Severe Erectile Dysfunction Group Research Articles

(201) Impact of a Natural Mixture with the Black Chocolate, Chili, Spices in Order to Improve Male Sexual Function

Abstract Introduction The Aztec emperor Montezuma was reported to have drunk up to fifty cups a day of chocolate with chili and spices in it. He had to keep up his stamina to satisfy his many wives. It is thought that the ingredients of this mixture dilates the blood vessels and creates energy and focus. Objective Referring to Montezuma, the purpose of this study was to verify whether is enough to drink every night one cup as Montezuma, by ED men making a nice intercourse with their partners’ women, at least once a week. Methods 101 patients with erectile dysfunction (ED) were enrolled between January 2014 and December 2017. Patients were classified as having mild (47), moderate (38) or severe (16) ED. Mean age was 50.3 years. A cup with black chocolate, chili and spices in it was administered by each patient, every night for 12 weeks. International Index of Erectile Function-Erectile Function (IIEF-EF) questionnaire was administered pre and post-treatment with all pts. Patients with concomitant medical diseases were excluded. Results IIEF-EF scores were significantly improved, with an increase of 79% in the mild ED group, an 83% improvement in the moderate ED group, and an improvement of 67% in the severe ED group compared with the baseline. The mean IIEF-EF scores for all patients showed significant improvement after 12 weeks of treatment (baseline 14.3±1.5 to 26.2 ±3.3; P= 0.01). Among other parameters penile rigidity and tumescence, showed significant improvement for all patients. No, significant side effects. Conclusions The black chocolate, chili and spices when mixed together, seem to work in synergy improving erectile function and in patients with ED, too. We reached the goal that nearly all patients performed a nice intercourse, once a week with their partners’ women. This study tell that what they quote about Emperor Montezuma are in fact true. Disclosure No.

Association between erectile dysfunction and Helicobacter pylori, folic acid, vitamin B12, and homocysteine: a cross-sectional study.

Previous studies have shown that Helicobacter pylori (Hp) infection is associated with erectile dysfunction (ED), but the mechanism is unclear. To assess the relationship between ED and Hp, folic acid (FA), vitamin B12 (B12), and homocysteine (HCY). This study included 84 patients with ED and 42 healthy men. We adopted an IIEF-5 score <21 (5-item International Index of Erectile Function) as the diagnostic criterion for ED, and the RigiScan monitoring device was used to preliminarily screen for and rule out psychogenic ED. Levels of Hp immunoglobulin G (Hp-IgG) titer, FA, B12, and HCY were compared between the ED group and the non-ED group, and the correlation between the indicators was evaluated. The median Hp-IgG titer was higher in the ED group than the control group (32.34 vs 20.88, P < .001). The ED group had lower median levels of B12 (195 vs 338, P < .001) and FA (4.66 vs 10.31, P < .001) and a higher median level of HCY (12.7 vs 8.1, P < .001). Multivariate logistic regression analysis showed that the level of FA (odds ratio,0.111; 95% CI, 0.031-0.399; P < .001) was an independent risk factor for ED. Specifically, FA level was significantly higher in the moderate ED group than the severe ED group, which had a higher median Hp-IgG titer and lower level of B12; although not significant, this was still a clinical trend. Hp-IgG titer was negatively correlated with levels of FA (r = -0.601, P < .001) and B12 (r = -0.434, P < .001) and with the IIEF-5 score (r = -0.382, P < .001) and positively correlated with HCY (r = 0.69, P < .001). The ED group had higher levels of Hp-IgG titer and HCY and lower levels of B12 and FA. This study is the first to link Hp infection, FA, B12, and HCY and further explain the relationship between these indicators and the underlying pathologic mechanisms that jointly cause ED. The limitation is that our study was based on Hp-IgG titers, which do not necessarily represent the full extent of Hp infection, despite the avoidance of invasive testing. Hp infection might lead to decreased FA and B12 and then increased HCY, which might be a mechanism leading to ED. Hp eradication or FA and B12 supplementation might have certain clinical value in the treatment of vascular ED.

Association between Advanced Glycation End-Products, Carotenoids, and Severe Erectile Dysfunction.

