Risk Of Erectile Dysfunction In Men Research Articles

COVID-19 is Associated with New Onset Erectile Dysfunction: Insights From a Multinational Registry

IntroductionAs the COVID-19 pandemic has been ongoing since 2019, we are just beginning to see some of the short and long-term effects of infection. Vascular integrity is necessary for erectile function, and endothelial damage associated with COVID-19 is likely to affect the penile vasculature. Recent studies have showed evidence of COVID-19 virus within penile tissue through electron microscopy. We hypothesized that the COVID-19 infection may be a contributing factor to subsequent development of erectile dysfunction (ED).ObjectiveTo determine if men with recent COVID-19 infection was associated with subsequent increased risk for development of erectile dysfunction.MethodsWe assessed the risk of ED in men with COVID-19 in the United States (US) using the TriNetX Research Network, a federated EMR network of over 42 healthcare organizations and 66 million patients from the US, from 2009-2020. We identified adult men (≥18 years) with a recorded COVID-19 infection (ICD-10-CM B34.2, U07.1, U07.2, J12.81, J12.82, B97.29) since January 1, 2020 and compared them to an equivalent number of adult men who had COVID-19. Men with prior history or diagnosis of ED were excluded. We accounted for confounding variables through propensity score matching for age, race, body mass index (BMI), and history of the following comorbid medical conditions: diabetes mellitus (ICD-10-CM E11), hypertension (ICD-10-CM I10), or hyperlipidemia (ICD-10-CM E78). We assessed the association between COVID-19 and ED (ICD-10-CM N52) as a primary outcome through regression analysis with statistical significance assessed at p<.05.ResultsPrior to propensity score matching, men with COVID-19 had an average age of 47.1 + 21.4 years, 13% had diabetes mellitus, and 27% had hypertension, while in men without COVID-19, average age was 42.4 + 24.3 years, 7% had diabetes, and 22% had hypertension. After propensity score matching, we compared 230, 517 men with COVID-19 to 232,645 men without COVID-19 and found that COVID-19 diagnosis was significantly associated with ED (OR 1.120, 95% CI 1.004-1.248, p=0.0416). Strengths include large sample size and adjustment for confounding variables. Limitations include lack of data regarding ED (mild vs moderate vs severe) or COVID-19 infection severity.ConclusionsOur study showed that there is an increased risk of developing ED post-COVID infection, suggesting possible long-term effects due underlying endothelial dysfunction. The exact mechanism of how COVID-19 virus leads to erectile dysfunction remains to be elucidated.DisclosureNo

The Association Between Pelvic Discomfort and Erectile Dysfunction in Adult Male Bicyclists

BackgroundBicycle riding's impact on erectile function remains a topic of great interest given cycling's popularity as a mode of transportation and exercise. AimWe evaluated risk factors for sexual dysfunction in male cyclists with the primary intention of determining if genital/pelvic pain and numbness are associated with erectile dysfunction (ED). MethodsWe surveyed male cyclists using an online anonymous questionnaire. Cyclists were queried on their demographics, cycling experience, and sexual function using the Sexual Health Inventory for Men (SHIM). ED was diagnosed when a completed SHIM score was <22. Regression analysis was used to evaluate the risk of ED in men with genital/pelvic pain or numbness after riding. The survey was designed in the United States. OutcomesQuantitative characterization of cycling habits, onset and timing of genital pain and numbness, and SHIM score. ResultsA total of 1635 participants completed the survey. A majority of men were over the age of 50 (58%, 934/1,607), Caucasian (88%, 1,437/1,635), had been active cyclists for over 10 years (63%, 1,025/1,635) and used road bikes (97%, 1,578/1,635). Overall, 22%, 30%, and 57% of men reported ED, genital pain, and genital numbness, respectively. While controlling for cohort demographics, body mass index, cycling intensity and equipment, and medical comorbidities, no saddle characteristics were associated with the risk of developing genital numbness. However, men reporting penile numbness were at higher risk of reporting ED (odds ratio [OR] = 1.453, P = .048). In addition, quicker onset of numbness and resolution of numbness within a day was associated with impaired erectile function. For example, numbness occurring less than 1 hour after cycling had greater odds of leading to ED than numbness after 5 hours (OR = 2.002, P = .032). Similarly, genital pain occurring less than 1 hour (OR = 2.466, P = .031) after cycling was associated with higher ED risk. Strengths & LimitationsStrengths include a large sample size of high-intensity cyclists and validated questionnaire use. Limitations include reliance on anonymous self-reported survey data and minimal inquiry into the riding preferences and terrain traversed by cyclists. ConclusionsPelvic pain and numbness are common complaints among male riders in the United States. Men with such complaints are more likely to also report ED especially if it occurs earlier in the ride. Although direction of causality and temporality are uncertain, alleviation of factors resulting in pelvic discomfort may reduce cycling's impact on sexual function. Such interventions are critical given that cycling for both active travel and aerobic exercise confers numerous health benefits.Balasubramanian A, Yu J, Breyer BN, et al. The Association Between Pelvic Discomfort and Erectile Dysfunction in Adult Male Bicyclists. J Sex Med 2020;17:919–929.

