mellitus, when compared with NHP. Conclusions The present study indicated a high prevalence of ED in Chinese adult males with history of prostatitis, and HP is an independent risk factor for erectile dysfunction.

Erectile Dysfunction in Men With Psoriatic Arthritis: A Population-based Cohort Study.

To define the incidence of erectile dysfunction (ED) in a population-based cohort of men with psoriatic arthritis (PsA). Data pertaining to demographics, ED, and potential confounding diagnosis were extracted from a comprehensive medical record system for a population-based cohort of men with PsA and an age-matched male comparator cohort. Cumulative incidence of ED adjusted for competing risk of death was compared between the 2 cohorts. There were 128 age-matched pairs of men with PsA and without PsA in the described cohorts. At baseline, there was a 7% prevalence of ED in men with PsA prior to diagnosis compared to a 3% prevalence of ED in the comparator cohort (P = 0.16). After PsA diagnosis/index date, diagnosis with PsA was associated with an increased risk of ED (age-adjusted HR 1.45, 95% CI 0.79-2.68), but this association did not reach statistical significance. This was based on 24 cases of ED in the men with PsA and 18 cases within the comparator cohort. No confounding factors or ED treatment strategies differed significantly between men with PsA and ED and comparators with ED. Men with PsA may have an increased risk of ED, which was detected but likely underpowered in this study. Whether this difference is secondary to higher prevalence of traditional risk factors of ED in men with PsA compared to the general population will require further study.

IMPACT OF METABOLIC AGE ON SEXUAL AND ANDROGENIC FUNCTION IN YOUNG PATIENTS

Erectile dysfunction is increasingly prevalent with age. Metabolic Age (metAge) refers to the number calculated by comparing Basal Metabolic Rate (BMR) of an individual to BMR average of his chronological age (chAge) group. It hence serves to reflect the metabolic status which is believed to influence sexual function. The aim of this study is to assess the relation between metAge & sexual function in men younger than 40 years of age Prospective observational study. A total of 120 male healthcare workers of a tertiary medical center were randomly selected through computer generated randomization tables. Subjects receiving exogenous testosterone or erectogenic medications were excluded. In addition to providing an early morning serum testosterone (T) sample, subjects were requested to fill the International Index of erectile function questionnaire (IIEF-5) & to undergo Bioelectric Impedance Analysis [BIA] of their metabolic status using TANITA body analyzer (TBF-410GS) (Illinois, USA). Risk factors for erectile dysfunction (ED) such as diabetes mellitus, hypertension, coronary artery disease & dyslipidemia were also assessed. Participants were divided according to their chAge into two groups (<40 & > 40 years). Ninety subjects were included (< 40 years, n=53; > 40 year, n=37). ED was reported by 48 (53%) subjects, while a low T level was detected in 18 (20%). Risk factors were detected in 41% of subjects. No significant relationship between risk factors & serum T or IIEF-5 results were observed. Participants with ED had significantly lower T levels (12.7 ± 4.6 vs.14.8 ± 3.9, p=0.02) compared to those without ED. Older chAge & metAge were observed in ED vs no ED participants as well, however without statistical significance. 24 (45.3%) subjects < 40 years of age had ED. Significantly lower T levels & significantly higher metAge & BMI were observed in participants <40 years with ED compared with their counterparts without ED (table 1). In this participant group (< 40years), significant correlations were observed between metAge & T (r-0.347, p=0.01), chAge (r0.384, p=0.005), visceral fat (r0.747, p<0.001), fat % (r0.78, p<0.001), weight ( r0.524. p<0.001), BMI (r 0.635, p<0.001) & BMR (0.347, p=0.01). Metabolic status may significantly influence the sexual & androgenic status of young men. An older metAge is observed in young men with ED & hypogonadism.Tabled 1Parameters< 40 years with ED (n=24)< 40 years without ED (n=29)P valueTestosterone (nmol/L)19.8 ± 4.114.5 ± 4.10.002metAge (years)44.6 ± 6.839.9 ± 8.50.034BMI (kg/m2)30.4 ± 4.227.9 ± 4.40.044Fat% (%)27.5 ± 5.324.5 ± 5.90.064Visceral fat (rate)10.6 ± 3.88.7 ± 3.80.072Muscle mass (kg)63.8 ± 8.861.4 ± 8.10.296BMR (Kj)8413.5 ± 1277.88022.0 ± 1128.90.242 Open table in a new tab

Erectile Dysfunction After Surgical Treatment of Lung Cancer: Real-World Evidence.

