AIM: To investigate the prevalence of erectile dysfunction(ED) and its association with depression in patients with chronic viral hepatitis.METHODS: This single center cross-sectional study was conducted from August 2...AIM: To investigate the prevalence of erectile dysfunction(ED) and its association with depression in patients with chronic viral hepatitis.METHODS: This single center cross-sectional study was conducted from August 2013 through January 2014. All outpatients with chronic viral hepatitis in our liver clinic between 18 and 80 years of age were considered eligible for this study. The exclusion criteria included well-established causes of ED, such as diabetes, hypertension, hyperlipidemia, alcohol abuse, liver cirrhosis, ischemic heart disease, renal disease, neurologic disease, and malignancy. We also excluded the patients who had incompletely answered the questionnaires. ED was assessed using the validated Korean version of the International Index of Erectile Function(IIEF-5) scale. The Korean version of the self-administered Beck Depression Inventory(BDI) scale was used to assess depression in the patients. Demographic and medical data were obtained from the patients' medical records. Current or past history of psychiatric diagnosis and drug history including the use of an antiviral agent and an antidepressant were also recorded. RESULTS: A total of 727 patients met the initial eligibility criteria. Six hundred seventeen patients were excluded because their medical records contained one or more of the previously determined exclusion criteria. The remaining 110 patients were assessed based on the BDI and IIEF-5 questionnaires. Based on the IIEF-5 scale, the prevalence of ED among patients with chronic viral hepatitis was 40%. Compared with the non-ED group, patients in the ED group were older. The proportion of patients in the ED group who had a job or who were na?ve peg-interferon users was lower than that in patients in the non-ED group. Patients with ED had significantly lower scores on the IIEF-5 scale than patients without ED(11.75 ± 4.88 vs 21.33 ± 1.86, P = 0.000). Patients with ED rated significantly higher scores on the BDI scale compared with patients without ED(12.59 ± 7.08 vs 5.30 ± 4.00, P = 0.000). Also, the IIEF-5 scores were negatively correlated with age, employment, and BDI scores. In the multiple logistic regression analysis, age and depression were independently associated with erectile dysfunction(P =0.019 and 0.000,respectively).CONCLUSION:Patients with chronic viral hepatitis have a high prevalence of ED.Age and depression are independent factors for ED in male patients with chronic viral hepatitis.展开更多
The premature ejaculation diagnostic tool （PEDT） is a brief diagnostic measure to assess premature ejaculation （PE）. However, there is insufficient evidence regarding its validity in the new evidence-based-defined...The premature ejaculation diagnostic tool （PEDT） is a brief diagnostic measure to assess premature ejaculation （PE）. However, there is insufficient evidence regarding its validity in the new evidence-based-defined PE. This study was performed to evaluate the validity of PEDT and its association with IIEF-15 in different types of evidence-based-defined PE. From June 2015 to January 2016, a total of 260 men complaining of PE and defined as lifelong PE （LPE）/acquired PE （APE） according to the evidence-based definition from Andrology Clinic of the First Affiliated Hospital of Anhui Medical University, along with 104 male healthy controls without PE from a medical examination center, were enrolled in this study. All individuals completed questionnaires including demographics, medical and sexual history, as well as PEDT and IIEF-15. After statistical analysis, it was found that men with PE reported higher PEDT scores （14.28 ± 3.05） and lower IIEF-15 （41.26 ± 8.20） than men without PE （PEDT： 5.32 ± 3.42, IIEF-15：52.66 ± 6.86, P 〈 0.001 for both）. It was suggested that a score of 〉9 indicated PE in both LPE and APE by sensitivity and specificity analyses （sensitivity： 0.875, 0.913; specificity： 0.865, 0.865, respectively）. In addition, IIEF-15 were higher in men with LPE （42.64 ± 8.11） than APE （39.43 ± 7.84, P 〈 0.001）. After adjusting for age, IIEF-15 was negatively related to PEDT in men with LPE （adjust r = -0.225, P 〈 0.001） and APE （adjust r = -0.378, P 〈 0.001）. In this study, we concluded that PEDT was valid in the diagnosis of evidenced-based-defined PE. Furthermore, IIEF-15 was negatively related to PEDT in men with different types of PE.展开更多
