Evaluation of blood platelet count and function in patients with erectile dysfunction

We evaluated and compared blood total platelet count, mean platelet volume (MPV) and platelet distribution width (PDW) values of patients with erectile dysfunction (ED) and control subjects. A total 57 male patients (mean age 49.7 ± 12 years) with ED and 59 control men (mean age 49.7 ± 10.7 years) were included in the study. All patients were evaluated using medical history with International Index of Erectile Function (IIEF) scores, physical examination and routine blood analysis. Total blood count, including white blood cell (WBC), total platelet counts, MPV and PDW parameters, were recorded in both groups. MPV values were detected to be significantly higher in patients with ED than control group: 10.7 ± 1 and 9.72 ± 1.5, respectively (P = 0.001). Similarly, PDW values were significantly higher in patients with ED than control group: 14.6 ± 2.8 and 12.9 ± 1.9, respectively (P = 0.001). However, mean platelet and mean WBC counts were similar in both groups (P = 0.45). We demonstrated that MPV and PDW values significantly increased in patients with ED compared with the control group. According to these findings, platelet function might play an important role in patients with ED that warrants further research.     

Effect of low-intensity extracorporeal shockwave therapy on nocturnal penile tumescence and rigidity and penile haemodynamics

The study aims to evaluate the effect of low-intensity extracorporeal shockwave therapy (Li-ESWT) on nocturnal erection and penile haemodynamics. Patients with erectile dysfunction (ED) were enrolled from January 2018 to March 2019. Self-reported erectile symptoms, the International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Scores (EHS), nocturnal penile tumescence and rigidity (NPTR) and cavernous duplex Doppler ultrasound (CDDU) were evaluated. NPTR and CDDU were evaluated by Rigiscan and vascular ultrasound system respectively. Comparisons of NPTR and CDDU parameters were performed before and after Li-ESWT (Renova, once a week, 4 weeks in total). A total of 35 cases (mean age 36.51 ± 11.47 years) were enrolled for analysis. The IIEF-5 (10.60 ± 5.99 vs. 15.13 ± 6.22, p = .003), EHS (p = .016) and self-reported erectile hardness (p = .014) were significantly improved after 1-month treatment. Nocturnal erection frequency (p = .010), duration of total erection (p = .017), duration of erectile rigidity ≥60% at penile tip and base (p = .014 and p = .002) and the best erectile rigidity at penile tip and base (p = .012 and p = .005) improved significantly after treatment. However, no CDDU parameters improved after Li-ESWT (all p > .05). Li-ESWT can effectively improve subjective erectile function and nocturnal erection in ED patients. Large sample and well-designed studies need to be developed for supporting the current findings.     

Assessment of the relationship between asymmetric dimethylarginine and severity of erectile dysfunction and coronary artery disease

The plasma concentration of asymmetrical dimethylarginine (ADMA), an inhibitor of nitric oxide synthase, has been linked to endothelial dysfunction. We investigated the relation between plasma ADMA concentration and severity of erectile dysfunction (ED) and coronary artery disease (CAD). We measured plasma levels of ADMA in 92 male patients. Patients were divided into three groups: group 1 (n = 41), patients with ED and without CAD; group 2 (n = 29), patients with stable CAD; group 3 (n = 22), control group (patients without CAD or ED). Erectile function was evaluated by the erectile function domain of the international index of erectile function (IIEF-EFD) a validated 15-item self-administered questionnaire. Erectile function is specifically addressed by six questions that form the so-called erectile function domain of the questionnaire. Each question is scored 0–5. ED is defined as any value <26. Patients with CAD who have stable angina pectoris were selected after coronary angiography. ADMA was analyzed by ELISA method. Group 1 had significantly higher concentrations of plasma ADMA than groups 2 and 3 (respectively, 0.75 ± 0.40 vs. 0.50 ± 0.30, P = 0.013; 0.75 ± 0.40 vs. 0.50 ± 0.25, P = 0.021). There was negative correlation between ADMA and IIEF-EFD score in all groups (n = 92) (r = −0.322, P = 0.002). In a multiple logistic regression analysis adjusting for age, hyperlipidemia, ADMA remained independent predictor for severe ED. Odds ratio for plasma ADMA was 14.151 (1.101–181.940; P = 0.042). First of all, this study provides that ADMA concentrations are significantly higher in patients who have ED when compared to patients with CAD and controls. Second, there was a negative correlation between ADMA and severity of ED. Elevating levels of circulating ADMA is an independent risk factor for severe of ED, and ADMA may be a link between CAD and ED.     

