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Belladelli F, Li S, Zhang CA, Del Giudice F, Basran S, Muncey W, Glover F, Seranio N, Fallara G, Montorsi F, Salonia A, Eisenberg ML. The Association Between Insomnia, Insomnia Medications, and Erectile Dysfunction. Eur Urol Focus 2024; 10:139-145. [PMID: 37690918 DOI: 10.1016/j.euf.2023.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/31/2023] [Accepted: 08/15/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Sleep quality and duration have been investigated for their association with health. Insomnia affects up to one-third of adults and may impact male erectile function. In addition, medical treatments for insomnia (many of which are sedatives) may also affect erectile quality. OBJECTIVE To investigate the association of erectile dysfunction (ED) in patients diagnosed with and treated for insomnia. DESIGN, SETTING, AND PARTICIPANTS We utilized the IBM MarketScan (2007-2016) Commercial and Medicare Supplemental Databases (v 2.0). Age- and enrollment-matched controls were selected among patients without insomnia diagnosis or treatment. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Cox proportional hazard models were used to estimate the risk of incident ED (ie, diagnosis alone, or diagnosis and treatment with phosphodiesterase-5 inhibitors [PDE5i], intracavernous injection (ICI)/urethral suppositories, and penile prosthesis) after the diagnosis or treatment of insomnia while adjusting for relevant comorbidities. RESULTS AND LIMITATIONS In total, 539 109 men with an insomnia diagnosis were identified. Of these men, 356 575 were also medically treated for insomnia. The mean (±standard deviation) follow-up times for patients diagnosed with insomnia and those diagnosed with and treated for insomnia were 2.8 ± 1.6 and 3.1 ± 1.8 yr, respectively. Men with insomnia were more commonly smokers and had a higher number of office visits and comorbidities than controls (p < 0.001). On an adjusted analysis, both untreated and treated insomnia were associated with increased risks of ED diagnosis (hazard ratio or HR [95% confidence interval {CI}]: 1.58 [1.54-1.62] and 1.66 [1.64-1.69], respectively; p < 0.001). Similarly, men with treated insomnia had a higher risk of having ED treated with PDE5i (HR [95% CI]: 1.52 [1.49-1.55]; p < 0.001) and ICI (HR [95% CI]: 1.32 [1.14-1.54]; p < 0.001) when compared with controls. A limitation of this study was that a lack of granularity regarding patient clinical characteristics (eg, severity of disease, laboratory data, etc.) is inherent to insurance claims data. In addition, the follow-up was limited and may affect associations at longer time points. CONCLUSIONS In the current report, a consistent association between insomnia and ED diagnosis was identified. Men diagnosed with insomnia only were found to have a higher risk of developing ED. Moreover, men with pharmacological insomnia treatments were more often prescribed treatments for ED. Given the prevalence of insomnia, future studies are warranted to delineate the association of insomnia and its treatment with erectile function. PATIENT SUMMARY Insomnia affects up to one-third of adults and impact male erectile function. Men only diagnosed with insomnia were found to have a higher risk of developing erectile dysfunction (ED). Moreover, men with pharmacological insomnia treatments were more often prescribed treatments for ED.
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Affiliation(s)
- Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy; Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Shufeng Li
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA; Department of Dermatology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Chiyuan A Zhang
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Francesco Del Giudice
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA; Department of Urology, University Sapienza, Rome, Italy
| | - Satvir Basran
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Wade Muncey
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Frank Glover
- Department of Urology, University Sapienza, Rome, Italy
| | - Nicolas Seranio
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Giuseppe Fallara
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Michael L Eisenberg
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA.