BackgroundSexual problems are common in male lung cancer survivors. However, the development of erectile dysfunction (ED) in lung cancer patients after surgery has been rarely explored. In this study, we aimed to explore the incidence and risk factors of ED after lung cancer surgery.MethodsFrom 2000 to 2012, 6025 and 24,100 male patients were included in each matched cohort of lung cancer and non-lung cancer patients, respectively. Poisson regression analysis was used to calculate the incidence rate ratio (IRR) and 95% confidence interval (CI).ResultsThe incidence of ED was higher in the lung cancer cohort compared to the non-lung cancer cohort (38.47 vs 28.28 per 10,000 person-years) with an adjusted IRR (aIRR) of 1.34 (95% CI: 1.06–1.70, p=0.014) after the confounders were adjusted for. An increased incidence of ED was observed in the lung cancer cohort aged 40–54 years (aIRR: 5.44, 95% CI: 2.25–13.15, p<0.001), 55–64 years (aIRR: 3.62, 95% CI: 1.61–8.17, p=0.002) years, and anxiety (aIRR: 2.99, 95% CI: 1.81–4.94, p<0.001). In addition, a higher incidence of emergency room (ER) visits (aIRR: 2.19, 95% CI: 1.98–2.42, p<0.001) was observed in lung cancer patients with ED compared to those without ED.ConclusionOur study results suggested that early surveillance and intervention of ED should be advocated in lung cancer patients after surgery.

Association of Peripheral Neuropathy with Erectile Dysfunction in US Men

BackgroundPeripheral neuropathy and erectile dysfunction are common conditions that have both been linked to cardiovascular disease and its risk factors, especially diabetes. The aim of this study was to assess the association of large-fiber peripheral neuropathy with erectile dysfunction in adult US males with and without diabetes. MethodsWe included all men aged ≥40 years from the 2001-2002 National Health and Nutrition Examination Survey (NHANES) with data on erectile dysfunction and peripheral neuropathy (n = 1213, including 206 men with diabetes). Erectile dysfunction was assessed by a single question during a self-paced, computer-assisted self-interview. Peripheral neuropathy was evaluated using standardized 10-g monofilament testing, which assesses lower extremity sensation. We used logistic regression to examine the association of peripheral neuropathy with erectile dysfunction overall and stratified by diabetes status, adjusting for demographic and cardiovascular risk factors. ResultsThe prevalence of peripheral neuropathy was 26.1% (51.2% in men with diabetes and 22.5% in men without diabetes). There was a significant independent association of peripheral neuropathy with erectile dysfunction overall (odds ratio [OR] 1.71, 95% confidence interval [CI], 1.20-2.43) and among US adult men without diabetes (OR 1.68; 95% CI, 1.11-2.56). The association in adults with diabetes was not statistically significant (OR 1.29; 95% CI, 0.39-4.26), possibly owing to limited power in this subgroup. ConclusionsOur study suggests that decreased lower extremity sensation, even in the absence of diabetes, is common and a novel risk factor for erectile dysfunction.

Is overactive bladder a risk factor for erectile dysfunction? A cross-sectional study

Aim: Erectile dysfunction (ED) is a sexual dysfunction characterized by the inability to achieve or maintain penile erection during sexual activity. Many risk factors have been identified in ED-related epidemiological studies. In experimental studies, a relationship is thought to exist between Overactive Bladder (OAB) and ED. We investigated the relationship between OAB and ED, its clinical reflections, and the odds ratio of OAB for ED. Methods: We conducted this cross-sectional prospective study between January-July 2020. Sixty patients referred to the urology outpatient clinic with complaints of OAB (Group 1) and 66 patients without urological complaints (Group 2) were included in the study. Patients’ erectile functions were evaluated with the IIEF-5 form. OAB was evaluated with the OAB-V8 form. Results: The groups were similar in terms of age, body mass index, comorbidity, and smoking status. IIEF-5 scores were higher in Group 2 [20.52 (3.51)] compared to Group 1 [18.17 (5.46)] (P=0.036). Correlation analysis between IEF-5 and OAB-V8 scores revealed a negative correlation; it was observed that the IIEF-5 score decreased as the OAB-V8 score increased (r=-0.260, P=0.045). The odds ratio of decreasing IIEF-5 score with each 1-unit increase of OAB-V8 score was 0.164 (P=0.04). It was observed that the patients diagnosed with OAB had lower IIEF-5 scores when they had nocturia. Conclusion: OAB is a risk factor for ED. The presence of nocturia symptoms is remarkable for ED in OAB patients. The effect of OAB should not be ignored in the treatment of ED.

Novel predictive risk factor of erectile dysfunction: Serum 25-hydroxy vitamin D.

The present study aimed to investigate the association between the severity of erectile dysfunction (ED) and serum 25-hydroxy vitamin D. It also sought to determine the cut-off level of serum 25-hydroxy vitamin D for ED. This study included 130 men who had ED between 2018 and 2019. Patients were divided into three groups according to their scores on the international index of erectile function-5 (IIEF-5) Turkish validated short form questionnaire. The serum 25-hydroxy vitamin D results were compared between the groups. The mean age of the patients was 49.28±13.62years. Groups 1, 2 and 3 included 44 (33.8%) patients with severe ED, 56 (43.1%) patients with moderate ED and 30 (23.1%) patients with mild ED, respectively. Statistical significance was observed between the groups and serum 25-hydroxy vitamin D levels. A positive correlation was detected between the IIEF-5 scores, serum testosterone and serum 25-hydroxy vitamin D levels. A cut-off level for serum 25-hydroxy vitamin D was calculated as 27.32ng/ml. During multivariate analysis, we found that serum 25-hydroxy vitamin D levels were independent prognostic risk factors for decreased IIEF-5 scores. Decreased serum 25-hydroxy vitamin D levels were associated with decreased IIEF-5 scores. Therefore, vitamin D replacement therapy may improve symptoms.

