Risk Factors For Erectile Dysfunction Research Articles

Abstract #795265: Frequency and Risk Factors of Erectile Dysfunction Among Bangladeshi Adult Men with Type 2 Diabetes Mellitus

Abstract #795265: Frequency and Risk Factors of Erectile Dysfunction Among Bangladeshi Adult Men with Type 2 Diabetes Mellitus

Is Blue Light the Next Little Blue Pill?: Effects of Light‐Stimulation on Erectile Dynamics

INTRODUCTIONMany major risk factors for erectile dysfunction (ED) are associated with depressed nitric oxide (NO) availability. Phosphodiesterase type 5 inhibitors are the current first line therapy for ED and are ineffective in 30–50% of patients, largely due to impaired NO production. New therapeutic approaches for ED are needed under such conditions. The phenomenon of light‐stimulated vasodilation has recently been described in aortic tissue, which is enhanced by G‐protein coupled receptor kinase 2 (GRK2) inhibition and particular for blue light. The objective of this project was to determine if this GRK2 sensitive photorelaxation response is active in erectile tissue and the contribution of the NO signaling pathway to the response.METHODSYoung male mice (n = 4–8 / experiment) were sacrificed and erectile tissue was harvested from the shaft of the penis. Ex vivo constriction and relaxation responses were assessed in a muscle strip myograph. The GRK2‐sensitive photorelaxation response was assessed ± 1 μM GRK2 inhibitor using nine different wavelengths (365–700 nm) of light at constant intensity (100 Lux), and then at nine different light intensities (1–1000 Lux) at 455 nm. The contribution of the NO signaling pathway to the GRK2‐sensitive response was tested with stimulations of 20 and 100 Lux at 455 nm with 1 μM GRK2 inhibitor ± the NO synthase inhibitor L‐NAME, the soluble guanylate cyclase (sGC) inhibitor ODQ, the protein kinase G (PKG) inhibitor Rp‐8‐Br‐cGMPS, or the NO scavenger cPTIO, as well as in tissue from mice with a deletion of endothelial + neuronal NO synthase. Differences in responses were determined by two‐way repeated measures ANOVA followed by Sidak’s post hoc test where appropriate.RESULTSMaximal relaxation responses at 455 nm increased with increasing light intensity in the absence (2–10%) and presence (57–103%) of the GRK2 inhibitor, demonstrating a stark increase in photorelaxation under GRK2 inhibition. However, this response waned more rapidly at intensities > 100 Lux. Significant GRK2‐sensitive responses were observed at 365, 395, 430, and 455 nm at 100 Lux intensity, with no significant responses observed in the 490–700 nm range. Both L‐NAME and deletion of endothelial/neuronal NO synthase increased the magnitude of relaxation at all time‐points at 20 Lux, and prolonged maximal relaxation at 100 Lux. CPTIO prolonged the relaxation response at both intensities. ODQ drastically blunted the photorelaxation response at all time points and intensities. Rp‐8‐Br‐cGMPS had no effect on photorelaxation.CONCLUSIONSGRK2‐sensitive photorelaxation was determined to be optimal in the 430–455 nm (violet‐blue) range at ~100 Lux. Depletion of NO by scavenging, enzyme inhibition or genetic deletion enhanced the response, which is sGC‐dependent but PKG‐independent. These findings have implications for treatment of ED due to low NO availability if the GRK2‐sensitive photorelaxation pathway can be harnessed therapeutically.

Sodium Tanshinone IIA Sulfonate Attenuates Erectile Dysfunction in Rats with Hyperlipidemia.

