Risk of severe erectile dysfunction in primary hyperaldosteronism: A population-based propensity score matching cohort study

Abstract

Background: An elevated plasma aldosterone level has been reported as an independent risk factor for severe erectile dysfunction in men. The aim of this study was to explore whether primary hyperaldosteronism patients experience erectile dysfunction after targeted treatment. Methods: We conducted a population-based cohort study of men with newly identified primary hyperaldosteronism/aldosterone-producing adenoma from January 1, 1997, to December 31, 2009. Men with essential hypertension and normotension were matched to the primary hyperaldosteronism group according to propensity score matching. Results: We identified 1,067 men with primary hyperaldosteronism (mean age, 46.7 ± 12.8 years) and matched them with the same number of men with essential hypertension or normotension. During the mean follow-up interval of 5.4 years, the incident rates of total erectile dysfunction were 5.7, 3.9, and 3.1 per 1,0 0 0 person-years for the primary hyperaldosteronism, essential hypertension, and normotension groups, respectively. Men with primary hyperaldosteronism exhibited a higher risk of erectile dysfunction compared with men with normotension (competing risks hazard ratio, 1.83), and no difference was seen in comparison with men who have essential hypertension. After adrenalectomy, men who have primary hyperaldosteronism had a higher risk of exhibiting severe erectile dysfunction compared with men who have essential hypertension (competing risks hazard ratio, 2.44) or normotension (competing risks hazard ratio, 2.90). Conclusion: Men with primary hyperaldosteronism reported a higher incidence of severe erectile dysfunction than normotension controls despite targeted treatment. The risk of severe erectile dysfunction increased after men who have primary hyperaldosteronism underwent adrenalectomy. This result raises the possibility of severe erectile dysfunction after adrenalectomy and calls for a prospective large-scale study of men who have aldosterone-producing adenoma regarding their erectile function both before and after adrenalectomy.

Human Papillomavirus Infection and the Risk of Erectile Dysfunction: A Nationwide Population-Based Matched Cohort Study

“…That is, whether patients with asymptomatic or self-resolving infection also have a higher risk of developing ED remains unknown. Second, due to inherent database limitations, this study lacked penile ultrasound data, other indicators that may affect erectile function such as the use of phosphodiesterase-5 (PDE5) inhibitors, and an erectile performance questionnaire; however, in a previous study, the ICD-9 code for ED has been validated with the International Index of Erectile Function score [ 56 ]. Third, as our study only included participants from one country of Asian origin, our findings may not be generalizable to other ethnic groups.…”

“…To ensure the reliability and accuracy of the diagnoses, the diagnoses had to be assigned by urologists for three or more ambulatory visits or at least one admission within a year. In a previous study, ICD-9 codes for ED have been validated, and corresponded to an International Index of Erectile Function score of less than 8 to define severe ED; using ICD-9 codes to enroll cases, the sensitivity was 80%, and the positive predictive value was 88.9% [ 56 ].…”