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PubMed2002

[Efficacy and safety of sildenafil in patients with erectile dysfunction and hypertension. Prognostic factors].

BACKGROUND: Our purpose was to assess the efficacy and safety of sildenafil as a treatment for erectile dysfunction in hypertensive patients, and to investigate those factors associated with a treatment failure. PATIENTS AND METHOD: Open, prospective study including 114 patients suffering from erectile dysfunction plus arterial hypertension who were evaluated by anamnesis, physical examination, blood tests including glycemia and lipidic and hormonal profiles, penile colour Doppler ultrasonography after intracavernosal prostaglandin E1 (PGE1) injection, and the Sexual Health Inventory for Men (SHIM). Efficacy of sildenafil was assessed by administering again the SHIM and by means of a global assessment questionnaire. Side effects were also recorded. Factors influencing treatment outcome were evaluated by univariate and multivariate statistical analysis. RESULTS: Overall, sildenafil was effective in 59.2% of 103 eligible patients. Efficacy in patients with psychogenic erectile dysfunction was 75%, whereas in those with an organic etiology, the efficacy was 50.7%. Age, diabetes mellitus, nocturnal penile tumescence, response to intracavernosal PGE1 injection and erectile dysfunction severity (defined by the SHIM basal score) significantly influenced treatment response (p < 0.05) after an univariate analysis. The multivariate analysis, however, selected only diabetes mellitus and severity of erectile dysfunction as the prognostic factors. No severe side effects were noticed. CONCLUSIONS: Sildenafil is a rather effective and well-tolerated treatment for erectile dysfunction in hypertensive patients. Baseline severity of erectile dysfunction and diabetes mellitus represent the prognostic factors most significantly associated with treatment outcome.

Erectile Dysfunction↗

PubMed2006

The hypoactive corpora cavernosa with degenerative erectile dysfunction: a new syndrome.

BACKGROUND: In a group of 22 patients with erectile dysfunction, vasculogenic, neurogenic, endocrinologic or psychogenic investigations failed to find a cause for their erectile dysfunction. The electro-cavernosograms of these patients recorded a diminished activity. We investigated the hypothesis that diminished corpus cavernosum electromyography activity was the cause of erectile dysfunction in these patients. METHODS: The study comprised the above mentioned 22 patients (study group, 43.8 +/- 5.9 SD years) and 15 healthy volunteers (control group, 41.8 +/- 5.1 SD years). The electro-cavernosograms were recorded in the flaccid, erectile and detumescent phases by 2 electrodes inserted into the corpus cavernosum. RESULTS: The electro-cavernosogram of the healthy volunteers registered in the flaccid phase regular slow waves and random action potentials. The wave variables declined significantly in the erectile phase (p < 0.01). In the study group, the slow wave variables in the flaccid phase exhibited a significant decrease (p < 0.05) compared to the healthy volunteers, and the rhythm was irregular. Erection did not occur with sildenafil administration or intracavernosal papaverine injection, and penile implant was performed. Biopsy examination showed degenerated muscle fibers, and fragmented collagen and elastic fibers with areas of fibrosis. CONCLUSION: A novel concept of the cause of erectile dysfunction was presented. Corpora cavernosa showed degenerative changes on histopathologic examination and exhibited diminished electromyography activity. They did not respond to sildenafil administration or intracavernosal papaverine injection. Penile implants were the only treatment. The condition is given the name 'hypoactive corpus cavernosum'. The cause of corpus cavernosum degenerative changes needs further study.

Adult↗

PubMed2004

Oral drug therapy for erectile dysfunction: overview and aeromedical implications.

Approximately 150 million men worldwide experience erectile dysfunction, whereby they are unable to maintain an erection adequate for satisfactory sexual performance. This population is projected to more than double in the next 25 yr. Introduction of the phosphodiesterase inhibitors has revolutionized the management of this common problem, encouraging many more men to seek treatment. The issue of erectile dysfunction treatment is a growing concern in the aviation community as well. This is particularly relevant in civil aviation, as this population is older and has co-morbidities that may contribute to the development of erectile dysfunction. In this article we will review the available options for oral treatment of erectile dysfunction and discuss implications regarding their use in aviators based on the information available in the literature.

Administration, Oral↗

PubMedDate not supplied

[Yohimbine in the treatment of erectile dysfunction].