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Belladelli F, Li S, Zhang CA, Muncey W, Del Giudice F, Glover F, Seranio N, Basran S, Fallara G, Montorsi F, Salonia A, Eisenberg ML. Use of phosphodiesterase 5 inhibitors is not associated with ocular adverse events. J Sex Med 2023; 20:1399-1406. [PMID: 37861186 DOI: 10.1093/jsxmed/qdad137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/14/2023] [Accepted: 07/30/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Phosphodiesterase 5 inhibitor (PDE5i) use has been linked to a number of ocular side effects, such as serous retinal detachment (SRD), retinal vascular occlusion (RVO), and ischemic optic neuropathy (ION). AIM We investigated the risk for SRD, RVO, and ION in patients using PDE5is. METHODS We utilized the IBM MarketScan (2007-2021) Commercial and Medicare Supplemental Databases (version 2.0) for this analysis. To estimate overall events risk, Cox proportional hazard models were applied to calculate the hazard ratios (HRs) for erectile dysfunction (ED) diagnosis and the different treatments, adjusting for region, median age, obesity, diabetes mellitus, hyperlipidemia, smoking, hypertension, coronary artery disease, and sleep apnea. Additionally, the same analyses were performed to calculate the HRs for benign prostatic hyperplasia (BPH) diagnosis and the different treatments. OUTCOMES HRs for SRD, RVO, and ION. RESULTS In total, 1 938 262 men with an ED diagnosis were observed during the study period. Among them, 615 838 (31.8%) were treated with PDE5is. In total, 2 175 439 men with a BPH diagnosis were observed during the study period. Among them, 175 725 (8.1%) were treated with PDE5is. On adjusted Cox regression analysis, PDE5i use was not associated with SRD, RVO, ION, and any ocular event when compared with ED diagnosis and other ED treatments. Importantly, as the intensity of ED treatment increased, so did the risk of ocular events. In addition, PDE5i use was not associated with SRD and ION when compared with BPH diagnosis and other BPH treatments. In contrast, in patients with BPH, PDE5i use was associated with RVO (HR, 1.14; 95% CI, 1.06-1.23). Importantly, patients with BPH receiving other medical treatment (ie, 5a reductase/alpha blocker; HR, 1.11; 95% CI, 1.06-1.16) or surgical treatment (HR, 1.10; 95% CI, 1.02-1.19) had a higher risk of RVO. CLINICAL IMPLICATIONS We did not observe any consistent association between PDE5i use and any ocular adverse events (SRD, RVO, and ION). STRENGTHS AND LIMITATIONS Because we did not have access to the patients' medical records, we recorded outcome definitions using ICD-9 and ICD-10 coding. CONCLUSIONS Patients using PDE5is for ED or BPH indications did not have an increased risk of ocular events, even when compared with other treatments for ED or BPH.
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Affiliation(s)
- Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan 20132, Italy
- University Vita-Salute San Raffaele, Milan 20132, Italy
- Department of Urology, School of Medicine, Stanford University, Stanford, CA 94305, United States
| | - Shufeng Li
- Department of Urology, School of Medicine, Stanford University, Stanford, CA 94305, United States
| | - Chiyuan A Zhang
- Department of Urology, School of Medicine, Stanford University, Stanford, CA 94305, United States
| | - Wade Muncey
- Department of Urology, School of Medicine, Stanford University, Stanford, CA 94305, United States
| | - Francesco Del Giudice
- Department of Urology, School of Medicine, Stanford University, Stanford, CA 94305, United States
- Department of Urology, University Sapienza, Rome 00185, Italy
| | - Frank Glover
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, United States
| | - Nicolas Seranio
- Department of Urology, School of Medicine, Stanford University, Stanford, CA 94305, United States
| | - Satvir Basran
- Department of Urology, School of Medicine, Stanford University, Stanford, CA 94305, United States
| | - Giuseppe Fallara
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan 20132, Italy
- University Vita-Salute San Raffaele, Milan 20132, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan 20132, Italy
- University Vita-Salute San Raffaele, Milan 20132, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan 20132, Italy
- University Vita-Salute San Raffaele, Milan 20132, Italy
| | - Michael L Eisenberg
- Department of Urology, School of Medicine, Stanford University, Stanford, CA 94305, United States
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Muhammad AZ, Grema BA, Shuaibu A, Michael GC. Prevalence, severity, and correlates of erectile dysfunction among male adult patients of a primary care clinic in North-West Nigeria. Afr Health Sci 2023; 23:670-681. [PMID: 38223611 PMCID: PMC10782352 DOI: 10.4314/ahs.v23i2.77] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
Background Erectile dysfunction (ED) is a common sexual problem that profoundly affects intimate relationships. It is poorly studied in North-western Nigeria. Objectives To assess the prevalence, severity and predictors of ED among adult males attending a primary care clinic in Northwest Nigeria. Methods A cross-section of 392 males (aged ≥25 years) were randomly selected from attendees of a family medicine clinic in Kano, Nigeria. Information regarding their biodata, lifestyle factors, and clinical characteristics was obtained using a structured questionnaire. The International Index of Erectile Function Questionnaire (version 5) and Patient Health Questionnaire-2 assessed ED and depression, respectively. Results The participants' mean age was 45±14.1 years (range: 26-86 years). Most participants were married (88.8%), had one sexual partner (71.7%), had tertiary education (44.4%) and were traders (49.7%). The prevalence of ED was 52.3% (205/392) [comprising mild (36.0%), mild-to-moderate (14.3%), moderate (1.5%) and severe (0.5%)]. Age, body mass index (BMI), marital status, number of sexual partners, monthly income, type of exercise, hypertension history, blood pressure reading, antihypertensive and peptic ulcer drug use were associated with ED (P<0.05). However, age (≥50years) (OR= 1.91, 95%CI [1.28-2.85], P=0.001) and overweight/obesity (OR =1.81, 95%CI [1.18-2.77], P=0.007) were the predictors of ED in this population. Conclusion ED prevalence was high, although mainly of the mild form. Age (≥50years) and overweight/obesity predicted ED. Hence, the need for early screening, objective grading of ED, identification of modifiable risk factors (e.g., overweight/obesity) and commencing proper treatment and prevention in this setting.