Hyperlipidemia is considered one of the most important risk factors for erectile dysfunction (ED). To determine the effect of sodium tanshinone IIA sulfonate (STS) as an antioxidant agent on ED in high-fat diet- (HFD-) induced hyperlipidemia in rats and to investigate if STS administration could improve erectile function via hydrogen sulfide (H2S) production by inhibition of oxidative stress. Hyperlipidemia was induced in Sprague-Dawley rats by feeding HFD for 16 weeks. The rats were randomly divided into 3 groups: control, HFD, and HFD treated with STS (10 mg/kg/day for 12 weeks, intraperitoneal injection). Erectile function including intracavernosal pressure (ICP), H2S production, and antioxidant capacity was assessed. In addition, cavernosal smooth muscle cells (CSMC) isolated from SD rats were pretreated with STS in vitro and exposed to H2O2. Expressions of nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1), activity of antioxidant enzymes, and H2S-generating enzymes within CSMC were examined. ICP was significantly decreased in HFD rats compared with control. In addition, decreased H2S production and expression of cystathionine ɣ-lyase (CSE) and cystathionine β-synthase (CBS) associated with increased oxidative stress were observed in the penile tissue of HFD rats. However, all these changes were reversed by 16 weeks after STS administration. STS also increased antioxidant defense as evidenced by increased expression of Nrf2/HO-1 in the penile tissue of HFD rats. In CSMC, pretreatment with STS attenuated the decreased expression of CSE and CBS and H2S production by H2O2. STS exerted similar protective antioxidative effect as shown in the in vivo hyperlipidemia model. The present study demonstrated the redox effect of STS treatment on ED via increased H2S production in HFD-induced hyperlipidemia rat model by increased antioxidant capacity via activation of the Nrf2/HO-1 pathway, which provides STS potential clinical application in the treatment of hyperlipidemia-related ED.

The Effects of Calorie Restriction and Exercise on Age-Related Alterations in Corpus Cavernosum.

BackgroundAging is an important risk factor for erectile dysfunction (ED). Both calorie restriction (CR) and physical exercise (PE) have been established as a non-medical method for the improvement of detrimental changes in aging. It is well documented that both CR and PE influence on sympathetic and parasympathetic systems; however, there are few studies on non-adrenergic non-cholinergic pathways. This study aims to investigate the NO-mediated mechanisms of CR and PE on corpus cavernosum in aged rats.Materials and Methods3 and 15 month-old rats were divided into five experimental groups: young rats fed ad libitum (Y-C), aged rats fed ad libitum (O-S), aged rats with CR (O-CR), aged rats with PE (O-PE), and aged rats with CR and PE (O-CR-PE). CR was applied to animals as a 40% reduction of daily food intake for 6 weeks. PE was moderate swimming at 30 min at 3 days/week. The effects of CR and PE were evaluated by histologic, biologic, and in-vitro tissue bath studies.ResultsThe outcomes in CR and PE groups (characterized by decreased nitrosative damage together with increased antioxidant capacity) were improved in comparison to the O-S. Apoptotic biomarkers were also lower and both endothelial and smooth muscle cell’ functions were preserved too. There was no statistical difference between apoptosis, antioxidant capacity, and nitrosative damage parameters. Contractile responses to phenylephrine and relaxation responses to carbachol were: O-CR > O-PE > O-CR-PE. In these groups, NOS protein levels determined by western-blot were: eNOS: O-CR = O-CR + PE > O-PE; iNOS: O-CR = O-PE > O-CR-PE; nNOS: O-PE > O-CR-PE > O-CR.ConclusionIn our study, both CR and PE prevented age-related changes in the corpus cavernosum of rats. Reducing nitrosative damage in the neurovascular structure was the main mechanism. CR and exercise restored the endothelial and smooth muscle cells in corpus cavernosum by decreasing apoptosis. The mechanism of enhancing functional response in corpus cavernosum with CR was the improvement of endothelial function via eNOS activation however it involves increases in the NO-cGMP signaling pathway by an endothelium-independent mechanism with PE. This might be a direct stimulation of smooth muscle cells by NO, which released from the cavernous nerve endings via nNOS activation.

Penile hemodynamics study in erectile dysfunction men: the influence of smoking obesity on the parameters of penile duplex.