Iochimbin hydrochloride was given to 153 men with erectile dysfunction. The results are available for 140 of them. The ability of iochimbin in a single dose of 5-10 mg to enhance arterial blood inflow to cavernous bodies of the penis was confirmed by dynamic angiopenoscintigraphy and Doppler ultrasonography. Iochimbin hydrochloride in a mean daily dose of 15-20 mg proved effective in erectile dysfunction--38 to 84% responders depending on the type of erectile dysfunction. Occasional side effects can be relieved by reducing the drug dose.

Administration, Oral↗

PubMedDate not supplied

Barriers to recognition of erectile dysfunction among diabetic Mexican-American men.

BACKGROUND: Diabetes is widespread among Mexican-Americans, and erectile dysfunction is a well-recognized complication for which effective treatments are available. Men who desire treatment, however, might not volunteer erectile complaints to their physician, especially across cultural lines. METHODS: We surveyed diabetic Mexican-American men cared for in two community health centers to estimate the prevalence of self-reported erectile dysfunction, to learn how frequently they discuss sexual function with their physician, and to evaluate factors that facilitate or inhibit discussion. RESULTS: Of the participants surveyed, 59 percent (95 percent confidence interval [CI] 48-70) reported always lacking erection in one or more proposed circumstances, whereas 82 percent (95 percent CI 73-91) reported frequent erectile insufficiency in the same circumstances. Patients reporting erectile problems were no more likely to have discussed sexual function with their physician than those who denied frequent erectile dysfunction. Of those with frequent erectile dysfunction, only 47 percent had had a discussion about sexual function with their physician. We found that these men did not initiate discussion because they were embarrassed or expect the physician to initiate the dialogue. CONCLUSIONS: Erectile dysfunction is common in diabetic Mexican-American men and is underrecognized by clinicians and underreported by patients. Because effective treatments exist, primary care physicians should routinely ask their diabetic patients about erectile function.

Adult↗

PubMed2001

Psychogenic erectile dysfunction. Classification and management.

Psychogenic factors are involved alone or in combination with organic causes in a substantial number of cases of erectile dysfunction. Epidemiologic studies have implicated the role of depressed mood, loss of self-esteem, and other psychosocial stresses in the cause of erectile dysfunction. A new definition and classification of psychogenic erectile dysfunction has been proposed based on recent clinical and research findings. According to this new classification, psychogenic erectile dysfunction is categorized as generalized or situational type, with subcategories of each type proposed. Traditional treatment approaches for psychogenic erectile dysfunction have included anxiety reduction and desensitization procedures, cognitive-behavioral interventions, guided sexual stimulation techniques, and couples' or relationship counseling. Recently, these approaches increasingly have been combined with pharmacologic therapy such as sildenafil. Special situations have been identified in which combining psychosocial interventions with medical therapy is recommended. These situations include problems of sexual initiation, low sexual desire, other sexual dysfunctions, and significant couples' or relationship problems. More research is needed on the role of psychosocial interventions in the treatment of erectile dysfunction.

Arousal↗

PubMed1997

The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction.

OBJECTIVES: To develop a brief, reliable, self-administered measure of erectile function that is cross-culturally valid and psychometrically sound, with the sensitivity and specificity for detecting treatment-related changes in patients with erectile dysfunction. METHODS: Relevant domains of sexual function across various cultures were identified via a literature search of existing questionnaires and interviews of male patients with erectile dysfunction and of their partners. An initial questionnaire was administered to patients with erectile dysfunction, with results reviewed by an international panel of experts. Following linguistic validation in 10 languages, the final 15-item questionnaire, the international index of Erectile Function (IIEF), was examined for sensitivity, specificity, reliability (internal consistency and test-retest repeatability), and construct (concurrent, convergent, and discriminant) validity. RESULTS: A principal components analysis identified five factors (that is, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) with eigenvalues greater than 1.0. A high degree of internal consistency was observed for each of the five domains and for the total scale (Cronbach's alpha values of 0.73 and higher and 0.91 and higher, respectively) in the populations studied. Test-retest repeatability correlation coefficients for the five domain scores were highly significant. The IIEF demonstrated adequate construct validity, and all five domains showed a high degree of sensitivity and specificity to the effects of treatment. Significant (P values = 0.0001) changes between baseline and post-treatment scores were observed across all five domains in the treatment responder cohort, but not in the treatment nonresponder cohort. CONCLUSIONS: The IIEF addresses the relevant domains of male sexual function (that is, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction), is psychometrically sound, and has been linguistically validated in 10 languages. This questionnaire is readily self-administered in research or clinical settings. The IIEF demonstrates the sensitivity and specificity for detecting treatment-related changes in patients with erectile dysfunction.