To investigate the association between skin advanced glycation end-products (AGEs) levels, blood antioxidative vitamin and carotenoid concentrations, and severe erectile dysfunction (ED) in community-dwelling men. This cross-sectional study used the 5-Item International Index of Erectile Function to identify 335 community-dwelling men with ED. The accumulation of skin AGEs was assessed noninvasively by measuring skin autofluorescence. Background-adjusted multivariable logistic regression analyses using the inverse probability of treatment weighting method were performed to evaluate the effects of AGEs, vitamins, and carotenoids on severe ED. Moreover, multiple linear regression analyses were performed to assess the association between skin AGEs levels and serum carotenoid concentrations. The median age of study participants was 57 years. Of the 335 men, 289 (86.3%) and 46 (13.7%) were classified into the mild/moderate and severe ED groups, respectively. Multivariable analyses revealed that skin AGEs levels, blood vitamins C and E, lutein, zeaxanthin, β-cryptoxanthin, α-carotene, β-carotene, total lycopene, and cis-lycopenes concentrations were significantly associated with severe ED, whereas all-trans lycopene concentrations were not. In the multiple linear regression analyses, serum zeaxanthin concentrations were negatively and significantly correlated with skin AGEs levels. Higher skin AGEs levels and lower blood antioxidative vitamin and carotenoid concentrations were significantly associated with severe ED. Serum zeaxanthin levels were negatively and significantly correlated with skin AGEs levels, suggesting the possible effects of zeaxanthin on ED by decreasing tissue AGEs levels.

Can Erectile Dysfunction Severity Predict Major Adverse Cardiovascular Events in Men Undergoing Dialysis? A Prospective Cohort Study.

To evaluate the impact of severe erectile dysfunction (ED) on future major adverse cardiovascular events (MACE) in men on dialysis. This prospective cohort study included 71 men on dialysis. ED was assessed using the Sexual Health Inventory for Men (SHIM). Men were divided into the mild/moderate ED (SHIM score ≥8) and severe ED (SHIM score ≤7) groups. The primary endpoint was MACE-free survival. MACE was a composite of myocardial infarction, cardiovascular death, and stroke. The secondary endpoints were cardiac event-free survival and overall survival (OS). Moreover, the predictive abilities of severe ED for 5-year MACE, 5-year cardiac events, and 5-year overall mortality were evaluated. The median age and follow-up period of the included men were 64 years and 58 months, respectively. The median SHIM score was 4.0; all had a degree of ED, and 64.7% had severe ED. In the background-adjusted multivariable analyses, severe ED was not significantly associated with shorter MACE-free survival (hazard ratio [HR], 1.890; 95% confidence interval [CI], 0.533-6.706; p=0.324), cardiac event-free survival (HR, 2.081; 95% CI, 0.687-6.304; p=0.195), and OS (HR, 0.817; 95% CI, 0.358-1.863; p=0.630). Severe ED did not significantly improve the predictive abilities for 5-year MACE, 5-year cardiac events, and 5-year overall mortality (p=0.110, p=0.101, and p=0.740, respectively). ED severity was not associated with shorter MACE-free survival, cardiac event-free survival, or OS, and ED severity could not improve the predictive abilities for these outcomes in men undergoing dialysis.

Correlation analysis of carotid artery intima-media thickness, serum 25(OH)D and men with erectile dysfunction.

Our goal is to investigate the connection between serum 25(OH)D and carotid artery intima-media thickness (CIMT) in men with erectile dysfunction (ED).Serum 25(OH)D and CIMT were measured in 124 participants with erectile dysfunction and 39 healthy controls. The relationship between them and different patient-related parameters and disease-related parameters was studied. Compared with the control group and mild ED group, the level of serum 25(OH)D in moderate ED group and severe ED group decreased significantly(P<0.05). The CIMT values of moderate ED group and severe ED group were higher than those of the control group(P<0.05). The CIMT value of severe ED group was significantly higher than that of mild ED group(P<0.05). IIEF-5 score was positively correlated with serum 25(OH)D level, but negatively correlated with CIMT value(P<0.05). After adjusting for the influence of confounding factors, The CIMT values, 25(OH)D and IIEF-5 score were substantially associated(P<0.05). The serum level of 25(OH)D and IIEF-5 score were positively correlated, while the CIMT values and IIEF-5 score were negatively correlated. The level of serum 25(OH)D should be analyzed in men with ED, especially in patients with vasculogenic ED, and supplementation is recommended for those who were with vitamin D deficiency.