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Affiliation(s)
- Abdullahi Z Muhammad
- Department of Family Medicine, Federal Medical Centre, Azare, Bauchi State, Nigeria
| | - Bukar A Grema
- Department of Family Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Godpower C Michael
- Department of Family Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
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Crafa A, Calogero AE, Cannarella R, Condorelli RA, Aversa A, La Vignera S. Productivity Index in Clinical Andrology: Research Directions on High-Impact Topics and in Particular on Male Infertility. J Clin Med 2023; 12:jcm12093152. [PMID: 37176596 PMCID: PMC10179551 DOI: 10.3390/jcm12093152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/23/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
PURPOSE Andrological diseases have an important social and economic impact as they cause a serious impairment of the quality of life of the affected patient. Epidemiologically, the impact of these disorders is progressively increasing, as demonstrated by the ever-growing prevalence of male infertility. This evidence justifies the rapid development of research in andrology that the scientific community has undertaken in recent decades. This study aims to evaluate the productivity index of the main andrological topics studied and reported in the literature. METHODS The total number of published articles was extracted from the Scopus database by entering the following keywords and mesh terms: "Male Infertility", "Erectile Dysfunction", "Premature Ejaculation", "Male Hypogonadism", "Testicular Tumors", "Prostate Cancer", "Prostatic hyperplasia", "Prostate hyperplasia", "Prostatitis", "Prostate inflammation", and "Male Accessory Gland Infections". Furthermore, a list of the top 50 researchers sorted by productivity was created for each topic. For male infertility, a further search was performed by combining the search term "male infertility" with the above-mentioned terms. Thus, a list of the top 30 authors in order of productivity was also extracted. The graphs were created using Excel. RESULTS AND CONCLUSIONS As could be expected, we observed that prostate cancer and male infertility were the two most investigated topics, followed by benign prostatic hyperplasia and erectile dysfunction, whose prevalence is set to increase given the progressive aging of the population. Less investigated is the inflammation of the accessory sexual glands. In conclusion, this study provides a ranking of the main andrological topics investigated in the literature, also presenting the top list of the most productive authors for each one.