Role of RigiScan parameters in differentiation of vascular erectile dysfunction

Male nocturnal penile tumescence and rigidity assessed by RigiScan monitoring device (GOTOP Inc.) is a noninvasive tool to differentiate organic from psychogenic erectile dysfunction (ED). This study aimed to determine the diagnostic value of RigiScan parameters in differentiating arterial ED from veno-occlusive ED. We recruited 102 male patients (mean ± SD, 32.3 ± 6.7 years old) presented with an overall score <21 in the 5-item version of the International Index of Erectile Function scoring system. Baseline data of the included subjects were collected, and the patients were then subjected to RigiScan monitoring, penile colour Doppler ultrasound, and dynamic infusion cavernosometry and cavernosography examination. These patients were allocated into psychogenic, arterial and venous ED group based on the results of these specific examinations. At last, psychogenic ED was identified in 56 out of 102 men, while arteriogenic ED was identified in 31 cases and venogenic ED in 15 out of the overall 102 cases. The erection episodes per night (1.6 ± 0.5 vs. 2.5 ± 0.9 for venogenic vs. arterial ED respectively) and the duration of tip erections ≥60% in the venogenic ED group (21.5 ± 10.5 min) were significantly lower than cases in arteriogenic ED individuals (34.5 ± 17.0 min). Besides, receiver operating characteristic analysis showed that the duration of tip erections with a cut-off value of 12.5 min had 81.4% sensitivity and 100% specificity for predicting a venogenic ED in cases with organic impotence. In conclusion, the duration of tip erection of RigiScan parameters was used to distinguish venogenic from arterial ED.     

HbA1c over 8.5% is not predictive of increased infection rate following penile prosthesis implant surgery in diabetic patients with erectile dysfunction

Diabetes mellitus is associated with increased risk of erectile dysfunction. Penile prosthesis implantation is an efficient therapeutic option for erectile dysfunction, but not without risk, as infection remains a prominent concern. This study investigates diabetes mellitus as a risk factor for penile prosthesis implantation infection and the relationship between haemoglobinA1c levels and infection rates. All diabetic patients with erectile dysfunction who underwent penile prosthesis implantation surgery between January 2012 and November 2019 at Hamad Medical Corporation, Qatar, were included in this retrospective observational study. A total of 599 diabetic patients with erectile dysfunction had penile prosthesis implantation. Mean age was 59.69 ± 31.19. Penile prosthesis implantation infection rate was 0.83% (5/599), while the mean haemoglobinA1c level was 7.58 ± 1.45 mmol/l (range: 4.1–12.6). A comparison between diabetic patients with penile prosthesis implantation infection and those without infection revealed no significant difference in the level of haemoglobinA1c between the two groups with mean haemoglobinA1c in patients with infected implants 7.14 and 7.59 for noninfected (p = 0.491). Limitations include retrospective single-centre design and low-infection rates reducing sample number. Penile prosthesis implantation infection rate in a large series of diabetic patients was low with no significant association between haemoglobinA1c level and penile prosthesis implantation infection observed.     

Effect of DDAH/ADMA/NOS regulation pathway on cavernae corporum cavernosorum rat penis of different age