Erectile dysfunction (ED) was established to be linked to the risk factors of coronary artery disease such as metabolic syndrome, hypertension, diabetes, smoking, obesity and dyslipidemia. To study the influence of smoking and obesity on penile hemodynamics in patients with erectile dysfunction. This prospective study was carried out on 130 patients above 40years and suffering from ED for more than 6months. Selected patients were divided into four groups: group 1 (nonsmokers/non-obese) N = 36, group 2 (nonsmokers/obese) N = 30, group 3 (smokers/non-obese) N = 34, group 4 (smokers and obese) N = 30. Other risk factors for ED were excluded except dyslipidemia. All patients were subjected to personal history, sexual history, history of medical disorders or operations, evaluation of erectile function using an abridged IIEF-5. Measuring of BMI, fasting lipid profile, blood sugar, TT, prolactin, and PSA was performed. Penile hemodynamics was evaluated using intracavernosal injection of 1cc Bimix (papaverin + phentolamine) and penile duplex ultrasound measuring the peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI), and cavernosal artery diameter before and after injection. The mean ages of group 1, group 2, group 3 and group 4 were 50.92 ± 6.52, 55.20 ± 7.18, 50.88 ± 7.66 and 52.30 ± 7.61, respectively, with no statistically significant (p = 0.341). A statistically significant difference observed between mean value of PSV between group 1 and all other groups on both sides and between group 3 and 4. Also, our results recorded a statistically significant difference between mean value of EDV and RI between group 1 and all other groups on both sides. Concerning the change in the cavernosal artery diameter after ICI, there was a significant difference was seen between the following groups 1 and 4, 3 and 4 on both sides and between groups 1 and 2 at right side only. There was a statistically significant difference between the study groups concerning patient's response to ICI (p value 0.000). A significant negative correlation between BMI and total testosterone was recorded (p = 0.001). Regarding the mean value of testosterone, a significant difference was observed between the different four groups (p = 0.002). And a statistically significant difference was reported between group 1 and group 2 (p = 0.004) and group 2 and group 3 (p = 0.007). Both smoking and BMI are strong risk factors for ED and affect response to ICI and penile duplex parameters (PSV, EDV, RI). Smoking and BMI together cause more deterioration of penile duplex parameters and response to ICI. The effect of smoking on EDV and RI was more than BMI. The effect of BMI on PSV, response to ICI and testosterone levels was more than smoking.

Blood Oxygen Accumulation Distribution Area Index Is Associated With Erectile Dysfunction in Patients With Sleep Apnea-Results From a Cross-sectional Study.

IntroductionObstructive sleep apnea (OSA) has been linked with erectile dysfunction (ED), but the relatively independent polysomnography (PSG) outcomes of apnea and nocturnal hypoxia may not effectively assess the physiological impairment of OSA well.AimTo propose a new calculation method, the blood oxygen accumulation distribution area index (BOADAI), for evaluating the association between OSA and ED.MethodsIn this study, 502 male participants with suspected OSA were enrolled. Clinical questionnaire, physical measurements, and PSG outcomes were obtained by 2 respiratory physicians. ED was assessed by a urologist using the International Index of Erectile Function-5 (IIEF-5). Whole pulse oxygen saturation curves during the sleep time were compressed into a fixed scale image, and the distribution area of oxygen saturation curves was outlined. We then calculated the value of the outlined area and normalized it by total sleep time. The least absolute shrinkage and selection operator logistic regression model was used for selecting the optimal variable associated with ED and model construction. The clinical net benefit of the BOADAI and its related modules was estimated and compared by decision curve analysis.Main Outcome MeasureED and OSA were assessed using the IIEF-5, clinical questionnaire, physical measurements, and PSG outcomes.ResultsThe frequency of ED in patients with OSA was significantly greater than that in the no-OSA group. Meanwhile, the new BOADAI was negatively correlated with the IIEF-5 score (r = −0.2525, P = .0000). Moreover, the least absolute shrinkage and selection operator method retained BOADAI but not the other PSG parameters such as respiratory disorder index and lowest SaO2. Finally, logistic regression analysis revealed that older age, lips with cyanochroia, systemic hypertension, and BOADAI were independently associated with ED, and decision curve analysis indicated the clinical usefulness of the BOADAI module.ConclusionThis study revealed novel evidence that OSA is a risk factor for ED. Meanwhile, the BOADAI could act as a potential clinical characteristic to evaluate ED in patients with OSA and to provide clinical treatment recommendations.Zheng W, Chen X, Huang J, et al. Blood Oxygen Accumulation Distribution Area Index Is Associated With Erectile Dysfunction in Patients With Sleep Apnea—Results From a Cross-sectional Study. Sex Med 2019; 8:36–44.

Sexual health in Polish elderly men with coronary artery disease: importance, expectations, and reality.