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Affiliation(s)
- Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Aldo Eugenio Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
- Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | | | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
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Sansone A, Reisman Y, Meto S, Dolci S, Jannini EA. The Role of the "Anti-Inflammatory" Couple for the Management of Hyperuricemia With Deposition. Sex Med 2022; 10:100562. [PMID: 36087454 PMCID: PMC9537271 DOI: 10.1016/j.esxm.2022.100562] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Gout is the most prevalent inflammatory crystal arthropathy worldwide and is a chronic disease requiring strict, lifelong adherence to drug therapy and healthy lifestyles. Gout has a heavy burden on the patient's sexual health, owing to the associated inflammatory status, long-term complications, and chronic pain; however, the effects of gout also extend to the partner's sexual health. AIMS We aimed to investigate how the presence of a partner could influence the complex interaction between risk factors for sexual dysfunctions in gout in order to define novel strategies to improve sexual health and disease management. METHODS Clinical and experimental data on the role of the couple in chronic diseases, as well as on the association between gout and sexual health, were searched through Pubmed. MAIN OUTCOME MEASURES Evidence from studies describing how the presence of a couple and leveraging sexual health can improve management and clinical outcomes for chronic diseases. RESULTS Treatment adherence can improve the sexual health of gout patients and their partners; likewise, by leveraging sexual health, it would be possible to promote better health-seeking behaviors, ultimately improving gout management. CLINICAL IMPLICATIONS Promoting awareness of the sexual health relevance of gout can potentially be a pivotal strategy to improve disease management and prevent the progression of sexual dysfunctions from subclinical to overt forms. STRENGTHS AND LIMITATIONS Identifying a bidirectional association between sexual health and disease management paves the way for improved disease control and can potentially prevent the development of sexual dysfunctions in couples affected by gout. However, the relevance of the couple has not been adequately addressed in gout management, and most evidence comes from other chronic diseases. CONCLUSION Improving gout management results in better sexual health, and vice-versa promoting better sexual health can improve disease control for gout. The presence of a partner improves the behavioral well-being of gout patients, with beneficial effects on both sexual health and gout management. Sansone A, Reisman Y, Meto S, et al. The Role of the "Anti-Inflammatory" Couple for the Management of Hyperuricemia With Deposition. Sex Med 2022;10:100562.
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Affiliation(s)
- Andrea Sansone
- Chair of Endocrinology & Medical Sexology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Suada Meto
- A. Menarini Industrie Farmaceutiche Riunite S.R.L, Florence, Italy
| | - Susanna Dolci
- Chair of Anatomy, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology & Medical Sexology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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Pozzi E, Fallara G, Capogrosso P, Boeri L, Belladelli F, Corsini C, Costa A, Candela L, Cignoli D, Cazzaniga W, Schifano N, Ventimiglia E, d'Arma A, Montorsi F, Salonia A. Primary organic versus primary psychogenic erectile dysfunction: findings from a real-life cross-sectional study. Andrology 2022; 10:1302-1309. [PMID: 35723046 DOI: 10.1111/andr.13212] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 05/03/2022] [Accepted: 05/24/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Erectile dysfunction aetiology (ED) has been historically identified as organic, psychogenic, and mixed. OBJECTIVES To stratify and compare a cohort of patients seeking medical help for ED for the first time according to the newly proposed binary classification of the EAU guidelines: "primary organic" versus "primary psychogenic". MATERIALS AND METHODS Complete data from 2009 consecutive patients presenting for ED were analysed. All patients completed the IIEF at baseline. According to the presence of ED-related risk factors indexed by the EAU guidelines on Sexual and Reproductive health, patients were categorised as having primary organic (≥1 risk factor) or primary psychogenic (0 risk factors) ED. Descriptive statistics compared the two groups. Linear regression analysis tested the association between the number of risk factors and ED severity. Locally estimated scatterplot smoothing (LOESS) method graphically explored the relationship between the number of risk factors for ED and the IIEF domains scores. RESULTS Median (IQR) age at first presentation was 50 (39-61) years. Of all, 1632 (86.2%) and 377 (13.8%) were identified as having primary organic and primary psychogenic ED, respectively. Overall, 1488 (74.1%) patients were >40 years of age; in this subgroup, most frequent risk factors were age, hypertension (29%), active smoking (42%), and alcohol intake (25.1%). Median (IQR) IIEF-EF score was 15 (7-22). Primary organic ED patients depicted lower IIEF-SD and -OF scores (all p ≤ 0.02), whilst groups did not differ in terms of IIEF-EF, -IS and -OS scores. DISCUSSION One out of nine patients complaining of ED depict criteria for primary psychogenic ED. Erectile function severity could be as severe as patients with organic ED. The single-centre-based cross-sectional nature of the study, raising the possibility of selection biases is our main limitation. CONCLUSIONS One out of nine patients presenting for ED depict criteria suggestive for primary psychogenic ED in the real-life setting. Patients with primary psychogenic and primary organic ED have comparable ED severity, thus outlining the importance of a comprehensive and tailored management work-up in every patient seeking medical help for the first time. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Edoardo Pozzi