Previous published studies have shown an improvement of penile hemodynamic parameters after low-intensity extracorporeal shockwave therapy(Li-ESWT).However,the clinical significance of these findings remains unclear,a...Previous published studies have shown an improvement of penile hemodynamic parameters after low-intensity extracorporeal shockwave therapy(Li-ESWT).However,the clinical significance of these findings remains unclear,and definitive selection criteria for Li-ESWT based on preexisting comorbidities have yet to be established.This was an observational study of 113 patients with ED,evaluated between January 2019 and December 2021 in Andrology Unit at the Department of Urology and Renal Transplantation,University of Foggia(Foggia,Italy).Penile dynamic Doppler was performed to evaluate vascular parameters and 5-item version of the International Index of Erectile Dysfunction(IIEF-5)questionnaire was administered to assess the severity of ED.This was repeated 1 month after treatment.Patients with a peak systolic velocity(PSV)<30 cm s−1 were considered eligible for Li-ESWT.Our protocol consisted of 8 weekly sessions with 1500 strokes distributed in 5 different locations along the penis.After treatment,a significant mean(±standard deviation[s.d.])PSV increase of 5.0(±3.4)cm s−1 was recorded and 52/113(46.0%)patients reached a PSV>30 cm s−1 at posttherapeutic penile dynamic Doppler.A clinically significant IIEF-5 score improvement was observed in 7 patients,21 patients,and 2 patients with mild-to-moderate,moderate,and severe pretreatment ED,respectively.No different outcomes were assessed based on smoking habits,previous pelvic surgery,or use of oral phosphodiesterase-5 inhibitor(PDE5i).On the other side,only 1(6.7%)in 15 patients with diabetes mellitus showed an IIEF-5 score improvement after Li-ESWT.Shockwave treatment determined a significant increase in PSV and correlated IIEF-5 improvement in ED patients.This advantage seemed particularly evident for moderate ED and was not affected by smoking habits,previous pelvic surgery,and use of PDE5i.Conversely,diabetic patients did not benefit from the treatment.展开更多
Background Erectile dysfunction （ED） is a common impairment among older men, and the prevalence rates increase sharply after age of 60 years. Most studies have focused on the prevalence rate or dangerouse factors. T...Background Erectile dysfunction （ED） is a common impairment among older men, and the prevalence rates increase sharply after age of 60 years. Most studies have focused on the prevalence rate or dangerouse factors. The aim of this study was to investigate the basic epidemiologic data about ED patients with different ED courses. The purpose of this researth was to understand the therapeutic effect of phosphodiesterase type 5 inhibitor （PDE5-1） and see how and why the ED course impact the progress of ED and the therapeutic effect of PDE5-1 treatment. Methods From June 2008 to June 2009, 4252 questionnaires （Quality of Erection Questionnaire, QEQ） were gathered from 46 centers by urology or andrology doctors all around China. Patients with ED （age 〉 20 years） filled in first half of the questionnaires when they came for the first time, and then completed the second half 4 weeks after PDE5-1 therapy. Results ED courses of most patients were less than 5 years （〈5 years, 74.0%; 5-10 years 20.8%; 〉10 years, 5.2%）. As ED course increasing, the incidence of the risk factors of ED, such as smoking, drinking, hypertension, diabetes, heart disease and hyperlipidemia also increase （P 〈0.01）. PDES-I was effective in improving the quality of sexual activities （P 〈0.01）. Administration of PDE5-1 improves satisfaction, enjoyment and frequency of sexual activities. The longer the ED course, the worse the therapeutic effect （〈5 years, 96.1%; 5-10 years, 94.9%; 〉10 years, 89.0%） （P 〈0.01）. Conclusions The ED course greatly affected the therapeutic effect of PDE5-1, the patients with ED should consult doctor at early stage of the disease. Admistration of PDE5-1 effectively improves the penile erection and the quality of sexual life of the patients hence should be considered as first-line medicine in the treatment of ED.展开更多