Deterioration in overall health, hormonal disturbances, and erectile dysfunction (ED) contributes to limitations in sexual activity in the elderly, which is further limited by incorrect beliefs about the hazards of sexual activity in cardiac patients. We aimed to analyze the occurrence of ED in elderly men, their perception of the relevance of good sexual function, and their expectations of physicians. A cross-sectional study encompassed 731 patients with coronary artery disease (CAD) subjected to cardiac rehabilitation. Demographic data and data on modifiable risk factors and patient expectations were collected. ED was assessed using the IIEF-5 questionnaire. Relationships among the risk factors for ED, occurrence of ED, and patient expectations, as well as the changes in the indicators between 2012 and 2016, were analyzed. The mean age of men was 70.7 ± 5.1 years. The prevalence of ED was 93.0%. The IIEF-5 score was significantly associated with age, tobacco smoking, exercise tolerance, time to diagnosis of CAD, and treatment with calcium channel blockers and diuretics. Patients declared that sexual activity was overall important (47.9%) or very important (25.6%). Three hundred and sixty (49.3%) patients expected their physician to show interest in their sexual health, but the topic was addressed in only 12.5%. Over the past few years, we have observed an increase in the awareness and importance of sexual health as well as a significant increase in patients' expectations of physicians to show interest in their sexual health. Patients' expectations of discussing and receiving treatment for ED remain an unmet medical need.

An Evaluation of the Frequency and Severity of Erectile Dysfunction in Hypertensive Married Men Compared with Normotensive Married Men

Background: Erectile dysfunction (ED) exerts a major burden on the quality of life of the patients and their sexual partners. It has been identified as an independent risk factor for cardiovascular disease. Hypertension is a well-established risk factor for ED. Both hypertension and erectile dysfunction has age dependent relationship. Objective: To evaluate the frequency and severity of erectile dysfunction in hypertensive married men compared with normotensive married men of similar demographic characteristics attending a tertiary care hospital of Bangladesh during the period from June 2017 to March, 2018. Methodology: This cross-sectional comparative study includes 75 hypertensive and 75 normotensive young and middle-aged married men (31–59 years) those visited our outpatient clinic. From them, 75 patients had hypertension and 75 were normotensive. Erectile dysfunction was evaluated with pre validated Bengali version of the International Index of Erectile Function (IIEF-5) questionnaire. Results: Erectile dysfunction (ED) was found in 61.3% of patients with hypertension compared with 37.3% of normotensive subjects. ED is more common and more severe among hypertensive patients than normotensive counterparts. Hypertension duration, hypertension severity and age were found positively correlated with erectile dysfunction. Taking regular medication and control of BP gave positive influence upon erectile status. No association was found between ED and smoking but a weak negative correlation of increased body mass index (BMI) and decreased ED was found in both hypertensive and normotensive group. Conclusion: Hypertensive patients present with erectile dysfunction more frequently than age matched normotensive individuals. As erectile dysfunction is a matter of embarrassment, doctors should be motivated to discuss such issue. Control of blood pressure seems to confer good influence upon the prevalence of erectile status. We need further studies to authenticate such observation and to unveil other risk factors of ED in our country and to go for appropriate management.

Effect of Regular Physical Exercise on the Progression of Erectile Dysfunction Among Male Patients with Diabetes Mellitus

There is no agreed management for Erectile Dysfunction (ED) for male patients with Diabetes Mellitus (DM). Regular Physical Exercise (PE) starts to be a more exciting area that needs further focus. This review attempts to gather available data about the ED burden, etiology, risk factors, assessment, and management. Further, it highlights the available evidence on the effect of PE on the progression of ED and the possible underline mechanisms. The available evidence is hugely supportive of the beneficial role of PE in the ED. The cardiovascular, neurological, endothelial, metabolic, and overall health benefits of PE are repeated mechanisms reported by many researchers. The possible explanation is quite not clear due to the complexity and bidirectional effect on many aspects related to the changes during PE. Further interventional studies are needed to determine the superiority of each factor. All physicians managing DM and ED are strongly invited to involve PE as part of their management plan in conjunction with other available treatment options. Research has to look after which type, duration, frequency, and intensity of PE is sufficient for detectable improvement in ED.