The effect of DDAH/ADMA/NOS pathway in penile tissue of rats of different age was investigated to better understand the mechanism of age‐related erectile dysfunction (ED). The Sprague Dawley male rats were assigned as the young group (3 month old, n = 10) and the old group (18 month old, n = 10) respectively. Intracavernous pressure (ICP) was measured before and after papaverine intracavernous injection. Pathology structure of penile tissue was evaluated under transmission electron microscope. The expression amounts of asymmetric dimethylarginine (ADMA) and cyclic guanosine monophosphate (cGMP) in penile tissue were detected by ELISA; the expression levels of isoform‐specific DDAH and NOS were assessed via Western blot. Compared with the young group, the ICP in the old group rat decreased significantly (33.46 ± 5.37 versus 39.71 ± 3.67 mmHg, P = 0.02) after papaverine injection. Diffused fibrosis and impairment of endothelial cell were observed in corpus cavernosum in the old group rats. Higher level of ADMA (10.83 ± 0.96 versus 7.51 ± 1.39 μmol per gpro, P = 3.14 × 10^?4) and lower level of cGMP (29.42 ± 3.84 versus 47.09 ± 6.07 nmol per gpro, P = 1.57 × 10^?6) were detected in penile tissue of the old group compared with those of the young group. Expression of DDAH1, DDAH2, endothelial NOS (eNOS) and neuronal NOS(nNOS) all decreased significantly in penile tissue of the old group rat. The DDAH/ADMA/NOS regulation pathway changes dramatically accompanying with lower ICP in old group rat compared with those of the young group. Such findings in rats are suggestive in understanding the mechanism of age‐related ED in humans.     

Erectile dysfunction and Peyronie’s disease in patient with retroperitoenal fibrosis

Objective  The aim of this study is to determine the sexual dysfunction in patient with retroperitoneal fibrosis (RPF) and also we explored probability of Peyronie’s disease (PD) in this patient group and to compare this with the controls. Materials and methods  Ten of 17 male RPF patients formed the basis of this study. Patient’s age, concomitant diseases were recorded. The diagnosis of PD was based on a palpable penile plaque or acquired penile curvature. Age-matched 88 patients who were admitted to our outpatient clinic with elevated PSA level served as the control group. All patients were asked to complete the IIEF-5 questionnaire. The severity of the erectile dysfunction (ED) was classified into four categories: severe (5–7), moderate (8–16), mild (17–21), and no ED (22–25). Concomitant systemic diseases were recorded. Statistical analyses were done by the Fisher’s exact test and an unpaired-sample t-test. Results  Patients with severe ED or no sexual intercourse in the study group and the control group during the study period were found to be 7 and 14, respectively. The median IIEF-5 score in RPF patients and the control group was 9.8 (min: 5 to max: 23) and 19 (min: 5 to max: 25), respectively. The differences between groups were statistically significant (P = 0.002). In particular, ED was reported in eight RPF patients (80%) which was severe in six (60%) and moderate in two (20%). ED was reported in 45 patients in the control group (51%) which was severe in 14 (15.9%), mild in 25 (28.4%), and moderate in six (6.8%). Patients with RPF had a significant tendency for severe ED compared with the control group (P = 0.0042). Two patients in the RPF group (20%) and one patient in the control group (1.1%) were found to have a penile plaque (P = 0.0279). Relative risk for developing a penile plague was found to be 0.8 in RPF. Conclusion  RPF patients are found to be more prone to developing ED. Penile plaque formation was identified in RPF patients, which may be presumed to relate to the pathological changes of the RPF process, but it remains unclear that these patients demonstrate a higher incidence of plaque formation than the normal population.     

Effects of transanal pelvic plexus stimulation on penile erection: clinical implications

Objective To determine the ability of transanal pelvic plexus stimulation (TPPS) in inducing penile tumescence in patients with non-neurogenic erectile dysfunction (ED) and to compare the erection degree with papaverine-induced erection. Patients and methods The cavernous electrical activity (CEA) in 21 men with non-neurogenic erectile dysfunction was measured during TPPS by electromyography of corpus cavernosum and the erection degree of penis (flaccid, semi-rigid, rigid) was noted. The stimulation amplitude was increased from 20 to 100 mA. All patients also underwent intracavernous papaverine injection and further CEA recordings were obtained. Results Twelve and nine patients were diagnosed with vasculogenic (VED) and non-vasculogenic ED (NVED), respectively. TPSS led to a penile erectile response in 12 patients (57%), whereas papaverine injection caused erection in 16 (76.2%) patients. The mean baseline CEA (16.9 ± 9.1 mV) did not change with TPPS, but papaverine significantly decreased the mean CEA to 12.3 ± 4.9 mV (P < 0.001). CEA recordings of 16 (76.2%) patients revealed a significant decrease after papaverine injection, however seven (33.3%) patients showed significant CEA decrease in response to TPPS. Both TPPS and papaverine were observed to have a higher effect in patients with NVED in terms of inducing penile erection and decreasing CEA compared to their effects in patients with VED. Conclusion TPPS induces penile erection and decreases CEA for some extent, but to a lesser degree compared to papaverine. As further improvements are achieved in the methodology of TPPS, it may be a valuable method in the evaluation patients with erectile dysfunction.     