Adult↗

PubMed2000

Switching from intracavernous prostaglandin E1 injections to oral sildenafil citrate in patients with erectile dysfunction: results of a multicenter European study. The Sildenafil Multicenter Study Group.

PURPOSE: Intracavernous injection is a well established medical therapy for erectile dysfunction. We assessed the rate of success when patients with erectile dysfunction who were effectively treated with intracavernous injections of prostaglandin E1 were changed to oral therapy with sildenafil citrate. MATERIALS AND METHODS: Only patients effectively managing erectile dysfunction by the intracavernous injection of 20 microg. or less prostaglandin E1 for more than 6 months were eligible for study enrollment. After a 4-week run-in phase while intracavernous prostaglandin E1 therapy continued and a 48-hour washout period 176 patients with erectile dysfunction received open label sildenafil orally for 12 weeks. Satisfaction with treatment was evaluated by the 11-item erectile dysfunction index of treatment satisfaction questionnaire. A successful change to sildenafil was prospectively defined as a questionnaire score of 0 to 100 after sildenafil that was greater than or equal to the score after intracavernous prostaglandin E1. RESULTS: Of the 176 patients 69% (95% confidence limit 62 to 76) successfully changed from intracavernous prostaglandin E1 injections to oral sildenafil and elected to continue oral treatment. Mean satisfaction score after sildenafil and prostaglandin E1 was 73.8 and 63.9, respectively (p <0.001). Only 3 patients (1.7%) discontinued therapy because of treatment related adverse events. CONCLUSIONS: More than two-thirds of the men with erectile dysfunction who were stable on intracavernous injections of 20 microg. or less prostaglandin E1 successfully changed to oral sildenafil, as determined by maintained or enhanced treatment satisfaction.

3',5'-Cyclic-GMP Phosphodiesterases↗

PubMed2003

Laboratory evaluations of erectile dysfunction: an evidence based approach.

PURPOSE: We evaluate the prevalence of laboratory abnormalities in men presenting for initial evaluation and therapy of erectile dysfunction. MATERIALS AND METHODS: The computerized charts of men receiving treatment for erectile dysfunction from 1987 to 2002 were retrospectively reviewed. We pooled laboratory data for 3,547 men with erectile dysfunction to assess the prevalence of laboratory abnormalities. Values of the common laboratory screening tests for erectile dysfunction were recorded for testosterone, prolactin, luteinizing hormone, thyroid-stimulating hormone, hemoglobin A(Ic), prostate specific antigen, hemoglobin, cholesterol and creatinine. RESULTS: Of those patients evaluated 18.7% had low testosterone, 4.6% had increased prolactin, 14.6% had abnormal luteinizing hormone, 4.0% had increased thyroid-stimulating hormone, 8.3% had increased prostate specific antigen, 26.5% had anemia and 11.9% tested had renal insufficiency. A high percentage of patients presenting with a primary complaint of erectile dysfunction had increased hemoglobin A(Ic) and total serum cholesterol levels (52.9% and 48.4%, respectively). CONCLUSIONS: An evidence based approach to standardization of laboratory evaluations for men presenting with erectile dysfunction is recommended. Laboratory screening should be directed to identify those risk factors that may benefit from lifestyle modification and pharmacological intervention.

Aged↗

PubMed1990

[Prostaglandin E1 injection in erectile dysfunction. Current diagnostic and therapeutic possibilities].

In erectile dysfunction formerly, for both diagnostic and therapeutic purposes, intracavernous injections of papaverine and the combination papaverine/phentolamine were employed. In recent years, promising results have been reported with prostaglandin E1. In a multicenter study, 10 to 20 micrograms prostaglandin E1 were administered for testing corpus cavernosum function. One hundred and fifteen out of 187 patients self-injected themselves with prostaglandin E1 at an average dose of about 13 micrograms. While priapism occurred in 5 to 10% of the patients injecting papaverine or papaverine/phentolamine, and fibrosis and tunica induration in 10 to 57% patients on long-term treatment, the risk of priapism was low in prostaglandin E1. Subsequently, induration and penile deviation were reported in 2 patients each. In this multicenter study, a subjective efficacy of more than 90% was observed, thus confirming similar results with prostaglandin E1 found in other studies. The present results show that prostaglandin E1 can be considered the drug of first choice for intracavernous injection treatment of erectile dysfunction.