Vitamin D Deficiency Is Associated with Erectile Dysfunction in Men with Type 2 Diabetes

<i>Background and aims</i>: Evidence suggests strong a relationship of vitamin D deficiency (VDD) with erectile dysfunction (ED) in men. The prevalence and long-term complications of diabetes are being recognize more increasingly that has the possible association again with VDD. Thus, the study aimed to find out the association between VDD and ED among Bangladeshi adult men with type 2 diabetes. <i>Materials & Methods</i>: This nested case-control study recruited 2860 adult patients with type 2 diabetes mellitus (T2DM) who had ED (aging between 30 - 69 years). The patients who found to have normal vitamin D level, were taken as control and those had VDD, were categorized as the case. The study was conducted in eight diabetes care centers of Bangladesh. Socio-demographic and personal information of the respondents were collected by face-to-face interview and disease-specific data were recorded from the patient’s diabetic record book. The bodyweight, height, waist circumference, hip circumference and blood pressure were also recorded. Fasting blood sample was collected to estimate serum levels of vitamin D, glucose, and free testosterone. <i>Results</i>: The diabetes patients with ED had more severe VDD [(25 OH)D <10 ng/mL] than the controls (61.28% and 62.16%, respectively). The more severe form of ED found in the lower levels of serum vitamin D. A linear relationship of VDD was found with ED [OR 2.83, CI 2.36, 3.97] in multivariate logistic regression analysis. <i>Conclusions</i>: Vitamin D deficiency is an independent risk factor of ED in men with type 2 diabetes mellitus and severity of ED is linearly associated with the degree of deficiency of vitamin D.

Erectile dysfunction and associated risk factors in male patients with ischemic stroke: A cross-sectional study.

Patients with ischemic stroke (IS) often suffered from the problem of erectile dysfunction (ED) and psychological disease. However, they are often ignored because these symptoms are more obvious in the convalescent stage of stroke, which affects the quality of sexual life of patients. This study aimed to investigate the incidence of ED, sexual quality of life, and mental state of patients after stroke, as well as analyze the relevant risk factors affecting their psychological status.A total of 361 IS patients were enrolled. The international erectile function index-5 scale was used to diagnose ED. Accordingly, the patients were divided into ED group and non-ED group. Magnetic resonance imaging was used to evaluate the brain lesions of patients. We assessed neurological deficits by the National Institutes of Health Stroke Scale score and patient health questionnaire-9 (PHQ-9) and general anxiety disorder-7 (GAD-7) were used to evaluate the depression and anxiety. The differences between the ED group and the non-ED group clinical factors were compared.The response rate was 88.6% (n = 320), and more than two-thirds of patients reported ED (77.8%). Patients with ED had higher PHQ-9 (8.40 ± 4.18 vs 4.94 ± 3.73, P < .01) and GAD-7 (6.73 ± 3.56 vs 4.51 ± 3.35, P < .01) scores, were more likely to have the frontal lobe (75.1% vs 49.3%, P < .01) and lateral ventricle (69.8% vs 53.5%, P = .01) lesions, with hypertension (75.1% vs 46.5%, P < .01) and hyperlipidemia (48.2% vs 25.4%), and on antihypertensive (67.9% vs 35.25, P < .01) and hypolipidemic drug (43.4% vs 16.9%, P < .01). Multivariate logistic regression analysis showed that antihypertensive drug (odds ratio [OR]: 2.50, 95% confidence interval [CI]: 1.02–6.10, P = .04), depression (OR: 1.18, 95% CI: 1.06–1.32, P < .01) and anxiety (OR: 1.13, 95% CI: 1.01–1.27, P = .04) might be the independent risk factors for ED group.ED is more common in male IS patients. Antihypertensive drug, depression and anxiety are the main factors affecting ED.

Erectile dysfunction in diabetes mellitus: A review

The International Diabetes Federation estimates that globally there are 425 million people with diabetes. Estimates of the prevalence of erectile dysfunction (ED) in men with diabetes range from 20% to 85% in different studies. Among men with ED, those with diabetes are likely to experience the problem 10–15 years earlier than men without diabetes. This review aims to provide an update of the epidemiology, pathophysiology and management of ED in diabetes patients in India. The proposed mechanisms of ED in diabetic patients include elevated advanced glycation end-products and increased levels of oxygen-free radicals, impaired nitric oxide (NO) synthesis, increased endothelin B receptor binding sites and ultrastructural changes, upregulated RhoA/Rho-kinase pathway, NO-dependent selective nitrergic nerve degeneration and impaired cyclic guanosine monophosphate-dependent kinase-1. Modifiable risk factors for ED include smoking, lack of physical activity, wrong diets, overweight or obesity, metabolic syndrome and excessive alcohol consumption. Therefore, the promotion of healthful lifestyles would yield great benefits in reducing the burden of ED. The treatment of diabetic ED is multimodal. The treatment of the underlying hyperglycaemia and comorbidities is of utmost importance to prevent the progression of the disease. The peripherally acting oral phosphodiesterase type 5 inhibitors are the mainstay of oral medical treatment of ED in diabetics. Vacuum erection devices are an additional a non-invasive treatment option. The local administration of vasoactive medication through urethral suppository or intracorporal injection can be effective with minimal side-effects.