Sexual dysfunction(SD)is a prevalent but very commonly ignored aspect in the treatment of liver diseases and cirrhosis.The etiology of SD is multifactorial and therefore treatment strategies are complex,especially in ...Sexual dysfunction(SD)is a prevalent but very commonly ignored aspect in the treatment of liver diseases and cirrhosis.The etiology of SD is multifactorial and therefore treatment strategies are complex,especially in females.Phosphodiesterase inhibitors are useful and effective in erectile dysfunction in males but in females,no single drug is available for SD,therefore multimodal treatment is required depending upon the cause.The foremost and fundamental requirement in both genders is to be stress-free and have adequate control of liver diseases.Improved quality of life is helpful in improving SD and vice versa is also true.Therefore,patients suffering from liver diseases should come forward and ask for treatment for SD,and physicians should actively enquire about SD while history taking and evaluating these patients.SD results in deterioration of quality of life,and both are modifiable and treatable aspects of liver diseases,which are never addressed actively,due to social taboos and fears of SD treatment in the presence of liver diseases.The diagnosis of SD does not require costly investigations,as the diagnosis can be established based on validated questionnaires available for both genders,therefore detailed targeted history taking using questionnaires is essential.Data are emerging in this area but is still at an early stage.More studies should be dedicated to SD in liver diseases.展开更多
We compared the efficacy and safety between once-daily dosing and on-demand use of udenafil for type 2 diabetic patients with erectile dysfunction （ED）. A multi-center, randomized, open-label, parallel-group, 12-wee...We compared the efficacy and safety between once-daily dosing and on-demand use of udenafil for type 2 diabetic patients with erectile dysfunction （ED）. A multi-center, randomized, open-label, parallel-group, 12-week study was conducted. 161 patients who improved with on-demand 200 mg of udenafil according to Sexual Encounter Profile （SEP） diary Question 2 and 3 （Q2 and Q3） were randomized into 200 mg on-demand （n = 80） or 50 mg once-daily （n = 81） dosing groups for 8 weeks. The dosing period was followed by a 4-week treatment-free period. The primary efficacy endpoint was the change of the International Index of Erectile Function （IIEF） erectile function domain （EFD） score. The secondary efficacy endpoints included changes to the SEP diary Q2, Q3, IIEF Q3, Q4, other domains of IIEF, Global Assessment Question, and shift to the normal rate （EFD 〉 26）. Vascular endothelial markers were also assessed. The IIEF-EFD score of both groups improved after 8 weeks of treatment （P 〈 0.0001）. There was no statistically significant difference between two groups. Improvement was not maintained after the treatment-free follow-up period. Similar results were observed in the secondary efficacy endpoints. There was also no significant difference in vascular endothelial markers. Daily udenafil was well-tolerated, and there was no significant difference in the adverse drug reactions and adverse events between the two groups. Flushing and headache were the most frequent adverse events. Both regimens improved ED in diabetic patients and were well-tolerated. Further studies are needed to assess the effect of daily udenafil treatment in diabetic patients.展开更多
Erectile dysfunction(ED),a condition closely related to cardiovascular morbidity and mortality,is frequently associated with obesity.In this study,we aimed to determine the prevalence of ED and evaluate the associated...Erectile dysfunction(ED),a condition closely related to cardiovascular morbidity and mortality,is frequently associated with obesity.In this study,we aimed to determine the prevalence of ED and evaluate the associated risk factors in a cohort of 254 young(18–49 years)nondiabetic obese(body mass index[BMI]≥30 kg m−2)men from primary care.Erectile function(International Index of Erectile Function[IIEF-5]questionnaire),quality of life(Aging Males'Symptoms[AMS scale]),and body composition analysis(Tanita MC-180MA)were determined.Total testosterone was determined using high-performance liquid chromatography–mass spectrometry.Multivariate logistic regression analysis was used to study the factors associated with ED.ED prevalence was 42.1%.Subjects with ED presented higher BMI,waist circumference,number of components of the metabolic syndrome,AMS score,insulin resistance,and a more unfavorable body composition than those without ED.Multivariate logistic regression analysis showed that a pathological AMS score(odds ratio[OR]:4.238,P<0.001),degree of obesity(BMI≥40 kg m−2,OR:2.602,P=0.005,compared with BMI 30–34.9 kg m−2),high-density lipoprotein(HDL)-cholesterol levels(OR:0.956,P=0.004),and age(OR:1.047,P=0.016)were factors independently associated with ED.In conclusion,we demonstrate that,in a primary care-based cohort of nondiabetic young obese men,ED affected>40%of subjects.A pathological AMS score,the degree of obesity,and age were positively associated with ED,while elevated HDL-cholesterol levels were inversely associated with the odds of presenting ED.Further prospective studies are needed to evaluate the long-term consequences of ED in this population.展开更多