The correlation between erectile function and adiponectin levels in men with late-onset hypogonadism

Aim: This study investigated the relationship between erectile dysfunction (ED) and adiponectin levels in hypogonadal men. Methods: In this study, 218 patients with hypogonadism (mean age: 65.1 ± 8.3 years) were enrolled. All patients underwent physical examinations, with measurement of body mass index, body fat ratio, and waist circumference. The erectile function was assessed using the sexual health inventory for men (SHIM) scoring system. Blood biochemical profiles such as free testosterone, fasting blood glucose, and lipid profile including adiponectin levels were measured. All patients were divided into two groups based on their SHIM score: normal to moderate ED (SHIM score ≥ 12) and severe ED (SHIM score < 12), and the factors associated with severe ED were determined. Patients with severe ED were divided into two groups based on adiponectin levels (cutoff value of 7.0 μg/mL), and their basic characteristics were compared between these two groups. Results: The severe ED group was older and had higher adiponectin levels. In patients with severe ED, various metabolic parameters were significantly worse in the low adiponectin groups than in the non-low adiponectin group. Conclusions: The risk of developing cardiovascular diseases is extremely high in hypogonadal men with severe ED who had lower serum adiponectin levels.

Relationships of low-grade systemic inflammation and nutritional status with erectile dysfunction severity in men on dialysis.

Low-grade systemic inflammation and malnutrition are frequently observed in patients on dialysis and contribute to the development of endothelial dysfunction; however, the role of these conditions in erectile dysfunction (ED) severity remains to be elucidated. To investigate the relationships of low-grade systemic inflammation and nutritional status with ED severity in men on dialysis. The present study included 71 men on dialysis. The sexual health inventory for men (SHIM) was used to assess ED. Men were classified as the mild/moderate (SHIM score ≥ 8) and severe ED (SHIM score ≤ 7) groups. C-reactive protein/albumin ratio (CAR) and Geriatric Nutritional Risk Index (GNRI) were used to evaluate low-grade systemic inflammation and nutritional status, respectively. We performed multivariate analysis to assess the relationships of CAR and GNRI with severe ED. The median age of the included men was 64 years old. All men had any degree of ED with 65% having severe ED. In the univariate analyses, a significant association was observed between elevated CAR (≥0.09) and severe ED (odds ratio [OR]: 4.038, p=0.025), whereas no significant association was observed between lower GNRI(&lt;92) and severe ED (OR: 2.357, p=0.109). In the multivariate analysis, an association between elevated CAR and severe ED was still significant (OR: 5.985, p=0.010). Low-grade systemic inflammation was significantly associated with ED severity, whereas lower GNRI was not. These results may be helpful for further research to identify the optimal treatment for men suffering from severe ED.

Association between Aortic Calcification Burden and the Severity of Erectile Dysfunction in Men Undergoing Dialysis: A Cross-Sectional Study.

Accelerated atherosclerosis is a major complication in patients with end-stage renal disease and it plays an important role in the pathogenesis of erectile dysfunction (ED). However, the association between aortic calcification burden and the severity of ED remains unclear. The aim of the present study was to investigate this association in men undergoing dialysis. This cross-sectional study included 71 men undergoing peritoneal dialysis and/or hemodialysis between July 2016 and May 2018 at Mutsu General Hospital. ED was assessed with the Sexual Health Inventory for Men (SHIM). Patients were divided into the mild/moderate (SHIM score ≥8) and severe ED groups (SHIM score ≤7). Aortic calcification index (ACI) was examined as a clinical indicator of abdominal aortic calcification. Multivariable logistic regression analysis was performed to identify the significant factors associated with severe ED. The median age of the study participants was 64 years; all had ED, with 64.8% having severe ED. In the multivariable analyses, a slight association was observed between ankle-brachial index and severe ED (odds ratio [OR], 0.058; p=0.072), whereas ACI was significantly associated with severe ED (OR, 1.022; p=0.022). Aortic calcification burden was independently associated with severe ED.

