Erectile Dysfunction Severity Might Be Associated with Poor Cardiovascular Prognosis in Diabetic Men

Heruti, Rafi; Uri, Inbal; Arbel, Yaron; Swartzon, Michael; Galor, Shay; Justo, Dan

doi:10.1111/j.1743-6109.2006.00420.x

Cited by 33 publications

(31 citation statements)

References 23 publications

(30 reference statements)

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“…The present results are supported by studies that used MDCT-CA to screen patients with ED 26, 28. In diabetic patients, increasing ED severity was associated with increased total CVD risk, 41 with poor CVD prognosis 42 . Therefore, ED could be used as a warning sign for SMI.…”

Section: Discussionsupporting

confidence: 78%

Relation Between Erectile Dysfunction and Silent Myocardial Ischemia in Diabetic Patients: A Multidetector Computed Tomographic Coronary Angiographic Study

et al. 2016

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IntroductionErectile dysfunction (ED) can precede coronary artery disease. In addition, silent myocardial ischemia (SMI) is more common in diabetic patients and is a strong predictor of cardiac events and death.AimTo evaluate the presence of SMI in patients with diabetes and ED using multidetector computed tomographic coronary angiography (MDCT-CA).MethodsThis study evaluated patients with diabetes and ED without any history of cardiac symptoms or signs. Erectile function was evaluated with the Sexual Health Inventory for Men score, erection hardness score (EHS), and maximal penile circumferential change by an erectometer. MDCT-CA was used for the detection of coronary artery stenosis.Main Outcome MeasuresSexual Health Inventory for Men score, EHS, maximal penile circumferential change, and coronary artery stenosis by MDCT-CA.ResultsOf 20 patients (mean age = 61.45 ± 10.7 years), MDCT-CA showed coronary artery stenosis in 13 (65%) in the form of one-vessel disease (n = 6, 30%), two-vessel disease (n = 2, 10%), and three-vessel disease (n = 5, 25%). Fifty percent of patients showed at least 50% vessel lumen obstruction of the left anterior descending coronary artery, which was the most commonly affected vessel (55%). Fifteen percent (3 of 20) of patients had greater than 90% stenosis, and two of them underwent an immediate coronary angioplasty with stenting to prevent myocardial infarction. Maximum coronary artery stenosis was positively correlated with age (P = 0.016, r = 0.529) and negatively correlated with EHS (P = .046, r = −0.449). Multivariate regression analysis using age and EHS showed that age was the only independent predictor of SMI (P = .04).ConclusionMDCT-CA can be a useful tool to identify SMI in diabetic patients with ED, especially in those of advanced age and/or with severe ED.

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Section: Discussionsupporting

confidence: 78%

Relation Between Erectile Dysfunction and Silent Myocardial Ischemia in Diabetic Patients: A Multidetector Computed Tomographic Coronary Angiographic Study

et al. 2016

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“…Accordingly, it is now thought that ED can be considered an early marker for cardiovascular disease 9–12. Its severity might be associated with poor cardiovascular outcome in adult diabetic men without coronary heart disease 85. The presence of ED should alert the physician to perform cardiovascular evaluation in these patients 49.…”

Section: Discussionmentioning

confidence: 99%

Sexual dysfunction in men with type 2 diabetes

Isidro

2012

Postgraduate Medical Journal

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Sexual dysfunction (SD) is common in type 2 diabetic men, but few subjects are diagnosed and treated. The prevalence of diabetes mellitus is increasing worldwide. It is expected that the number of subjects suffering from SD increases in the near future. Most studies of SD in diabetic men have focused on erectile dysfunction. There is a dearth of studies in the area of the other forms of SD. SD has consequences on the psychological well-being and reproductive function. They can be the first symptom of comorbidities or a treatment side effect. Erectile dysfunction is increasingly being recognised as an early marker of organic incipient systemic disease. Evaluation for any SD includes a complete medical history, detailed sexual history, physical examination, psychosocial assessment and, sometimes, complementary studies. Initial treatment of any SD should eliminate any modifiable factor that may lead to or aggravate the dysfunction. Phosphodiesterase type 5 inhibitors are the preferred therapy for most men with organic erectile dysfunction who do not have a specific contraindication to their use. Pharmacological treatment of premature ejaculation includes on-demand or daily dosing of certain selective serotonin reuptake inhibitors or clomipramine and on-demand topical local anaesthetics. Delayed ejaculation and anejaculation due to vascular or neuropathic damage are usually irreversible. The issue of infertility in patients with anejaculation or retrograde ejaculation seeking to have children should be addressed. No study specifically conducted in diabetic men on the treatment of hypoactive sexual desire disorder, apart from that occurring in the context of hypogonadism, has been published.

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“…Moreover, diabetes is commonly associated with hypertension, hyperlipidemia, overweight and obesity, metabolic syndrome, smoking, sedentary lifestyles, and autonomic neuropathy, which are recognized as risk factors for ED 34–37,53. Both microvascular51,54,55 and macrovascular48,56,57 diabetic complications also increase the risk of ED in diabetic men. The use of several medications frequently assumed by diabetic patients, such use of antihypertensive drugs (β-blockers, thiazide diuretics, and spironolactone), psychotropic drugs (antidepressants), and certain fibrates, have all been associated with an additive deleterious effect on diabetic ED 58,59.…”

Section: Erectile Dysfunctionmentioning

confidence: 99%

Diabetes and sexual dysfunction: current perspectives

Maiorino¹,

Bellastella²,

Esposito³

2014

DMSO

164

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Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It has been associated with sexual dysfunction, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, as compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction are less conclusive, although most studies have reported a higher prevalence of female sexual dysfunction in diabetic women as compared with nondiabetic women. Female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. Hyperglycemia, which is a main determinant of vascular and microvascular diabetic complications, may participate in the pathogenetic mechanisms of sexual dysfunction in diabetes. Moreover, diabetic people may present several clinical conditions, including hypertension, overweight and obesity, metabolic syndrome, cigarette smoking, and atherogenic dyslipidemia, which are themselves risk factors for sexual dysfunction, both in men and in women. The adoption of healthy lifestyles may reduce insulin resistance, endothelial dysfunction, and oxidative stress – all of which are desirable achievements in diabetic patients. Improved well-being may further contribute to reduce and prevent sexual dysfunction in both sexes.

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Erectile Dysfunction Severity Might Be Associated with Poor Cardiovascular Prognosis in Diabetic Men

Cited by 33 publications

References 23 publications

Relation Between Erectile Dysfunction and Silent Myocardial Ischemia in Diabetic Patients: A Multidetector Computed Tomographic Coronary Angiographic Study

Relation Between Erectile Dysfunction and Silent Myocardial Ischemia in Diabetic Patients: A Multidetector Computed Tomographic Coronary Angiographic Study

Sexual dysfunction in men with type 2 diabetes

Diabetes and sexual dysfunction: current perspectives

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