Significance of platelet distribution width as a severity marker of erectile dysfunction

Mean platelet volume (MPV) and Platelet distribution width (PDW) are potential markers in platelet activation. In present study, we aimed to evaluate MPV and PDW as potential severity markers for those patients who are complaining erectile dysfunction (ED). A total of 358 participants were enrolled in this study. The whole cohort was asked to complete the International Index of Erectile Function‐5 (IIEF‐5) questionnaire. The participants were classified into 3 groups: control group (n = 120), mild ED (n = 118) and severe ED (n = 120). We found in our cohort MPV and PDW were significantly higher in both mild ED group and severe ED group than control group (9.24 ± 0.70 and 9.71 ± 0.80 versus 8.56 ± 0.62 for MPV; 14.48 ± 1.29 and 14.98 ± 1.60 versus 12.86 ± 1.13 for PDW respectively). The MPV and PDW increased as the disease progressed. In the mild and severe ED groups, a significant inverse correlation was detected between the mean values of IIEF‐5 score and PDW. Furthermore, in the receiver operating characteristic curve analysis, the area under the curve of the MPV and PDW to predict severe ED was 0.818 and 0.848 respectively. Our study establishes a dose‐dependent association between the PDW and ED. Therefore, the PDW can serve as a potential marker for predicting the severity of ED.     

Male Sexual Function in Patients Receiving Different Types of Renal Replacement Therapy

BackgroundPatients with end-stage renal disease (ESRD) experience erectile dysfunction (ED). Although it is a benign disorder, ED is related to physical and psychosocial health, and it has a significant impact on the quality of life (QOL). The objective of the present study was to investigate the effects of different renal replacement therapies on ED.MethodsA total of 100 ESRD patients and 50 healthy men were recruited to the present cross-sectional study. The study was consisted of 53 renal transplantation (RT; group I; mean age, 39.01 ± 7.68 years; mean duration of follow-up, 97.72 ± 10.35 months) and 47 hemodialysis (HD) patients (group II; mean age, 38.72 ± 9.12 years; mean duration of follow-up, 89.13 ± 8.65 months). The control group consisted of 50 healthy men (group III; mean age 39.77 ± 8.51 years). Demographic data and laboratory values were obtained. All groups were evaluated with the following scales: International Index of Erectile Function (IIEF)-5 and Short Form (SF)-36 questionnaires, and Beck Depression Inventory (BDI). The patients whose IIEF score were ≤21 were accepted as having ED.ResultsThe mean age of these groups were similar (P > .05). Total IIEF-5 scores of men in groups I, II, and III were 19.5 ± 4.5, 16.4 ± 5.9, and 22.5 ± 3.4, respectively. The mean total IIEF-5 score of control group was higher than those of groups I and II (P < .001). Posttransplant group mean total IIEF-5 score was also higher than the HD group (P < .05). Groups I and II significantly differed from control group in terms of presence of ED (IIEF score ≤21: Group I, n = 28 [52.8%]; group II, n = 29 [61.7%]; and group III, n = 12 [%24], respectively [P < .001]), whereas there was no difference between groups I and II. In the logistic regression analysis (variables included age, BDI, and renal replacement therapy [HD and transplantation]), ED was independently associated with age (odds ratio [OR], 1.1; 95% confidence interval [CI], 1.05–1.2), BDI (OR, 1.1; 95% CI, 1.01–1.13). Additionally, ED was not associated with renal replacement therapy (OR, 1.46; 95% CI, 0.60–3.57). Physiologic health domain of SF-36 was significantly better in healthy controls (P < .001). Patient groups were similar in terms of BDI score (P > .05). ED score was negatively correlated with BDI (r = ?0.368; P < .001), and positively correlated with SF-36 (r = 0.495; P < .001) in all patient groups.ConclusionPatients with ESRD had significantly lower sexual function and lower QOL scores than the healthy control men. Notably, the mode of renal replacement therapy had no impact on male sexual function.     