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

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

MP09-17 5-ALPHA REDUCTASE INHIBITORS FOR TREATMENT OF BENIGN PROSTATIC HYPERPLASIA DOES NOT INCREASE THE RISK OF ERECTILE DYSFUNCTION

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Medical & Non-surgical Therapy1 Apr 2017MP09-17 5-ALPHA REDUCTASE INHIBITORS FOR TREATMENT OF BENIGN PROSTATIC HYPERPLASIA DOES NOT INCREASE THE RISK OF ERECTILE DYSFUNCTION Katrina Hagberg, Hozefa Divan, Rebecca Persson, Susan Jick, and J. Curtis Nickel Katrina HagbergKatrina Hagberg More articles by this author , Hozefa DivanHozefa Divan More articles by this author , Rebecca PerssonRebecca Persson More articles by this author , Susan JickSusan Jick More articles by this author , and J. Curtis NickelJ. Curtis Nickel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.325AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES 5-alpha reductase inhibitors (5ARIs) have been reported to increase the risk of erectile dysfunction (ED) in patients treated for benign prostatic hyperplasia (BPH); however BPH itself is an ED risk factor (potential confounding by indication). We conducted a cohort study with nested case-control analyses using the United Kingdom's Clinical Practice Research Datalink to estimate the risk of ED in men who used 5ARIs for the treatment of BPH. METHODS We identified men aged 40+ with BPH who received at least one prescription for a 5ARI (finasteride or dutasteride), alpha blocker (AB), or both. Exposures were classified as 5ARI only, 5ARI+AB, and AB only. Cases were men who had a first ED diagnosis or treatment (surgery or phosphodiesterase type-5 inhibitor prescription) during follow-up. We calculated incidence rates (IRs) and adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CIs). We also conducted a nested case-control analysis to control for major confounders and calculated adjusted odds ratios (ORs) with 95%CIs. RESULTS We identified 71,849 men, among whom 5,814 were identified as new cases of ED over the 20 year study period (1992-2011). The incidence rate of ED was lowest among users of 5ARI only (15.3 per 1000 person-years) and similar among users of 5ARI+AB (19.2 per 1000 person-years) and AB only (20.1 per 1000 person years). The risk of ED was not elevated with use of 5ARI only (IRR=0.92, 95%CI 0.85-0.99) or 5ARI+AB (IRR=1.09, 95%CI 0.99-1.21) in comparison with AB only. In the nested case-control analysis, ORs were 0.94 (95%CI 0.85-1.03) for 5ARI only and 0.92 (95%CI 0.80-1.06) for 5ARI+AB, compared to AB only, and remained null regardless of number of prescriptions or exposure timing. The risk of ED increased with longer duration of BPH, independent of exposure. CONCLUSIONS In a large, 20 year, real world observational study, 5ARI therapy for BPH does not significantly increase the risk of clinically meaningful incident ED compared to AB treatment. Risk of ED increased with longer duration of BPH. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e106-e107 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Katrina Hagberg More articles by this author Hozefa Divan More articles by this author Rebecca Persson More articles by this author Susan Jick More articles by this author J. Curtis Nickel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Erectile Dysfunction in Male Adults With Atopic Dermatitis and Psoriasis