Alprostadil↗

PubMed2003

Erectile dysfunction in Singapore: prevalence and its associated factors--a population-based study.

PURPOSE: To study the prevalence of erectile dysfunction (ED) in Singapore males aged 30 and above and its association with demographic, medical and other risk factors. METHODOLOGY: A population based cross sectional study of 729 men aged 30 and above in Singapore was conducted using the abridged, five-item version of the International Index of Erectile Function (IIEF-5). Presence of erectile dysfunction was defined as IIEF-5 score of less than 21. Erectile dysfunction was further categorised into mild (IIEF-5: 16-20), moderate (IIEF-5: 11-15) and severe (IIEF-5: <11). A logistic regression model was used to identify significant independent risk factors for ED. RESULTS: Overall, 51.3% of respondents (n=374) reported some degree of erectile dysfunction. Of these, 23.2% have mild ED, 8.8% have moderate ED and 19.3% had severe ED. The prevalence of ED increased from 42.8% for men in their forties to 77.4% in their sixties. The prevalence of severe ED increased from 9.1% in men in their forties to 43.5% in their sixties and 77.0% in those aged 70 and above. Age above 50 years is the single most significant risk factor on multivariate analysis when adjusted for all confounding factors. Other important risk factors include Indian ethnic group, lower household income, physical inactivity, diabetes mellitus and cardiac diseases. CONCLUSION: Erectile dysfunction is common amongst Singaporean men. Age is the single most important physiologic factor affecting erectile function. The prevalence and severity increased significantly with age after 50 years old. With an ageing population, erectile dysfunction may become a significant health problem. Health care providers should plan their resources accordingly.

Adult↗

PubMed1998

Elucidating the etiology of erectile dysfunction after definitive therapy for prostatic cancer.

PURPOSE: To determine the etiology of treatment-induced erectile dysfunction among patients who underwent surgery or radiotherapy for prostatic cancer. METHODS AND MATERIALS: Ninety-eight patients were evaluated for erectile dysfunction after definitive therapy for prostate cancer with Duplex ultrasonography before and after intracorporal prostaglandin injection. Patients were classified as having arteriogenic, cavernosal, mixed (arteriogenic/cavernosal), or neurogenic impotence based upon the results of the Duplex studies. RESULTS: Among patients who underwent radical prostatectomy (RP), 31 (52%) had cavernosal dysfunction, 19 (32%) had arteriogenic dysfunction, 3 (5%) were classified as mixed, and 7 (12%) as neurogenic dysfunction. Among patients treated with radiotherapy (RT), 24 (63%) had arteriogenic dysfunction, 12 (32%) had cavernosal dysfunction, 1 (2.5%) were classified as mixed, and 1 (2.5%) as neurogenic dysfunction. A multivariate analysis identified prior RT as the only predictor of an arteriogenic etiology (p < 0.001) and prior RP as the only predictor of a cavernosal etiology (p < 0.04) for erectile dysfunction among these patients. In the RP and RT groups, the median erectile responses were 70 and 65%, respectively. Arterial peak flows < 25 cc/min predicted for a suboptimal erectile response with intracavernosal prostaglandin injections. Among 47 patients with arterial peak flows < 25 cc/min, 21 (55%) had erectile responses of < 70%, while for 51 patients with arterial peak flows > or = 25 cc/min, 31 (39%) had erectile responses of < 70% (p < 0.039). CONCLUSIONS: While the etiology of erectile dysfunction after definitive therapy for prostatic cancer is likely a multifactorial phenomenon, these data suggest that the predominant etiology among patients who undergo RT is arteriogenic and among patients who undergo RP is veno-occlussive/cavernosal pathology. This information may have implications for the design of more effective therapies to address erectile dysfunction in this patient population.

Aged↗

PubMed2001

Pudendal nerve conduction to evaluate organic erectile dysfunction.