阴茎微循环检测在阳痿诊断中的价值

目的：探讨阴茎头微循环检测在阳痿诊断中的意义。方法：检测２２例勃起功能障碍病人的阴茎微循环,与１７例健康志愿者进行比较。结果：血管性阳痿病人阴茎头微血管密度（２６．８±６．３ｖｓ４７．８±６．２,Ｐ＜０．０１）和异常微血管百分率（３３．２±３．６ｖｓ１２．８±１．３,Ｐ＜０．０１）与对照组相比有显著性差异;心理性阳痿病人的两项指标（微血管密度４７．２±６．８ｖｓ４７．８±６．２,Ｐ＞０．０５;异常微血管百分率１３．１±１．１ｖｓ１２．８±１．３,Ｐ＞０．０５）与对照组相比没有统计学差异。结论：阴茎头微循环障碍与阳痿病人的器质性改变有关,阴茎头微循环检测可用于血管性阳痿的辅助诊断。     

Uroflowmetric assessment of acute effects of sildenafil on the voiding of men with erectile dysfunction and symptomatic benign prostatic hyperplasia

Purpose  To evaluate the acute effects of sildenafil (50 mg) on the micturation of men with erectile dysfunction (ED) and concomitant benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) using uroflowmetric parameters. Materials and methods  A total of 68 male patients randomized into two groups (36 treatment, 32 control groups) with International Prostate Symptom Score (IPSS) greater than 7 and International Index of Erectile Dysfunction-erectile function domain score lower than 26 were enrolled in the study. Patients in the treatment group received a single dose of 50 mg of oral sildenafil. Patients in the control group received no treatment. Prevoiding urine volumes determined ultrasonographically and voided urine volumes were also recorded. Statistical comparisons were made with the use of analysis of variance (ANOVA). Results  Mean ages were similar between treatment and control groups (60.4 ± 9.8 and 58.6 ± 8.3 years, respectively, P = 0.430). In the treatment group the maximum and average flow rates increased significantly (Q _max from 15.6 ± 6.8 cc/s to 19.3 ± 7.2 cc/s, P < 0.0001; Q _avg from 7.3 ± 3.0 cc/s to 9.1 ± 3.0 cc/s, P < 0.0001) with sildenafil administration, while other parameters studied remained unchanged. Conclusion  Despite the limitations of variations of uroflowmetry, this study showed that sildenafil improves Q _max and Q _avg in patients suffering from ED with concomitant BPH-LUTS. Long-term studies are needed to evaluate the effects on IPSS, side effects, and drug interactions.     

老年勃起功能障碍的临床分析

目的 :分析老年勃起功能障碍 (ED)病人的临床特点。　方法 :4 8例 60岁以上ED病人 ,同期 4 0岁以下ED病人 4 0例作为对照 ,分别比较两组的病因、病程、常见危险因子、体质指数及勃起功能 (EF)积分的差异。　结果 :60岁以上组与对照组相比 ,以器质性ED为主 ( 3 1/48) ,病程为 ( 6.2 3± 0 .77)年对 ( 3 .82± 0 .4 5 )年 ,伴常见危险因子者为 3 1例对 8例 ,体质指数为 ( 2 4 .5 6± 0 .3 6)对 ( 2 4 .18± 0 .3 5 ) ,EF积分为 ( 8.98± 0 .5 8)分对 ( 12 .5 8± 0 .71)分。统计学检验表明 ,两组病因组成、病程、常见危险因子伴随者比例及EF积分有显著差异 (P <0 .0 1) ,而体质指数无显著差异 (P =0 .77)。　结论 :老年ED病人以器质性ED为主 ,伴随常见危险因子增多 ,病程延长 ,ED加重。     

Age‐stratified cut‐off points for the nocturnal penile tumescence measurement using Nocturnal Electrobioimpedance Volumetric Assessment (NEVA®) in sexually active healthy men