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Giuseppe Fallara
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Paolo Capogrosso
- Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy
| | - Luca Boeri
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Christian Corsini
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Antonio Costa
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Luigi Candela
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Daniele Cignoli
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Walter Cazzaniga
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Nicolò Schifano
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Eugenio Ventimiglia
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Alessia d'Arma
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
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Lin V, Lai CM, Wu R, Wu CH, Wang CT. Does the timing of performing robot-assisted radical prostatectomy after prostate biopsy affect the outcome? UROLOGICAL SCIENCE 2022. [DOI: 10.4103/uros.uros_39_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Wang J, Zhao J, Zhang C, Zhang Y, Jiang N, Wei X, Wang J, Yu J. Comorbidity, lifestyle factors, and sexual satisfaction among Chinese cancer survivors. Cancer Med 2021; 10:6058-6069. [PMID: 34254466 PMCID: PMC8419754 DOI: 10.1002/cam4.4118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 04/05/2021] [Accepted: 06/13/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives This study aims to explore the prevalence of sexual satisfaction among Chinese cancer survivors, and explore the association of sexual satisfaction with comorbidity and lifestyle factors. Methods A cross‐sectional study was performed among 3996 Chinese cancer survivors recruited at Shanghai Cancer Rehabilitation Club from March to April 2017. Data were collected through self‐reported questionnaires. The questionnaire includes information about demographic, cancer characteristics, comorbidities, lifestyle factors, and sexual satisfaction. Sexual satisfaction was measured by a single‐item scale. The distribution of sexual satisfaction among different demographic and cancer characteristics was compared using the chi‐squared test. Logistic regression models were conducted to assess the effects of lifestyle factors, comorbidities on sexual satisfaction after adjustment for demographic and cancer characteristics. Results More than 40% of male and female cancer survivors reported no sexual satisfaction. Sexual satisfaction of cancer survivors is significantly associated with both the number and the type of comorbidities. Heart disease, musculoskeletal system disease, diabetes, and hyperlipidemia are the comorbidities significantly associated with sexual satisfaction of cancer survivors. Lifestyle factors other than smoking, including exercise or fitness, drinking alcohol, and eating fruits and vegetables are significantly correlated with sexual satisfaction. Besides, all of the above associations show gender differences. In addition, demographic characteristics include sex, age, marital status, living status, and average monthly income are also significantly associated with sexual satisfaction of cancer survivors. Conclusion Comorbidity and lifestyle factors are associated with sexual satisfaction of cancer survivors, and the associations show gender differences. Improving the lifestyles of cancer survivors, and controlling and reducing their comorbidities are important for improving their sexual satisfaction. This study aims to investigate the prevalence of sexual satisfaction among Chinese cancer survivors, and explore the association of sexual satisfaction with comorbidity and lifestyle factors. Comorbidity and lifestyle factors are associated with sexual satisfaction of cancer survivors, and the associations show gender differences. Improving the lifestyles of cancer survivors, and controlling and reducing their comorbidities are important for improving their sexual satisfaction.
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Affiliation(s)
- Jingya Wang
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Jie Zhao
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Chenggang Zhang
- Shanghai Xuhui Centre for Disease Control and Prevention, Shanghai, China
| | - Yuxin Zhang
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Nan Jiang
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Xiaomin Wei
- Shanghai Health Promotion Center, Shanghai, China
| | - Jiwei Wang
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Jinming Yu
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
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Akgül M, Yazıcı C, Doğan Ç, Özcan R, Şahin MF. Erectile dysfunction iceberg in an urology outpatient clinic: How can we encourage our patients to be more forthcoming? Andrologia 2021; 53:e14152. [PMID: 34137466 DOI: 10.1111/and.14152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 11/28/2022] Open
Abstract
The study's aim was to document the rates of declared and hidden erectile dysfunction (ED) at urology outpatient clinic while attempting to develop a method to encourage patients to talk about ED. A total of 506 patients, all of whom underwent the same procedure by the same clinician with a standard algorithm, were prospectively evaluated. The patients who declared ED as their primary or secondary symptom were grouped as 'very early treatment seekers' (VETS) and 'early treatment seekers' (ETS) respectively. The patients who hid their ED until directly questioned and the patients whose ED was diagnosed with an IIEF-5 questionnaire were grouped as 'late treatment seekers' (LTS) and 'very late treatment seekers' (VLTS) respectively. The total number of ED was 291 (57.5%), comprised of 54 (18.6%) patients in the VETS, 48 (16.5%) in the ETS, 143 (49.1%) in the LTS and 46 (15.8%) in the VLTS groups. The rate of severe ED was significantly higher in the VETS group, whereas the rate of mild ED was significantly higher in the VLTS group (p < .001). Most of the patients would not seek help for their ED until the clinician directly or indirectly questioned them. Simple manipulations uncovered the hidden ED patients.