Noninvasive low-intensity extracorporeal shockwave treatment(Li-ESWT)has been widely used to treat erection disorders.There is no clear information regarding either the selection of patients for the treatment or the t...Noninvasive low-intensity extracorporeal shockwave treatment(Li-ESWT)has been widely used to treat erection disorders.There is no clear information regarding either the selection of patients for the treatment or the treatment protocol.In this study,we aimed to investigate the efficacy of extracorporeal shockwave therapy in diabetic patients with severe erectile dysfunction(International Index of Erectile Function-5[IIEF-5]scores of 5 to 7).Sixty-three diabetes mellitus patients with erectile dysfunction having IIEF-5 scores of 5 to 7 and not showing a recovery of potency despite phosphodiesterase type 5 inhibitor therapy for the past 6 months were included in the study.The patients were evaluated based on their IIEF-5 scores and Erection Hardness Scale scores.The IIEF-5 score(mean±standard deviation[s.d.])increased from 5.29±1.67 to 5.56±1.85,with a difference of 0.27±0.18(P>0.05).The Erection Hardness Scale scores(mean±s.d.),on the other hand,increased from 1.46±0.50 to 1.48±0.50,with a difference of 0.02±0(P>0.05).In conclusion,the response to phosphodiesterase type 5 inhibitors did not change after extracorporeal shockwave treatment in diabetes mellitus patients with severe erectile dysfunction(IIEF-5 scores of 5 to 7).展开更多
文摘AIM: To investigate the prevalence of erectile dysfunction(ED) and its association with depression in patients with chronic viral hepatitis.METHODS: This single center cross-sectional study was conducted from August 2013 through January 2014. All outpatients with chronic viral hepatitis in our liver clinic between 18 and 80 years of age were considered eligible for this study. The exclusion criteria included well-established causes of ED, such as diabetes, hypertension, hyperlipidemia, alcohol abuse, liver cirrhosis, ischemic heart disease, renal disease, neurologic disease, and malignancy. We also excluded the patients who had incompletely answered the questionnaires. ED was assessed using the validated Korean version of the International Index of Erectile Function(IIEF-5) scale. The Korean version of the self-administered Beck Depression Inventory(BDI) scale was used to assess depression in the patients. Demographic and medical data were obtained from the patients' medical records. Current or past history of psychiatric diagnosis and drug history including the use of an antiviral agent and an antidepressant were also recorded. RESULTS: A total of 727 patients met the initial eligibility criteria. Six hundred seventeen patients were excluded because their medical records contained one or more of the previously determined exclusion criteria. The remaining 110 patients were assessed based on the BDI and IIEF-5 questionnaires. Based on the IIEF-5 scale, the prevalence of ED among patients with chronic viral hepatitis was 40%. Compared with the non-ED group, patients in the ED group were older. The proportion of patients in the ED group who had a job or who were na?ve peg-interferon users was lower than that in patients in the non-ED group. Patients with ED had significantly lower scores on the IIEF-5 scale than patients without ED(11.75 ± 4.88 vs 21.33 ± 1.86, P = 0.000). Patients with ED rated significantly higher scores on the BDI scale compared with patients without ED(12.59 ± 7.08 vs 5.30 ± 4.00, P = 0.000). Also, the IIEF-5 scores were negatively correlated with age, employment, and BDI scores. In the multiple logistic regression analysis, age and depression were independently associated with erectile dysfunction(P =0.019 and 0.000,respectively).CONCLUSION:Patients with chronic viral hepatitis have a high prevalence of ED.Age and depression are independent factors for ED in male patients with chronic viral hepatitis.