IntroductionPatients with psoriasis have increased risk of cardiovascular disease, but data on atopic dermatitis (AD) are less clear-cut. However, it is well-established that erectile dysfunction (ED) can serve as a risk marker for coronary disease. AimTo investigate the incidence, prevalence, and risk of ED in men with psoriasis and AD. MethodsThe sample included all Danish men at least 30 years old. In patients with AD and psoriasis, we determined disease severity based on use of systemic therapy. We performed a cross-sectional study (January 1, 2008) using logistic regression to estimate the prevalence and odds ratio of ED. Moreover, in a cohort study design, patients were followed from January 1, 2008 through December 31, 2012, and Cox regression models were used to estimate adjusted hazard ratios of new-onset ED. Models were adjusted for potential confounding factors, including age, socioeconomic status, health care consumption, smoking, alcohol abuse, diabetes, and cholesterol-lowering drug use. Main Outcome MeasuresThe outcome was initiation of pharmacotherapy used for treatment of ED. ResultsThe sample consisted of 1,756,679 Danish men (age range = 30–100 years), of which 2,373 and 26,536 had adult AD (mild = 1,072; severe = 1,301) and psoriasis (mild = 21,775; severe = 4,761), respectively. Mean ages (SDs) were 53.0 (14.6), 46.7 (12.0), and 56.3 (13.8) years for the general population, patients with AD, and patients with psoriasis, respectively. Prevalences of ED were 8.7%, 6.7%, and 12.8% for the general population, patients with AD, and patients with psoriasis, respectively. Adjusted odds ratios (logistic regression) of ED were decreased in patients with AD (0.68; 0.57–0.80) but increased in those with psoriasis (1.15; 1.11–1.20). Adjusted odds ratios for mild and severe AD were 0.63 (0.48–0.82) and 0.72 (0.58–0.88), respectively, and those for psoriasis these were 1.16 (1.11–1.21) and 1.13 (1.03–1.23). Adjusted hazard ratios (Cox regression) were 0.92 (0.76–1.11) for AD and 1.14 (1.08–1.20) for psoriasis. The ED risk was not increased in men with mild AD (0.85; 0.63–1.14) or severe AD (0.97; 0.76–1.24) but was significantly increased in men with mild psoriasis (1.13; 1.09–1.20) and severe psoriasis (1.17; 1.04–1.32). ConclusionWe found an increased prevalence and risk of ED in men with psoriasis, whereas the risk was comparable to (and even slightly lower than) the general population for men with AD.Egeberg A, Hansen PR, Gislason GH, et al. Erectile Dysfunction in Male Adults With Atopic Dermatitis and Psoriasis. J Sex Med 2017;14:380–386.

Erectile dysfunction as a marker for cardiovascular disease diagnosis and intervention: a cost analysis.

Erectile dysfunction (ED) is a risk factor for cardiovascular disease (CVD). We examine the costs of screening men with ED for CVD risk factors and the cost savings of treating these at risk men. This study aims to evaluate the effect of screening men presenting with ED for CVD risk factors and to determine the cost effectiveness of this screening protocol. The known incidence and prevalence of ED and CVD, the rate of undiagnosed CVD, and the effects of CVD treatment were used to model the change in prevalence of acute CVD events and ED as a function of the number of men with ED and CVD. The cost savings associated with reduction in acute cardiovascular (CV) events and ED prevalence was estimated over 20 years. Acute CVD event rate reduction and associated cost savings were modeled over 20 years. The relative risk of ED in men with CVD is 1.47 and the coprevalence of both ED and CVD was estimated at 1,991,520 men. Approximately 44% of men with CVD risk factors are unaware of their risk. If all men presenting with ED were screened for CVD, 5.8 million men with previously unknown CVD risk factors would be identified over 20 years, costing $2.7 billion to screen. Assuming a 20% decrease in CV events as a result of screening and treatment, 1.1 million cardiovascular events would be avoided, saving $21.3 billion over 20 years. Similarly, 1.1 million cases of ED would be treated, saving $9.7 billion. Together, the reduction in acute CVD and ED treatment cost would save $28.5 billion over 20 years. Screening for CVD in men presenting with ED can be a cost-effective intervention for secondary prevention of both CVD and, over the longer term, ED.