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Affiliation(s)
- Murat Akgül
- Department of Urology, Tekirdağ Namik Kemal University Faculty of Medicine, Tekirdağ, Turkey
| | - Cenk Yazıcı
- Department of Urology, Tekirdağ Namik Kemal University Faculty of Medicine, Tekirdağ, Turkey
| | - Çağri Doğan
- Department of Urology, Tekirdağ Namik Kemal University Faculty of Medicine, Tekirdağ, Turkey
| | - Rıdvan Özcan
- Department of Urology, Tekirdağ Namik Kemal University Faculty of Medicine, Tekirdağ, Turkey
| | - Mehmet Fatih Şahin
- Department of Urology, Tekirdağ Namik Kemal University Faculty of Medicine, Tekirdağ, Turkey
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Adam A, McDowall J, Aigbodion SJ, Enyuma C, Buchanan S, Vachiat A, Sheahan J, Laher AE. Is the History of Erectile Dysfunction a Reliable Risk Factor for New Onset Acute Myocardial Infarction? A Systematic Review and Meta-Analysis. Curr Urol 2020; 14:122-129. [PMID: 33224004 PMCID: PMC7659409 DOI: 10.1159/000499249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 08/19/2019] [Indexed: 11/19/2022] Open
Abstract
Acute myocardial infarction (AMI) occurs as a manifestation of coronary atherosclerotic disease. The occurrence of erectile dysfunction (ED) following AMI is well documented and this association and pathophysiology is often interrelated. Few studies have objectively assessed the diagnostic value of ED as a risk factor for AMI, in general. In this review, we aimed to better outline the diagnostic predictability of ED as a precursor for 'first/new onset' AMI. This review was performed using selective search terms, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The Cochrane, Embase, PubMed, Scopus and Web of Science databases were searched (September 2018). Selected studies were further assessed for relevance and quality (Critical Appraisal Skills Program tool-Oxford). Four studies [573 participants; mean 143 (SD ± 76.3604) and median 141 participants] were eligible for analysis. Meta-analysis of the studies resulted in a pooled sensitivity of 51.36% (95% CI: 47.37-55.33%). For the single study which reported true negative and false positive cases, a specificity of 76.53% (95% CI: 68.57-83.00%) was calculated. The results of this systematic review and meta-analysis suggest that a history of ED should be used as a risk factor for new onset AMI.
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Affiliation(s)
- Ahmed Adam
- Division of Urology, Department of Surgery, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, London, UK
- Department of Urology, Helen Joseph Hospital and Rahima Moosa Mother and Child Hospital, London, UK
- Division of Urology, Wits Donald Gordon Medical Centre, London, UK
| | - Jared McDowall
- Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, London, UK
| | - Sunday Joseph Aigbodion
- Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, London, UK
| | - Callistus Enyuma
- Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, London, UK
| | - Sean Buchanan
- Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, London, UK
- Africa Institute of Emergency Medicine, London, UK
| | - Ahmed Vachiat
- Division of Cardiology, Wits Donald Gordon Medical Centre, Johannesburg, South Africa, London, UK
| | - Judy Sheahan
- Department of Paramedic Science, Faculty of Health, Social Care and Education, Kingston and St George's Universities of London, London, UK
| | - Abdullah Ebrahim Laher
- Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, London, UK
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11
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Pozzi E, Capogrosso P, Boeri L, Belladelli F, Baudo A, Schifano N, Abbate C, Dehò F, Montorsi F, Salonia A. Longitudinal Risk of Developing Cardiovascular Diseases in Patients With Erectile Dysfunction—Which Patients Deserve More Attention? J Sex Med 2020; 17:1489-1494. [DOI: 10.1016/j.jsxm.2020.03.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 03/22/2020] [Accepted: 03/26/2020] [Indexed: 12/31/2022]
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12
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Martínez-Holguín E, Lledó-García E, González J, Hernández-Fernández C. Three-piece inflatable penile prosthesis: Ectopic reservoir placement. Actas Urol Esp 2020; 44:367-376. [PMID: 32423611 DOI: 10.1016/j.acuro.2020.