Associations of impaired grip strength and gait function with the severity of erectile dysfunction in men undergoing dialysis: a cross-sectional study

Objective To investigate the associations of impaired muscle strength and gait function with the severity of erectile dysfunction (ED) in men undergoing dialysis. Methods This cross-sectional study included 63 men undergoing dialysis. ED was assessed with the Sexual Health Inventory for Men (SHIM). Patients were divided into the mild/moderate (SHIM score ≥8) and severe ED groups (SHIM score ≤7). Correlations between variables were analyzed using Spearman’s rank correlation coefficient. Multivariable logistic regression analyses were performed to evaluate the impact of impaired grip strength and gait function on the severity of ED. Results The median age of the study participants was 62 years; all had ED, with 67% having severe ED. Spearman’s rank correlation test demonstrated significant negative and positive correlations between gait function and SHIM score (ρ = −0.257, p = 0.042) and between grip strength and SHIM score (ρ = 0.305, p = 0.015), respectively. In the multivariable analyses, impaired grip strength was significantly associated with severe ED (odds ratio [OR]: 4.965, p = 0.017), whereas gait function was not (OR: 3.147, p = 0.064). Conclusion Impaired muscle strength was significantly associated with severe ED, whereas impaired gait function had a marginal effect on this erectile condition.

MP27-04 BASELINE PREOPERATIVE ERECTILE FUNCTION AND CARDIOVASCULAR MORTALITY AFTER RADICAL PROSTATECTOMY

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation I (MP27)1 Sep 2021MP27-04 BASELINE PREOPERATIVE ERECTILE FUNCTION AND CARDIOVASCULAR MORTALITY AFTER RADICAL PROSTATECTOMY Egor Sokolov, Evgeny Veliev, Ragif Veliev, Andrey Bogdanov, and Dmitry Goncharuk Egor SokolovEgor Sokolov More articles by this author , Evgeny VelievEvgeny Veliev More articles by this author , Ragif VelievRagif Veliev More articles by this author , Andrey BogdanovAndrey Bogdanov More articles by this author , and Dmitry GoncharukDmitry Goncharuk More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002024.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A number of studies show an obvious connection between erectile dysfunction (ED) and the development of cardiovascular diseases (CVD), which occupy one of the leading places in the structure of mortality in cancer patients. In these circumstances, it is potentially promising to use the erectile function (EF) status before surgery as an indicator of the general health of patients and a predictor of overall survival (OS). The objective was to study the causes of death of patients with prostate cancer (PC) after radical prostatectomy (RP) and evaluate OS depending on the preoperative EF. METHODS: The study is based on a series of 2642 RP performed at one medical institution between January 2003 and December 2017 Total of 1203 patients met the inclusion criteria and were divided into two groups: 620 patients with preserved EF or mild preoperative erectile dysfunction (ED) according to the five-item International Index of Erectile Function (IIEF-5) score (group 1) and 583 patients with mild-to-moderate, moderate or severe preoperative ED (group 2). The Mann-Whitney U test and chi-square test were used for statistical analysis. Survival was assessed using the Kaplan-Meier method with a log-rank test. RESULTS: A total of 101 deaths were observed in the study cohort; the median time to death was 72 months. Cardiovascular diseases (CVD) were the cause of death in 43.6% of patients, PC - 30.7%, other oncological diseases - 19.8%, other causes - 5.9%. There were no significant differences between the groups in age, body mass index, or degree of comorbidity. Biochemical relapse was observed in 19.8% in the group with preserved EF and 20.7% in the group with a baseline IIEF score <17 (p = 0.76). In the group with higher EF before RP, there was a tendency to higher 10- and 15-year OS: 92.8% and 83.7% versus 89.7% and 82.5%, respectively (p=0.074). Significant differences between the groups were observed in the mortality from CVD: in the group with higher IIEF score, almost three times less patients died from CVD (12 and 32), and cardiovascular survival was 97.8% and 93.5% versus 96.7% and 91.6% after 10 and 15 years (p=0.0014). CONCLUSIONS: A lower baseline EF is associated with higher cardiovascular mortality in patients after RP. The preoperative IIEF-5 score could be used as one of the predictors of further cardiovascular events and OS of patients. This can be helpful in preoperative selection of patients as well as initial treatment planning. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e473-e473 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Egor Sokolov More articles by this author Evgeny Veliev More articles by this author Ragif Veliev More articles by this author Andrey Bogdanov More articles by this author Dmitry Goncharuk More articles by this author Expand All Advertisement Loading ...

The Relationship Between Gensini Score and Erectile Dysfunction in Patients with Chronic Coronary Syndrome.