文摘The premature ejaculation diagnostic tool （PEDT） is a brief diagnostic measure to assess premature ejaculation （PE）. However, there is insufficient evidence regarding its validity in the new evidence-based-defined PE. This study was performed to evaluate the validity of PEDT and its association with IIEF-15 in different types of evidence-based-defined PE. From June 2015 to January 2016, a total of 260 men complaining of PE and defined as lifelong PE （LPE）/acquired PE （APE） according to the evidence-based definition from Andrology Clinic of the First Affiliated Hospital of Anhui Medical University, along with 104 male healthy controls without PE from a medical examination center, were enrolled in this study. All individuals completed questionnaires including demographics, medical and sexual history, as well as PEDT and IIEF-15. After statistical analysis, it was found that men with PE reported higher PEDT scores （14.28 ± 3.05） and lower IIEF-15 （41.26 ± 8.20） than men without PE （PEDT： 5.32 ± 3.42, IIEF-15：52.66 ± 6.86, P 〈 0.001 for both）. It was suggested that a score of 〉9 indicated PE in both LPE and APE by sensitivity and specificity analyses （sensitivity： 0.875, 0.913; specificity： 0.865, 0.865, respectively）. In addition, IIEF-15 were higher in men with LPE （42.64 ± 8.11） than APE （39.43 ± 7.84, P 〈 0.001）. After adjusting for age, IIEF-15 was negatively related to PEDT in men with LPE （adjust r = -0.225, P 〈 0.001） and APE （adjust r = -0.378, P 〈 0.001）. In this study, we concluded that PEDT was valid in the diagnosis of evidenced-based-defined PE. Furthermore, IIEF-15 was negatively related to PEDT in men with different types of PE.
文摘Previous published studies have shown an improvement of penile hemodynamic parameters after low-intensity extracorporeal shockwave therapy(Li-ESWT).However,the clinical significance of these findings remains unclear,and definitive selection criteria for Li-ESWT based on preexisting comorbidities have yet to be established.This was an observational study of 113 patients with ED,evaluated between January 2019 and December 2021 in Andrology Unit at the Department of Urology and Renal Transplantation,University of Foggia(Foggia,Italy).Penile dynamic Doppler was performed to evaluate vascular parameters and 5-item version of the International Index of Erectile Dysfunction(IIEF-5)questionnaire was administered to assess the severity of ED.This was repeated 1 month after treatment.Patients with a peak systolic velocity(PSV)<30 cm s−1 were considered eligible for Li-ESWT.Our protocol consisted of 8 weekly sessions with 1500 strokes distributed in 5 different locations along the penis.After treatment,a significant mean(±standard deviation[s.d.])PSV increase of 5.0(±3.4)cm s−1 was recorded and 52/113(46.0%)patients reached a PSV>30 cm s−1 at posttherapeutic penile dynamic Doppler.A clinically significant IIEF-5 score improvement was observed in 7 patients,21 patients,and 2 patients with mild-to-moderate,moderate,and severe pretreatment ED,respectively.No different outcomes were assessed based on smoking habits,previous pelvic surgery,or use of oral phosphodiesterase-5 inhibitor(PDE5i).On the other side,only 1(6.7%)in 15 patients with diabetes mellitus showed an IIEF-5 score improvement after Li-ESWT.Shockwave treatment determined a significant increase in PSV and correlated IIEF-5 improvement in ED patients.This advantage seemed particularly evident for moderate ED and was not affected by smoking habits,previous pelvic surgery,and use of PDE5i.Conversely,diabetic patients did not benefit from the treatment.