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The complications associated to the placement of the reservoir are infrequent but potentially serious. Therefore, technical alternatives have been developed for the performance of the procedure in different locations (ectopic). The aim of this review is to revise the evidence available on the different options for the ectopic placement of the reservoir. MATERIAL AND METHOD Narrative review based on a bibliographical search limited to PubMed- indexed relevant manuscripts, in Spanish or English, for the period 2000-2019, using «penile prosthesis», «ectopic reservoir», radical prostatectomy», «radical cystectomy», «pelvic radiotherapy», and «renal transplantation» as key words. Non original articles and reviews were not considered eligible. A total of 11 manuscripts were included. RESULTS Pelvic alterations after surgery and/or radiotherapy increase the difficulty in the placement of the prosthesis reservoir. In order to minimize the risk of complications, different modifications have been performed on the devices, and technical innovations have been developed for the submuscular placement of the reservoir. The available evidence regarding the functionality and complications of these techniques is limited to single institution, low volume, and retrospective series with short follow-up periods. The functionality seems to be adequate using the adapted devices. The complications are infrequent and mild in severity. CONCLUSIONS Although the available evidence is still limited, the ectopic placement of the reservoir may be considered a safe, effective, and reproducible technique. In addition, it may result particularly useful in cases of altered pelvic anatomy.
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13
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Lin H, Zhao L, Wu H, Cao M, Jiang H. Sexual life and medication taking behaviours in young men: An online survey of 92 620 respondents in China. Int J Clin Pract 2020; 74:e13417. [PMID: 31512342 DOI: 10.1111/ijcp.13417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/15/2019] [Accepted: 09/06/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To assess sexual life and medication taking behaviours in young Chinese men. METHODS An online survey was conducted across China between January 2017 and April 2017. Among the participants, men aged 19-40 years were included in the analysis. The respondents filled in the online questionnaire assessing sexual life and medication taking behaviours by themselves, including general information, cognition of erectile dysfunction (ED) and treatment-related questions. Erection hardness score (EHS) was used to measure the erection hardness status. RESULTS Among the young respondents, 20.54% had grade I-II EHS, 58.14% searched the internet for online ED-related information, 26.49% took an ED medication and 50.89% took an ED medication without the advice of a physician or pharmacist. The respondents who took medication had less sexual intercourse per week (P < .001) and worse EHS (P < .001), and were more willing to seek information from physicians, pharmacists, friends and relatives instead of online sources (P < .001), compared with those not taking medication. The most common comorbidities in patients with grade I-II EHS were hyperlipidaemia, cardiovascular disease (CVD), prostate diseases and diabetes mellitus. CONCLUSION About 20% of young Chinese men needed further assessment for ED. The majority of respondents obtained ED-related information by online search and took an ED medication without professional advice. These data could help clinicians understand the current status of sexual life and medication taking behaviours of young Chinese men.
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Affiliation(s)
- Haocheng Lin
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Andrology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Lianming Zhao
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Andrology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Han Wu
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Andrology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Mengyang Cao
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Andrology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Hui Jiang
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Andrology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
- Department of Human Sperm Bank, Peking University Third Hospital, Beijing, China
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14
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Goldstein I, Goren A, Li VW, Tang WY, Hassan TA. Epidemiology Update of Erectile Dysfunction in Eight Countries with High Burden. Sex Med Rev 2020; 8:48-58. [DOI: 10.1016/j.sxmr.2019.06.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/04/2019] [Accepted: 06/24/2019] [Indexed: 12/31/2022]
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15
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Goldstein I, Goren A, Li VW, Maculaitis MC, Tang WY, Hassan TA. The association of erectile dysfunction with productivity and absenteeism in eight countries globally. Int J Clin Pract 2019; 73:e13384. [PMID: 31389146 DOI: 10.1111/ijcp.13384] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/27/2019] [Accepted: 06/16/2019] [Indexed: 12/12/2022] Open
Abstract