A Cross-Sectional Study According to Risk Factors Associated with Erectile Dysfunction in Men

Background: Erectile dysfunction (ED) is a common condition in general population. It has a negative impact on the couple’s quality of life. In 1995, it was estimated that it affected 152 million people worldwide, and that it would affect more than 322 million people in 2025 with a large increase in developing countries. Several studies have suggested a causal link between ED and cardiovascular disease. In the Democratic Republic of Congo, no studies exist on this subject. Nonetheless, we are seeing increased promotion on the management of sexual disorders in our media, which could testify to the extent of this problem. Objective: To assess the extent of cardiovascular risk factors for ED in Kinshasa. Material and Methods: This is a cross-sectional study for analytical purposes. It collected several categories of individuals from May 1 to October 31, 2018. The severity of ED was assessed by the IIEF-5 score and the associated risk factors sought via logistic regression. Results: The mean age of the respondents was 59.9 ± 19.2 years, more than half of the respondents were over the age of 60 years old (60%). The ED proportion was 78.8%, and 75% of respondents had at least moderate ED. This anomaly was significantly elevated among respondents aged over 60 years (94.8%), diabetics (87.5%), hypertensive patients (92.3%) and stroke victims (86%). The independently associated risk factors were: age > 60 years [ORa: 9.87; 95% CI: 6.42 - 10.48, p p = 0.013] and the stroke [ORa: 2.1; 95% CI: 1.36 - 3.39; p = 0.012%]. The age threshold predicting ED was 67 years. Conclusion: ED is a frequent disorder in our environment and likely to affect the quality of life of men who suffer from it. There is an ED and cardiovascular risk factors correlation. A proactive attitude of the caregiver in current practice would allow early detection of ED with a view to early and optimal management.

Elevated Total Testosterone Level in an Adult with Erectile Dysfunction

Erectile dysfunction affects a growing number of men with a significant impact on social function. The cause may be medical and psychological both. Of many risk factors for erectile dysfunction, hyperthyroidism can lead to increased total testosterone by an increase in sex hormone-binding globulin secreted from the liver. Here, we present a case of an adult male with a high total testosterone level who complained of erectile dysfunction. On a complete review of medical history and additional laboratory tests, the diagnosis of hyperthyroidism leading to increased total testosterone was made. The complete review of the patient’s history before hormonal analysis helps to troubleshoot the mismatch between clinical symptoms and laboratory results.

The erection conundrum: risk factors for erectile dysfunction among middle-aged and elderly men in Lamongan, East Java, Indonesia

Background: The most common sexual problem affecting the general population of men is Erectile Dysfunction (ED) with a global estimated number of over 100 million. It affects the biological, psychological, and social aspect of life which can cause frustration, depression, and anxiety. Unfortunately, the attention towards the disease in Indonesia is often overlooked as evidenced by the lack of studies regarding the prevalence and risk factors for the disease. This study aims to evaluate possible risk factors of Erectile Dysfunction among elderly males in Lamongan, East Java.Methods: This is a quantitative study with an analytical observational design, performed using a case-control approach. Respondents consisted of male inpatients as well as outpatients aged 40 years or more in Ngimbang General Hospital evaluated using the International Index of Erectile Function (IIEF) questionnaire. The patient’s comorbid data are taken from the Medical Record to ensure proper diagnosis. The acquired data are then analysed using the ordinal logistic regression method.Results: A total of 174 men were evaluated. There are 62 people with no ED (35.6%), 39 people with mild ED (22.4%), 35 people with mild to moderate ED (20.1%), 16 people with moderate ED (9.2%), and 22 people with severe ED (12.6%). Significant risk factors are older age (OR: 1.29; CI: 1.23-1.37), Diabetes (OR: 6.56; CI: 2.77-15.56), and hypertension (OR: 5.19; CI: 2.27-11.88) (all, p &lt; 0.05); whereas dyslipidemia and smoking habit are insignificant (p&gt;0.05).Conclusion: Age, diabetes, and hypertension are significant risk factors for Erectile Dysfunction.