OBJECTIVE: This study aimed to evaluate the value of testing pudendal nerve conduction in men with erectile dysfunction. DESIGN: This open prospective study was conducted on 150 men with documented erectile dysfunction of at least 6 mo of duration, all of whom underwent pudendal nerve conduction by the same investigator. RESULTS: Only patients with erectile dysfunction and low back pain (n = 9) showed statistically significant prolonged pathologic pudendal nerve conduction latency of 43.1 msec/div (SD +/- 11.3 msec/div, P < 0.05). There were no correlations between the pudendal nerve conduction latency in patients suffering from erectile dysfunction associated with diabetes mellitus, local trauma, pelvic surgery, or antihypertensive drugs. CONCLUSIONS: Pudendal nerve conduction may contribute valuable information to the evaluation of patients with erectile dysfunction caused by neurologic deficits as manifested by low back pain.

Adult↗

PubMed1996

[A new vacuum mechanism for the etiologic treatment of erectile dysfunction].

OBJECTIVES: To demonstrate the usefulness of the new, computerized and programmable electronic vacuum erection devices in the etiological treatment and prevention of erectile dysfunction. METHODS: In erectile dysfunction due to incipient fibrosis of the penile vascular system, the programmable vacuum erection devices that achieve passive erection with low negative pressures, act as dilators of the corpus cavernosum arterial vascular system. RESULTS: 20 patients with grades I and II erectile dysfunction were treated with the new Vacuum Plus Tratamiento (VPT) with highly satisfactory results. CONCLUSIONS: The results achieved with the new vacuum erection devices like the VPT show their efficacy in the etiological treatment, as well as prevention, of erectile dysfunction arising from fibrosis of the penile vascular system.

Equipment Design↗

PubMed2006

Age related testosterone depletion in patients with erectile dysfunction.

PURPOSE: We assessed the pattern of age related testosterone depletion in patients with erectile dysfunction. MATERIALS AND METHODS: A total of 305 patients with erectile dysfunction who had a normal testosterone level at baseline visit and who completed the study were candidates for analysis. Erectile function was assessed using the International Index of Erectile Function. Patients underwent routine laboratory investigations plus total testosterone and prolactin assessment at the baseline visit and on a yearly basis for 4 years. RESULTS: The mean age +/- SD was significantly higher in 210 patients with decreased testosterone (55.3 +/- 7.3 years) than in 95 patients with steady testosterone (remaining within the normal range) (50.8 +/- 10.2 years). There was a significant decrease in yearly mean testosterone level throughout the study in all the age groups (determined by decades) older than 30 years. Of the study population 68.9% had decreases in testosterone levels throughout the 4 years of visits. Hypogonadism (testosterone lower than normal range) developed in 7.6% of the study population. There was a significant decrease in mean testosterone at any visit in comparison to previous visits. There were significant associations between decreased levels of testosterone and increased severity of erectile dysfunction at baseline visit, longer duration and poor metabolic control of diabetes, ischemic heart disease, hyperprolactinemia and low desire. CONCLUSIONS: This study clearly demonstrated a decrease in testosterone level throughout the 4-year followup in patients with erectile dysfunction. Patients with decreasing testosterone were older than patients with a steady testosterone level.

Adult↗

PubMed2003

Comparison of satisfaction rates and erectile function in patients treated with sildenafil, intracavernous prostaglandin E1 and penile implant surgery for erectile dysfunction in urology practice.

PURPOSE: We compared erectile function status and satisfaction rates in patients who received treatment for erectile dysfunction (ED) with sildenafil, intracavernous prostaglandin E1 (ICI) and penile implant surgery (IPP). MATERIALS AND METHODS: A total of 138 consecutive patients who received treatment for ED between April 2000 and April 2001 were considered candidates for study. Mean followup was 19.54 months. Of the patients 27 were not available for followup and 26 were not on any form of treatment. Of the patients receiving treatment for ED 85 were administered the Erectile Dysfunction Inventory for Treatment Satisfaction (EDITS) questionnaire and the Erectile Function Domain (EFD) of the International Index of Erectile Function questionnaire. Three treatment groups were identified, including 31 patients on sildenafil citrate, 22 on ICI and 32 who underwent IPP. Mean total EDITS, EDITS Index and EFD scores in the 3 groups were considered for statistical evaluation. RESULTS: There was no statistical difference in the total EDITS (25.59 versus 27.06, p = 0.48), EDITS Index (58.16 versus 61.15, p = 0.49) or EFD (22.91 versus 20.26, p = 0.12) score between the groups on ICI and sildenafil citrate, respectively. Total EDITS, EDITS Index and EFD scores were significantly higher in patients who underwent IPP than those on sildenafil citrate (36.09 versus 27.06, p <0.001, 82.03 versus 61.51, p <0.001 and 27.88 versus 20.26, p <0.001, respectively). Total EDITS, EDITS Index and EFD scores were significantly higher in patients who underwent IPP than those on ICI (36.09 versus 25.59, 82.03 versus 58.16 and 27.88 versus 22.91, respectively, all p <0.001). CONCLUSIONS: At a mean followup of 19.54 months patients who underwent penile implant surgery had significantly better erectile function and treatment satisfaction than those receiving sildenafil citrate and intracavernous prostaglandin E1.