IntroductionIn previous studies, the relationship between atherosclerosis and erectile dysfunction (ED) was examined, but the relationship and correlation between Gensini score which evaluates the extent and severity of chronic coronary syndrome (CCS), and ED severity were not investigated.AimTo evaluate the relationship between Gensini score and ED in patients with CCS.MethodsWe included 142 consecutive male patients with the diagnosed CCS and underwent an elective coronary angiography between January 2019 and March 2020.Main Outcome MeasureCorrelation analysis demonstrated that Gensini score significantly negatively correlated with the International Index Erectile Function - 5 (IIEF-5) score (r = -0.417, P < .001).ResultsSevere ED was present in 48 (33.8%) patients, moderate ED in 31 (21.8%) patients, and mild ED in 22 (15.5%) patients. 41(28.9%) patients did not have ED. Both the No ED and Mild ED groups were statistically significantly lower than the Severe ED group in terms of the Gensini score (P < .05). When the recommended optimal cut-off point and accuracy measurements were made for the Gensini score, the area under curve (AUC) value in predicting ED was 0.806 (95% CI: 0.732-0.880, P < .001). Multivariate logistic regression analysis demonstrated that independent predictors for ED were Gensini score and age (P < .001, and P = .026, respectively). Every 1 unit increase in Gensini score resulted in a 6% increase in the occurrence of ED (OR = 1.06, CI:1.03-1.10, P < .001).ConclusionED can be caused by endothelial dysfunction. Patients with severe CSS and high Gensini score should be evaluted for ED. ED may be a sign of severe CCS and a high Gensini score. It is also necessary to evaluate cardiological in patients with ED.Deger M, Ozmen C, Akdogan N, et al. The Relationship Between Gensini Score and Erectile Dysfunction in Patients with Chronic Coronary Syndrome. Sex Med 2021;9:100376.

Onychomycosis and Erectile Dysfunction. Does Common Etiology Cause Togetherness?

Background: We tried to determine the frequency of co-occurrence of erectile dysfunction (ED) and Onychomycosis (OM).&#x0D; Material and Method: The sociodemographic form and IIEF-5 form were filled by the male patients who were admitted to the Urology Polyclinic of Karabük University Medical Faculty with the complaints of ED between April 2019 - April 2020. The patients with ED were included in the study. All the male patients were divided into three groups as mild, moderate and severe according to ED severity. The dermatologist (H.A) examined the presence of OM by taking samples from the toenails of the male patients.&#x0D; Results: Looking at the IIEF-5 scores of 95 patients accepted to the study, it was found that 22 (23.1%) had mild, 20 (21%) moderate and 53 (55.9%) severe ED. Smoking history was higher in the severe ED group (p 0.114).&#x0D; Conclusion: Erectile dysfunction and OM disease can often be seen together. However, no relationship was found with the severity of ED.

Relation of glycated hemoglobin and vitamin D deficiency with erectile dysfunction in patients with type 2 diabetes mellitus.

Erectile dysfunction (ED) is seen very often in the men with type 2 diabetes mellitus (DM). Due to the ability of vitamin D to reduce endothelial damage and oxidative stress, its role in preventing cardiovascular risk has been demonstrated in some studies. Since ED and cardiovascular disease have common pathogenic mechanisms, many studies have evaluated a possible relationship between vitamin D deficiency and ED. Total 120 patients with type 2 diabetes mellitus were evaluated in this study. Vitamin D and HbA1c values were statistically compared according to International Index of Erectile Dysfunction (IIEF-5) scores. 23.3% of 120 patients had mild, 38.3% had mild to moderate, 21.7% had moderate and 16.7% had severe ED. There was statistically difference in vitamin D levels of the patients according to IIEF-5 scores. Also, significant difference was found in HbA1c levels between the patients with severe ED and other groups. Cut-off point for vitamin D and HbA1c were determined according to IIEF-5 score in patients who were divided in to two groups (14.41 and 11.1). A statistically significant correlation was found between both cut-off points and IIEF-5 scores. Our study shows that patients with ED have a vitamin D deficiency and a poor glycemic control.