Erectile dysfunction: An emerging component of metabolic syndrome?

Objective: To evaluate the association of erectile dysfunction(ED) with risk factors of metabolic syndrome (MS). Materials and Methods: The study was conducted in 60 male subjects visiting the outpatient Department of Urology, out of which 30 subjects had vasculogenic erectile dysfunction evidenced by the IIIEF-5 scoring system. A score of 22 and above was considered as no ED and a score of 21 and less was considered positive for ED. Participants with a known history of spinal cord/ pelvic injury, vascular surgery, multiple sclerosis, cardiac diseases, bronchial asthma, severe genital anatomic defects, chronic renal failure, liver cirrhosis, long term hypertensives, and hypogonadism were excluded. Anthropometric analysis was done. Blood pressure, height, and weight were measured. BMI was calculated. 12hour fasting blood glucose and lipid profile were measured. Results: The mean BMI of the cases and controls was 27.7 2.01 kg/m2 and 23.2 1.88 kg/m2 respectively, which was statistically significant (p were obese. A significant statistical difference (p triglycerides(TG), low-density lipoprotein(LDL), very low- density lipoprotein(VLDL) between the two groups. The mean HDL was low in cases but no significant difference was seen (p >0.05). Conclusion: As our study showed a positive correlation between the risk factors of MS and ED, ED should be considered as a predictive factor for a cardiac event. All men should be questioned about their sexual history and erectile function as a part of the initial assessment of cardiovascular disease riskTo evaluate the association of erectile dysfunction(ED) with risk factors of metabolic syndrome (MS). Keywords: Erectile dysfunction, Metabolic syndrome, Risk factor, Initial assessment.

Treatment with nitrite prevents reactive oxygen species generation in the corpora cavernosa and restores intracavernosal pressure in hypertensive rats

Hypertension is a risk factor for erectile dysfunction (ED) and both conditions are associated with oxidative stress. Given that nitrite is described to display antioxidant effects, we hypothesized that treatment with nitrite would exert antioxidant effects attenuating both reactive oxygen species (ROS) generation in the corpora cavernosa (CC) and ED induced by hypertension. Two kidney, one clip (2K1C) hypertension was induced in male Wistar rats. Treatment with sodium nitrite (15 mg/kg/day, p.o., gavage) was initiated two weeks after surgery to induce hypertension and maintained for four weeks. Nitrite abrogated both the decrease in intracavernosal pressure and endothelial dysfunction of the CC induced by hypertension. Treatment with nitrite decreased hypertension-induced ROS generation in the CC assessed in situ using the fluorescent dye dihidroethidium (DHE) and with the lucigenin assay. Western immunoblotting analysis revealed that nitrite prevented the increase in Nox1 expression in the CC from 2K1C rats. Decreased concentrations of hydrogen peroxide (H2O2) were found in the CC from hypertensive rats and treatment with nitrite prevented this response. Treatment with nitrite increased the fluorescence of DAF-2DA in the CC from sham-operated rats and restored nitric oxide (NO) levels in the CC from 2K1C rats. In summary, we found novel evidence that nitrite reversed the decrease in intracavernosal pressure induced by 2K1C hypertension. This response was partially attributed to the antioxidant effect of nitrite that blunted ROS generation and endothelial dysfunction in the CC. In addition, nitrite-derived NO may have promoted direct protective actions against hypertension-induced CC dysfunction.

Prevalence of and risk factors for erectile dysfunction in young nondiabetic obese men: results from a regional study.

Erectile dysfunction (ED), a condition closely related to cardiovascular morbidity and mortality, is frequently associated with obesity. In this study, we aimed to determine the prevalence of ED and evaluate the associated risk factors in a cohort of 254 young (18–49 years) nondiabetic obese (body mass index [BMI] ≥30 kg m−2) men from primary care. Erectile function (International Index of Erectile Function [IIEF-5] questionnaire), quality of life (Aging Males' Symptoms [AMS scale]), and body composition analysis (Tanita MC-180MA) were determined. Total testosterone was determined using high-performance liquid chromatography–mass spectrometry. Multivariate logistic regression analysis was used to study the factors associated with ED. ED prevalence was 42.1%. Subjects with ED presented higher BMI, waist circumference, number of components of the metabolic syndrome, AMS score, insulin resistance, and a more unfavorable body composition than those without ED. Multivariate logistic regression analysis showed that a pathological AMS score (odds ratio [OR]: 4.238, P < 0.001), degree of obesity (BMI ≥40 kg m−2, OR: 2.602, P = 0.005, compared with BMI 30–34.9 kg m−2), high-density lipoprotein (HDL)-cholesterol levels (OR: 0.956, P = 0.004), and age (OR: 1.047, P = 0.016) were factors independently associated with ED. In conclusion, we demonstrate that, in a primary care-based cohort of nondiabetic young obese men, ED affected >40% of subjects. A pathological AMS score, the degree of obesity, and age were positively associated with ED, while elevated HDL-cholesterol levels were inversely associated with the odds of presenting ED. Further prospective studies are needed to evaluate the long-term consequences of ED in this population.