The current nocturnal penile tumescence (NPT) measurement is based on standard cut‐off levels defined regardless of age. This study was conducted to provide age‐stratified cut‐off points for NPT measurement. Forty sexually active healthy men between 20 and 60 years old were enrolled and divided equally into four groups defined by age (20–29, 30–39, 40–49 and 50–60 years.). None of the candidates had sexual dysfunction or sleep disturbance or used supportive medication to enhance sexual function. Erectile function was evaluated by using the 5‐item version of the international index of erectile function (IIEF‐5). NPT was observed using the nocturnal electrobioimpedance volumetric assessment (NEVA^®). The NPT values of healthy men aged 20–60 years varied from 268.7% to 202.3%. The NPT differed significantly between age groups (P < 0.0009); however, no significant differences between men aged 30–39 and 40–49 (P = 0.593) were observed. Age was weakly associated with IIEF‐5 scores (P = 0.004), whereas a strong and negative correlation between age and NPT (P < 0.0001) was found. IEF‐5 scores were not significantly associated with NPT (P = 0.95). Therefore, the standard values for NPT testing should be considered in the evaluation of the nocturnal penile activity of men of all ages.     

Association between serum folic acid level and erectile dysfunction

This study measured the serum folic acid (FA) level in patients with erectile dysfunction (ED) and evaluated the possible association between the serum FA level and erectile function. The study divided 120 patients with ED into 3 groups of 40 patients each: those with severe, moderate and mild ED. Forty healthy men served as controls. Fasting serum samples were obtained, and the total testosterone, cholesterol and FA levels were measured using chemiluminescent immunoassays. There were no significant differences in the mean age, mean body mass index or mean serum total testosterone and cholesterol levels among the three ED groups and controls (P > 0.05). The mean serum FA concentrations were 7.2 ± 3.7, 7.1 ± 3.2, 10.2 ± 4.6 and 10.7 ± 4.6 ng ml^?1 in the severe, moderate and mild ED and control groups respectively. The mean serum FA concentration was significantly higher in the control group than in the severe and moderate ED groups (both P < 0.001), but not the mild ED group (P = 0.95). Considering the significant differences in the serum FA levels between the control and ED groups, serum FA deficiency might reflect the severity of ED.     

Visceral adiposity index is useful for evaluating obesity effect on erectile dysfunction

Studies show that erectile dysfunction (ED) is associated with obesity, and it has been shown that the possibility of developing sexual dysfunction in obese men is 30% higher compared to those with normal weight. Obesity is measured using various methods, for example waist circumference (WC) measurement or body mass index (BMI), but recently, visceral adiposity index (VAI) has also been utilised to better assess obesity and metabolic syndrome. In our study, the potential link between VAI and ED was investigated. The data of 176 patients who presented to the urology outpatient clinic with erection complaints were retrospectively screened. A control group was also established with 122 men without complaints of erectile dysfunction. The erectile functions of all participants were determined using the International Erectile Function Index‐5 (IIEF‐5) scoring. In addition, their serum fasting blood glucose, total testosterone (TT), triglyceride (TG), low‐density lipoprotein (LDL) cholesterol and high‐density lipoprotein (HDL) cholesterol levels were measured. The physical examination comprised the measurement of WC, height and weight, and BMI. The mean age of the participants was 58.7 ± 8.4 for the ED group and 57.1 ± 7.5 for the control group. The mean VAI was statistically significantly higher in the ED group (5.32 ± 2.77) compared to the control group (4.11 ± 1.93) (p < 0.001). Since VAI contains both physical and metabolic parameters, our findings suggest that it discloses the effects of WC, BMI, HDL and TG more clearly. VAI is considered useful for the assessment of the effect of obesity on ED patients.     

肾移植与血液透析治疗对尿毒症患者阴茎勃起功能影响的临床对照研究

目的:研究对比男性尿毒症患者接受肾移植与接受血液透析治疗勃起功能的变化及与生殖激素水平变化的关系。方法:收集2009年5月至2012年1月在我院门诊进行随访的肾移植男性患者35例、血液透析治疗的尿毒症患者30例,应用国际勃起功能指数(IIEF-5)调查表、夜间勃起功能(NEVA)测定仪评估阴茎勃起功能,同时测定生殖激素水平。结果:接受肾移植手术者勃起功能障碍(ED)患病率为51.4%,血液透析者ED患病率为73.3%(P<0.05);肾移植后的ED患者发病情况要明显轻于单纯血液透析的ED患者;肾移植中重度ED患者(25.7%)要明显少于单纯血液透析者(46.6%);肾移植组中ED患者夜间阴茎勃起次数、勃起强度及持续时间均强于单纯血液透析组ED患者(P<0.05);接受肾移植患者较单纯血液透析血清睾酮水平上升[(4.32±1.37)vs(2.53±1.12)ng/ml,P<0.05],雌二醇[(19.57±2.29)vs(43.38±5.58)pg/m)]和催乳激素[(8.59±1.19)vs(17.22±3.31)mIu/ml]明显下降(P均<0.05)。结论:肾移植受者肾功能良好时其总体勃起功能要优于单纯血液透析的尿毒症患者。     