Seasonal fluctuation of erectile dysfunction: A cross‐sectional study from a tertiary university hospital across 10 years

Erectile dysfunction (ED) shares several risk factors with diabetes mellitus (DM), hypertension (HT) and coronary vascular disease (CVD), which were well-associated with seasonal fluctuation with the highest peak in winter. In this study, we aimed to determine whether ED demonstrates seasonal fluctuations with the above-mentioned systemic diseases. Database from a tertiary university hospital between 2010 and 2020 was deciphered to retrieve patients diagnosed with ED. Patients with primary bladder tumour and post-procedural ED constituted the negative control groups from the same study period. International index of erectile function questionnaire (IIEF-15) was used to segregate included patients into mild/moderate and severe ED groups. The probability of detecting DM, HT and CVD in patients with severe ED was significantly higher than that of with mild/moderate ED (p<0.05). More ED symptoms emerged and were diagnosed in the winter seasons even though no statistical significance was observed between patients with mild/moderate and severe ED (p=0.946, Cramer's V coefficient=0.19). The seasonal variation of patients with bladder tumour and post-procedural ED groups showed no significant difference (p>0.05, both). ED admissions are associated with higher peaks in the winter seasons. This may help in daily clinical practice to warrant better clinical and epidemiological interpretation of ED.

Baseline erectile function and overall survival after radical prostatectomy

Introduction. A number of studies show an obvious connection between erectile dysfunction (ED) and the development of cardiovascular diseases (CVD), which occupy one of the leading places in the structure of mortality in cancer patients. In these circumstances, it is potentially promising to use the erectile function (EF) status before surgery as an indicator of the general health of patients and a predictor of overall survival (OS). Purpose of the study. To study the causes of death of patients with prostate cancer (pca) after radical prostatectomy (RP) and evaluate OS depending on the preoperative EF. Materials and methods . The study is based on a series of 2642 Rp performed at one medical institution between January 2003 and December 2017. Total of 1203 patients met the inclusion criteria and were divided into two groups: 620 patients with preserved EF or mild preoperative erectile dysfunction (ED) according to the five-item International Index of Erectile Function (IIEF-5) score (group 1) and 583 patients with mild-to-moderate, moderate or severe preoperative ED (group 2). The Mann-Whitney U test and chi-square test were used for statistical analysis. Survival was assessed using the Kaplan-Meier method with a log-rank test. Results. A total of 101 deaths were observed in the study cohort; the median time to death was 72 months. Cardiovascular diseases (CVD) were the cause of death in 43.6% of patients, pc — 30.7%, other oncological diseases — 19.8%, other causes — 5.9%. There were no significant differences between the groups in age, body mass index, or degree of comorbidity. Biochemical relapse was observed in 19.8% in the group with preserved EF and 20.7% in the group with a baseline IIEF score &lt;17 (p = 0.76). In the group with higher EF before RP, there was a tendency to higher 10- and 15-year OS: 92.8% and 83.7% versus 89.7% and 82.5%, respectively (p = 0.074). Significant differences between the groups were observed in the mortality from cVD: in the group with higher IIEF score, almost three times less patients died from CVD (12 and 32), and cardiovascular survival was 97.8% and 93.5% versus 96.7% and 91.6% after 10 and 15 years (p = 0.0014). Conclusions. A lower baseline EF is associated with higher cardiovascular mortality in patients after Rp. The preoperative IIEF-5 score could be used as one of the predictors of further cardiovascular events and OS of patients. This can be helpful in preoperative selection of patients as well as initial treatment planning.

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 of pupil responses with severity of erectile dysfunction in diabetes mellitus.

Purpose:To investigate the relation between erectile dysfunction (ED) severity and pupillary functions in patients with diabetes mellitus (DM).Methods:This prospective and observational study included 90 patients with type 2 DM and ED. Patients divided into three subgroups according to severity of ED: (i) Mild ED, (ii) Moderate ED and (iii) Severe ED groups. Thirty age-matched healthy subjects formed the control group. Main outcome measures were pupil diameter and average speed of pupil dilation. Static and dynamic pupillometry analysis was performed using the Sirius Topographer (CSO, Firenze, Italy).Results:Mean pupil diameter during static and dynamic pupillometry analysis were significantly greater in the control group than in the all study groups (P < 0.05). Mean pupil diameter in static pupillometry analysis was significantly different in each study group and pupil was more miotic in the Severe ED group than in the both Moderate and Mild ED groups (P < 0.05 for each). Dynamic pupillometry analysis revealed that mean pupil diameter and mean average dilation speed were significantly different in each study group throughout measurement period and the highest speed was observed in the Mild ED group and the lowest speed was observed in the severe ED group (P < 0.005 for each).Conclusion:Our study results suggest that abnormal pupil functions due to diabetic autonomic neuropathy may indicate the associated ED in patients with DM.

Is the plasma endocan level a reliable predictor for the severity of erectile dysfunction?