Adult↗

PubMed1993

Diagnosis and treatment of psychogenic erectile dysfunction in a urological setting: outcomes of 18 consecutive patients.

The diagnostic criteria and treatment outcomes of 18 consecutive patients with psychogenic erectile dysfunction were examined. Average patient age was 38 years, and all patients had either awakening penile or masturbatory rigidity. Each patient was studied with home monitoring (ART-1000) on 2 consecutive nights. The average number of maximum erectile episodes, the event during which the maximum rigidity was maintained for at least 5 minutes, was 1.6. The maximum sleep erectile episodes averaged 11.2 minutes during which penile rigidity averaged 572 gm. The main predictor for remission of erectile dysfunction in this study was whether the dysfunction was primary or secondary. Of 14 patients with secondary psychogenic erectile dysfunction, that is history of being able to achieve and maintain penile rigidity sufficient for at least 5 minutes of vaginal intercourse, 10 (71%) experienced remission. Three patients noticed spontaneous remission during the initial evaluation and another 3 experienced remission within 3 months of completion of the evaluation and reassurance that they had normal erectile capacity. Two patients had remission while considering penile vascular surgery and in 2 normal erectile function returned during injection therapy. Only 2 of 3 patients referred for sex therapy actually received it (Freudian theory), and neither noticed improvement in erectile function. One patient received yohimbine without benefit. None of the patients elected treatment with the vacuum constriction device. All 4 patients with primary psychogenic erectile dysfunction, that is never able to achieve and/or maintain penile rigidity sufficient to achieve vaginal intercourse, failed to respond to physician reassurance and time. Of 2 patients who received sex therapy (1 Freudian and 1 behavioral) without improvement in erectile function 1 has entered the pharmacological erection program and has achieved vaginal penetration, and the other is considering the pharmacological erection program. The remaining 2 patients have deferred all therapy. Based on this experience, we currently reassure patients with secondary psychogenic erectile dysfunction that they have erectile capacity for sustained vaginal intercourse and schedule a followup visit in 3 months. Additional individualized therapy (pharmacological erection program, vacuum constriction device, sensate focus/psychodynamic specific therapy or penile prosthesis) is offered as needed and requested. Patients with primary psychogenic erectile dysfunction are initially offered the pharmacological erection program or the vacuum constriction device and sex sensate focus/psychodynamic specific therapy. The penile prosthesis is considered for treatment failures.

Adult↗

PubMed1998

[Erectile dysfunction in diabetics. Epidemiological profile in Senegal].

OBJECTIVE: The objective of this study was to report the epidemiological profile of erectile dysfunction in a population of diabetic men. MATERIAL AND METHODS: This was a prospective study including 431 diabetic patients seen in the outpatients department. 69 of these patients suffered from erectile dysfunction. A control group of 138 patients was randomly selected according to age from among the remaining 362 patients. Each patient was submitted to complete clinical examination. The medical and surgical history, particularly vascular, neurological, endocrine and urological, was recorded. The patient's smoking and drinking habits and treatment with any antidiabetic or other drugs were also recorded. Statistical analysis was performed according to the case-control method. The limit of significance was p < 0.05. RESULTS: The overall prevalence of erectile dysfunction was 16%. This rate is lower than those reported in the literature. Among the various risk factors, only complications of diabetes, especially neurological complications, were clearly correlated with the risk of erectile dysfunction (p = 0.0004). Similarly, the prevalence of erectile dysfunction increased with the duration of diabetes (p = 0.049). CONCLUSION: The prevalence of erectile dysfunction in diabetic patients often appears to be overestimated in the literature. Methodological biases would explain the marked variation of reported prevalence rates. In contrast, our study confirms previous reports that neurological factors play a predominant role.

Adolescent↗