文摘Background Erectile dysfunction （ED） is a common impairment among older men, and the prevalence rates increase sharply after age of 60 years. Most studies have focused on the prevalence rate or dangerouse factors. The aim of this study was to investigate the basic epidemiologic data about ED patients with different ED courses. The purpose of this researth was to understand the therapeutic effect of phosphodiesterase type 5 inhibitor （PDE5-1） and see how and why the ED course impact the progress of ED and the therapeutic effect of PDE5-1 treatment. Methods From June 2008 to June 2009, 4252 questionnaires （Quality of Erection Questionnaire, QEQ） were gathered from 46 centers by urology or andrology doctors all around China. Patients with ED （age 〉 20 years） filled in first half of the questionnaires when they came for the first time, and then completed the second half 4 weeks after PDE5-1 therapy. Results ED courses of most patients were less than 5 years （〈5 years, 74.0%; 5-10 years 20.8%; 〉10 years, 5.2%）. As ED course increasing, the incidence of the risk factors of ED, such as smoking, drinking, hypertension, diabetes, heart disease and hyperlipidemia also increase （P 〈0.01）. PDES-I was effective in improving the quality of sexual activities （P 〈0.01）. Administration of PDE5-1 improves satisfaction, enjoyment and frequency of sexual activities. The longer the ED course, the worse the therapeutic effect （〈5 years, 96.1%; 5-10 years, 94.9%; 〉10 years, 89.0%） （P 〈0.01）. Conclusions The ED course greatly affected the therapeutic effect of PDE5-1, the patients with ED should consult doctor at early stage of the disease. Admistration of PDE5-1 effectively improves the penile erection and the quality of sexual life of the patients hence should be considered as first-line medicine in the treatment of ED.
文摘Sexual dysfunction(SD)is a prevalent but very commonly ignored aspect in the treatment of liver diseases and cirrhosis.The etiology of SD is multifactorial and therefore treatment strategies are complex,especially in females.Phosphodiesterase inhibitors are useful and effective in erectile dysfunction in males but in females,no single drug is available for SD,therefore multimodal treatment is required depending upon the cause.The foremost and fundamental requirement in both genders is to be stress-free and have adequate control of liver diseases.Improved quality of life is helpful in improving SD and vice versa is also true.Therefore,patients suffering from liver diseases should come forward and ask for treatment for SD,and physicians should actively enquire about SD while history taking and evaluating these patients.SD results in deterioration of quality of life,and both are modifiable and treatable aspects of liver diseases,which are never addressed actively,due to social taboos and fears of SD treatment in the presence of liver diseases.The diagnosis of SD does not require costly investigations,as the diagnosis can be established based on validated questionnaires available for both genders,therefore detailed targeted history taking using questionnaires is essential.Data are emerging in this area but is still at an early stage.More studies should be dedicated to SD in liver diseases.
文摘We compared the efficacy and safety between once-daily dosing and on-demand use of udenafil for type 2 diabetic patients with erectile dysfunction （ED）. A multi-center, randomized, open-label, parallel-group, 12-week study was conducted. 161 patients who improved with on-demand 200 mg of udenafil according to Sexual Encounter Profile （SEP） diary Question 2 and 3 （Q2 and Q3） were randomized into 200 mg on-demand （n = 80） or 50 mg once-daily （n = 81） dosing groups for 8 weeks. The dosing period was followed by a 4-week treatment-free period. The primary efficacy endpoint was the change of the International Index of Erectile Function （IIEF） erectile function domain （EFD） score. The secondary efficacy endpoints included changes to the SEP diary Q2, Q3, IIEF Q3, Q4, other domains of IIEF, Global Assessment Question, and shift to the normal rate （EFD 〉 26）. Vascular endothelial markers were also assessed. The IIEF-EFD score of both groups improved after 8 weeks of treatment （P 〈 0.0001）. There was no statistically significant difference between two groups. Improvement was not maintained after the treatment-free follow-up period. Similar results were observed in the secondary efficacy endpoints. There was also no significant difference in vascular endothelial markers. Daily udenafil was well-tolerated, and there was no significant difference in the adverse drug reactions and adverse events between the two groups. Flushing and headache were the most frequent adverse events. Both regimens improved ED in diabetic patients and were well-tolerated. Further studies are needed to assess the effect of daily udenafil treatment in diabetic patients.