The aim of our study was to assess the correlation between serum endocan level and erectile dysfunction (ED). A total of 92 patients were reviewed in this study after institutional review board approval. The patients' characteristics were recorded, including age, body mass index, blood pressure, smoking history, serum creatinine, glucose, lipid profile, total testosterone, and Beck Depression Inventory scores. ED was evaluated with the Sexual Health Inventory for Men (SHIM) questionnaire and classified as severe, moderate, or mild. Scores of > 18 indicate normal erectile function and were recruited for the control group. Sixty-three patients with a median age of 56years in the ED group and 29 patients with a median age of 55years in the control group were compared. ED was classified as severe in 20, moderate in 25, and mild in 18 patients. A significant difference was determined between the severe ED group and the control group for serum endocan levels (p < 0.001). A significant negative correlation between the SHIM score and endocan levels (rho -0.65; p < 0.01), age and SHIM score (rho -0.32; p = 0.04), BMI and SHIM score (rho -0.25; p = 0.03), and BMI and total testosterone (rho -0.16; p = 0.04) was determined upon Spearman's correlation analysis. A positive correlation was also determined between total testosterone and SHIM score (rho 0.50; p = 0.04). Patients' age (p = 0.037) and serum endocan level (p = 0.029) were determined as significant in the multivariate analysis. This study demonstrated the presence of an association between plasma endocan levels and ED. Endocan may be used as a new diagnostic marker for the severity of ED.

Low serum melatonin levels are associated with erectile dysfunction.

ABSTRACTObjective:Melatonin is a hormone secreted from the pineal gland and has anti-oxidative and anti-inflammatory effects. Oxidative stress is considered as an important factor in the etiology of erectile dysfunction (ED), and in many experimental models, positive results have been obtained with melatonin treatment. This study aimed to measure serum melatonin levels in ED patients and to investigate the possible relationship between ED and melatonin levels.Materials and Methods:Sixty-two patients diagnosed with mild, moderate or severe ED according to the five-item International Erectile Function Index (IIEF-5) and 22 healthy individuals were included in the study. The serum melatonin levels, anthropometric data, and other biochemical and hormonal parameters of all the subjects were recorded. Detailed anamnesis was also obtained in terms of diabetes, hypertension, cardiovascular diseases, smoking status, and alcohol use.Results:The serum melatonin level was found 34.2±13.3 ng/dL in the mild ED group, 33.3±14.7 ng/dL in the moderate ED group, 34.8±17.2 ng/dL in the severe ED group, and 44.6±16.5 ng/dL in the control group. The serum melatonin levels were significantly lower in all ED groups compared to the control group (p=0.019). There was no significant difference in the serum melatonin levels between the three ED groups. Diabetes, hypertension, cardiovascular diseases, smoking and alcohol use were not significantly different between the ED groups (p>0.05).Conclusion:We consider that if our findings are supported by further studies with larger populations, the measurement of the serum melatonin level may have a future role in the diagnosis and treatment of ED.

Significance of serum endothelial cell specific molecule-1 (Endocan) level in patients with erectile dysfunction: a pilot study.

This study aimed to measure the serum endocan level of patients with erectile dysfunction (ED) and to investigate the possible association between the Endothelial-specific molecule-1 (Endocan) level and ED. Twenty healthy and sixty-four male patients included in the study were divided into four groups: severe ED (19 patients), moderate ED (24 patients), mild ED (21 patients) and control group (20 healthy men). The erectile function of all the patients was evaluated using the International Index of Erectile Function-5 (IIEF-5) questionnaire. The body mass index (BMI) of each participant was determined, together with levels of fasting blood glucose, total testosterone, low- and high-density lipoprotein cholesterol, triglyceride and endocan in serum samples. No significant difference was found between the three ED groups and the control group in terms of the mean age, BMI and the levels of cholesterol and fasting blood glucose (P>0.05). The mean serum endocan level was found to 1.076±0.5, 0.674±0.40 and 0.671±0.3 ng ml-1 in the severe, moderate and mild ED groups, respectively. This indicated that the highest value was obtained from the severe ED group, and the difference between the severe ED group and the other groups was statistically significant. In the control group, the serum endocan level was 0.73±0.46 ng ml-1, which was significantly higher compared to the moderate and mild ED groups (P<0.05). The significant difference between the control and ED groups in terms of the serum endocan level can assist in the evaluation of endothelial pathologies in the etiology ED.