P806High normal blood pressure and vascular parameters in patients with erectile dysfunction

Abstract Purpose High blood pressure (BP) is a common risk factor for erectile dysfunction (ED) which is considered as an early clinical manifestation of generalized vascular disease. High–normal BP (130–139/85–89 mmHg) is associated with high rates of progression to hypertension. Aim of the study is to examine vascular and structure parameters of patients with high-normal BP complaining of ED. Methods We assessed macrovascular and microvascular (penile vascular damage) changes in four age-matched groups without a history of diabetes and cardiovascular disease; Normal BP (n=162), high-normal BP (n=87), stage I hypertension (n=49) and stage II and III hypertension (n=44). All hypertensive patients were not receiving antihypertensive therapy. Indices of vascular function and structure including carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), carotid intima media thickness (cIMT) and microvascular damage (penile vasculature) were evaluated in all patients. Microvascular damage was examined by measuring penile peak systolic velocity (PSV) with a dynamic penile color Doppler ultrasonography after intracavernous injection of prostaglandin E1. Lower PSV values indicate severe penile vascular disease. Results Body-mass index (BMI) was significantly higher in patients with hypertension and patients with high- normal BP compared to subjects with normal BP. Smoking prevalence and LDL-C level were not different between the four subgroups. Figure shows a progressive increase in PWV and cIMT from normal BP group, to patients with high- normal BP and to untreated patients with hypertension. Compared to patients with normal BP, patients with high- normal BP had significantly higher PWV (p&lt;0.01), cIMT (p&lt;0.05), AIx (p&lt;0.05) and lower penile PSV (p&lt;0.01). Interestingly, figure shows that the individuals with high- normal BP level and patients with stage I hypertension had similar AIx and penile PSV denoting no difference in central haemodynamics and penile vasculature between the two groups. High-normal BP and vascular parameters Conclusions Middle-aged men with high-normal BP have significant microvascular and macrovascular damage compared to subjects with normal BP. The ultrasonographically documented functional changes in the vascular wall of the smaller in size penile vasculature are similar to that of men with stage I arterial hypertension. These findings bring new insights into the clinical significance of high- normal BP, which might be a premising therapeutic target for men with ED who are considered to be at a higher cardiovascular risk.

Prevalence and risk factors for erectile dysfunction in HIV-infected patients in Salvador, Brazil

BackgroundEffective antiretroviral therapy (ART) has increased life expectancy for HIV patients to levels close to that observed for general population. Comorbidities are also increasing, due to ageing of such population. Erectile dysfunction (ED) has been a frequent finding in men living with HIV. ObjectivesThe goals of the present study were to define the prevalence of ED and associated factors in HIV-infected men, in a referral center of Salvador city, Brazil. MethodsHIV-infected men ≥18 years of age, receiving care at the AIDS Clinics of Complexo Hospitalar Professor Edgard Santos (C-HUPES), Universidade Federal da Bahia were consecutively included in the study until the estimated sample size (N=134) was reached. Patients filled a structured questionnaire on clinical-epidemiological characteristics, as well as the International Index on Erectile Function to assess ED. ResultsMost (55%) were black and single (79%), mean age 44.8 years. ED was detected in 29 (21.6%) patients; 86% of ED cases were classified as severe. The only factors associated with ED were low income (p=0.02) and unemployment (p=0.01). No association was found between ED and frequency of comorbidities, age, or ART used by patients. ConclusionIn a referral center in Salvador city, socio-economic problems were the main factors associated with ED. Psychological impact of poor social conditions should be routinely assessed in patients with ED to implement preventive measures for ED.