基金The authors wish to thank all the study participants for their collaboration.The research group belongs to the“Centros de Investigacion en Red”(CIBERobn,of the“Instituto de Salud Carlos III).MMV was supported by a“Rio Hortega”grant from“Instituto de Salud Carlos III,”Madrid,Spain(CM18/00120)JCFG was supported by a research contract from Servicio Andaluz de Salud(SAS,B-0003-2017)+2 种基金FCD and LGS were supported by Nicolas Monardes(C-0032-2016,C-0028-2018)from Consejeria de Salud,cofunded by the Fondo Europeo de Desarrollo Regional-FEDER,Madrid,SpainDCC by FPU(FPU13/04211)from Ministerio de Educacion,Cultura y DeporteThis work was supported in part by a grant from Servicio Andaluz de Salud(PI-0173-2013).
文摘Erectile dysfunction(ED),a condition closely related to cardiovascular morbidity and mortality,is frequently associated with obesity.In this study,we aimed to determine the prevalence of ED and evaluate the associated risk factors in a cohort of 254 young(18–49 years)nondiabetic obese(body mass index[BMI]≥30 kg m−2)men from primary care.Erectile function(International Index of Erectile Function[IIEF-5]questionnaire),quality of life(Aging Males'Symptoms[AMS scale]),and body composition analysis(Tanita MC-180MA)were determined.Total testosterone was determined using high-performance liquid chromatography–mass spectrometry.Multivariate logistic regression analysis was used to study the factors associated with ED.ED prevalence was 42.1%.Subjects with ED presented higher BMI,waist circumference,number of components of the metabolic syndrome,AMS score,insulin resistance,and a more unfavorable body composition than those without ED.Multivariate logistic regression analysis showed that a pathological AMS score(odds ratio[OR]:4.238,P<0.001),degree of obesity(BMI≥40 kg m−2,OR:2.602,P=0.005,compared with BMI 30–34.9 kg m−2),high-density lipoprotein(HDL)-cholesterol levels(OR:0.956,P=0.004),and age(OR:1.047,P=0.016)were factors independently associated with ED.In conclusion,we demonstrate that,in a primary care-based cohort of nondiabetic young obese men,ED affected>40%of subjects.A pathological AMS score,the degree of obesity,and age were positively associated with ED,while elevated HDL-cholesterol levels were inversely associated with the odds of presenting ED.Further prospective studies are needed to evaluate the long-term consequences of ED in this population.
文摘Noninvasive low-intensity extracorporeal shockwave treatment(Li-ESWT)has been widely used to treat erection disorders.There is no clear information regarding either the selection of patients for the treatment or the treatment protocol.In this study,we aimed to investigate the efficacy of extracorporeal shockwave therapy in diabetic patients with severe erectile dysfunction(International Index of Erectile Function-5[IIEF-5]scores of 5 to 7).Sixty-three diabetes mellitus patients with erectile dysfunction having IIEF-5 scores of 5 to 7 and not showing a recovery of potency despite phosphodiesterase type 5 inhibitor therapy for the past 6 months were included in the study.The patients were evaluated based on their IIEF-5 scores and Erection Hardness Scale scores.The IIEF-5 score(mean±standard deviation[s.d.])increased from 5.29±1.67 to 5.56±1.85,with a difference of 0.27±0.18(P>0.05).The Erection Hardness Scale scores(mean±s.d.),on the other hand,increased from 1.46±0.50 to 1.48±0.50,with a difference of 0.02±0(P>0.05).In conclusion,the response to phosphodiesterase type 5 inhibitors did not change after extracorporeal shockwave treatment in diabetes mellitus patients with severe erectile dysfunction(IIEF-5 scores of 5 to 7).