Predicting risk of erectile dysfunction in patients with nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is one of the risk factors for erectile dysfunction (ED). We aimed to predict the risk of ED in patients with NAFLD. The study included 146 male patients complaining impotence admitted to the urology outpatient clinic aged 24–80 years without a history of alcohol use who underwent abdominal ultrasonography between February 2018 and January 2019. 106 patients with NAFLD and 40 men without NAFLD were included in the study. Clinical and laboratory parameters, ED status according to International Index of Erectile Function-5 were compared between patients with and without NAFLD. The mean age of patients was 51.47 ± 10.34 years. NAFLD was detected in 72.6% of the patients. No statistically significant difference was found regarding mean age, BMI, IIEF-5 scores, DM status, serum glucose levels (p > .05). Fasting insulin levels, hypertension (HT), insulin resistance (IR) and ED status of the patients with NAFLD were significantly higher than patients without NAFLD (p < .05). NAFLD was found to be a significantly independent associated with ED. We also found that patients with NAFLD have risk of ED 2.92 times higher than without NAFLD (OR: 2.92). For the patients presenting with erectile dysfunction, hepatic steatosis should also be considered.     

复方玄驹胶囊联合盐酸阿朴吗啡治疗勃起功能障碍的临床研究

目的:观察复方玄驹胶囊联合盐酸阿朴吗啡治疗阴茎勃起功能障碍(ED)的疗效。方法:采用复方玄驹胶囊联合盐酸阿朴吗啡治疗115例ED患者为治疗组,单用盐酸阿朴吗啡治疗111例作为对照组,经连续2个月的治疗后,观察两组的国际勃起功能问卷(IIEF-5)的评分改变情况。结果:治疗组与对照组IIEF-5的评分在治疗前分别为(11.42±2.38)、(11.56±2.65)分,两组比较差异无显著性(P>0.05);治疗后分别为(17.85±2.68)、(13.96±3.25)分,均有明显提高(P<0.01),而治疗组在治疗后的评分明显高于对照组(P<0.01);治疗组的显效率、有效率和总有效率均高于对照组。结论:复方玄驹胶囊联合盐酸阿朴吗啡治疗ED有较好疗效,值得临床推广使用。     

An independent indicator of erectile dysfunction is C-reactive protein/albumin ratio

Research has found that, instead of passive lipid-accumulated vascular damage, atherosclerosis which is the primary cause of erectile dysfunction (ED) can be seen as an active inflammatory cycle and that inflammation has a central role in the entire atherosclerotic process. As an inflammatory marker, serum C-reactive protein (CRP)/albumin ratio (CAR) may link to ED and ED severity. The CAR, demographic features and other criteria of 198 patients with ED who visited our outpatient clinic during March 2019–April 2020 were prospectively evaluated. The research also included healthy control subjects without systemic or infectious diseases. The mean difference of CAR between ED and no ED was statistically significant (0.55 ± 0.27 and 0.79 ± 0.49, p = .002 respectively). On the basis of the ROC analysis, CAR has a good ED diagnostic value with an area under the curve (AUC) of 0.63 (95% CI:0.541–0.714) and better diagnostic performance to distinguish ED severity (AUC:0.73, 95% CI:0.620–0.842). Additionally, mean CAR gradually increased with increasing severity of ED (for all p < .001). The CAR has been described as an independent ED indicator in the multivariate analysis (p = .001OR = 8.934; 95% CI:2.449–32.583). Increased CAR is associated with ED severity and increased ED risk. For CAR predicting ED and ED severity, a considerable cut-off point was identified.