Shift Work Sleep Disorder and Night Shift Work Significantly Impair Erectile Function

ObjectivesHere we examine the association between shift work sleep disorder (SWSD) and erectile dysfunction (ED) in shift workers. MethodsMen presenting to a single andrology clinic between January 2014 and July 2017 completed validated questionnaires: International Index of Erectile Function (IIEF), Patient Health Questionnaire-9 (PHQ-9), and the nonvalidated SWSD Questionnaire. Men were also asked about shift work schedule, comorbidities, phosphodiesterase 5 (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 ED as assessed using the IIEF. ResultsOf the 754 men completing questionnaires, 204 reported nonstandard shift work (begins before 7 am or after 6 pm, regularly extends out of that frame, or rotates frequently) and 48 were found to have SWSD using a screening questionnaire. Nonstandard shift work alone did not result in worse IIEF-EF scores (P = .31), but those who worked nonstandard shifts and had SWSD demonstrated IIEF-EF scores 2.8 points lower than men without SWSD (P < .01). When assessing for the type of shift work performed, men who worked night shifts had IIEF-EF scores 7.6 points lower than men who worked during the day or evening (P < .01). Testosterone use improved IIEF-EF scores for men with SWSD by 2.9 points, ameliorating the effect of SWSD on ED. However, baseline testosterone levels were not associated with worse erectile function in this cohort. ConclusionMen with SWSD have worse erectile function, with men who work night shifts having even poorer erectile function. These findings suggest that circadian rhythm disturbance may significantly impact erectile function. While 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.Rodriguez KM, Kohn TP, Kohn JR, et al. Shift Work Sleep Disorder and Night Shift Work Significantly Impair Erectile Function. J Sex Med 2020;17:1687–1693.

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.

Association between Frailty and Erectile Dysfunction among Chinese Elderly Men

Objective This study is aimed at assessing association between frailty and erectile dysfunction among Chinese elderly men. Methods This community-based study was conducted with a sample of 341 Chinese elderly men (aged 60 to 83 years old) in Fuyang City (Anhui Province, China). Each of the participants completed a standard questionnaire, including demographics (age, height, weight, yearly income, educational status, comorbidity, lifestyle factors, etc.), medical and sexual history, and the Chinese version of Tilburg Frailty Indicator (TFI) and International Index of Erectile Function-5 (IIEF-5) for assessing frailty and erectile dysfunction (ED). Results The prevalence of ED and frailty in Chinese elderly men was 77.13% and 68.04%, respectively. Compared with the non-ED group, the ED group had increased age, spouse's age, BMI, prevalence of diabetes, and scores of TFI and lower yearly income, educational levels, and ratio of irregular intercourse (less than once per week) (all P < 0.05). Multivariate analysis indicated that age (OR: 0.860, 95% CI: 0.763-0.969), diabetes (OR: 0.330, 95% CI: 0.165-0.661), irregular intercourse (OR: 3.416, 95% CI: 1.874-6.229), and scores of TFI (OR: 0.906, 95% CI: 0.846-0.970) were regarded as independent risk factors for ED (all P < 0.05). And after adjusting for age, the TFI score had a negative significant association with the IIEF score (r = −0.134, P = 0.013). Conclusion This study confirmed the strong associations between ED and frailty among elderly men. Sexual health care for elderly men with ED should be assessed and taken addressed on the multidimensional assessments of frailty.

P-02-31 Erectile Function after Corporoplasty for Peyronie's Disease

Surgical interventions for Peyronie's disease (PD) may be divided into three primary groups: plication corporoplasty, substitution corporoplasty and implantation of penile prosthesis with additional surgical steps to take care of deformation, such as manual modeling. All these techniques may influence erectile function. We performed a retrospective analysis of medical records of 374 patients with PD. The final analysis was performed on data of 342 patients who were available for follow-up visit. Erectile function outcomes were evaluated by interview, questionnaires and penile doppler ultrasound when indicated. A major portion of patients in our population (n = 285; 83.3%) were sexually active; seven patients (2%) had sexual intercourse only 1-2 times per month; finally, 50 patients (14.6%) reported on not being sexually active at all. Among 285 sexually active patients, 139 (48.8%) were completely satisfied with their erection, and 62 (21.7%) have pointed out at not being satisfied with their erectile function. Among all patients, 197 were completely satisfied with length and appearance of their penis (57.6%), 88 were relatively satisfied with those outcomes (25.7%) and 57 patients were unsatisfied (16.7%). Prevalence of risk factors for erectile dysfunction (ED) in our sample has greatly increased during follow-up. IIEF questionnaire has shown that 105 patients (36.8%) had no ED (> 26 points); 74 patients (26%) had mild ED; 67 patients (23.5%) had mild-to-moderate ED; 21 patients (7.4%) had moderate ED; and 18 patients (6.3%) had severe ED.