AIM To evaluate the association of erectile dysfunction (ED) with work productivity loss, activity impairment and health-related quality of life (HRQoL) across Brazil, China, France, Germany, Italy, Spain, the UK and the US. METHODS This cross-sectional observational study used data from adult men (40-70 years old; N = 52 697) from the 2015 and 2016 National Health and Wellness Surveys. ED assessment was based on self-reported difficulty in achieving or maintaining an erection in the past 6 months. Impairment to work and non-work activities and HRQoL were assessed for each country and compared against the US. Multivariable models tested interactions between ED status and country for each outcome. RESULTS Overall ED prevalence was reported as 49.7%, with Italy reporting the highest rate (54.7%). Men with ED reported significantly higher absenteeism (7.1% vs 3.2%), presenteeism (22.5% vs 10.1%), overall work productivity impairment (24.8% vs 11.2%), activity impairment (28.6% vs 14.5%) and significantly lower Mental Component Summary scores (MCS; 46.7 vs 51.2), Physical Component Summary scores (PCS; 48.3 vs 53.0), and health state utilities (SF-6D: 0.693 vs 0.778; all, P < 0.001) than men with no ED. After adjusting for covariates, compared with the US, the association of ED status with overall work productivity impairment was greatest in the UK (26% higher; P < 0.05), and with MCS, PCS and SF-6D scores was greatest in China (-2.67, -1.58, and -0.043 points, respectively; all, P < 0.001). Greater ED severity was significantly associated with higher impairment to work and non-work activities and lower HRQoL, with China reporting the highest burden, compared with the US (most P < 0.05). CONCLUSION ED poses a significant burden with respect to work productivity and HRQoL, with greater severity associated with worse outcomes. Better management and earlier detection may help reduce this burden, especially in countries reporting a strong association between ED and poor economic and health outcomes.
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Affiliation(s)
- Irwin Goldstein
- Director of Sexual Medicine, Alvarado Hospital, San Diego, California
| | - Amir Goren
- Health Outcomes Practice, Kantar Health, New York, New York
| | - Vicky W Li
- Health Outcomes Practice, Kantar Health, New York, New York
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Zheng JB, Liang QF, Li JH, Zhang SC, Yu XH, Zhao J, Liang GQ, Shi HJ, Zhou WJ, Zhu QX. Longitudinal Trends of AMS and IIEF-5 Scores in Randomly-Selected Community Men 40 to 80 Years Old: Preliminary Results. J Sex Med 2019; 16:1567-1573. [PMID: 31447383 DOI: 10.1016/j.jsxm.2019.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/12/2019] [Accepted: 07/18/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Most of conclusions on the relationship between age and reproductive health in aging men relied on cross-sectional data. AIM To better characterize the natural degradation trajectory of reproductive health of aging men based on longitudinal data. METHODS A community cohort study was performed in randomly selected men 40 to 80 years old, initiated in 2012 and followed up in 2014 and 2016. Participants were investigated by face-to-face structured interview, including demographic information and International Index of Erectile Function (IIEF-5) and Aging Males' Symptoms (AMS) scales. MAIN OUTCOME MEASURES The differences among the 3 assessments of IIEF-5 and AMS were analyzed, and progression trajectories were traced. RESULTS The high degree of variability on AMS and IIEF-5 was evident across individual subjects, as was the variability within individuals. The average IIEF-5 score of 248 subjects decreased from 16.9 to 14.1 during the 4 years, and the total AMS score increased from 22.6-27.0 (P < .001). Longitudinal data, both of individuals and of groups, showed the more rapid increase or decrease on AMS or IIEF-5 scores over 4 years in the 61-70 age group than in other age groups. CLINICAL IMPLICATION The evidence of the greatest changes on AMS and IIEF-5 scores in the 61-70 age group prompts the importance of early intervention to postpone the degradation of reproductive health. STRENGTH & LIMITATIONS Compared with cross-sectional data, longitudinal data can provide a more natural progression trajectory of reproductive health of aging male individuals. The low follow-up rate might affect the parameter estimation to some extent. CONCLUSION Cohort data over 4 years' follow-up showed more abrupt changes on AMS and IIEF-5 scores in the 61-70 age group than in other age groups. Zheng J-B, Liang Q-F, Li J-H, et al. Longitudinal Trends of AMS and IIEF-5 Scores in Randomly-Selected Community Men 40 to 80 Years Old: Preliminary Results. J Sex Med 2019;16:1567-1573.
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Affiliation(s)
- Jun-Biao Zheng
- Department of Urology, The First People's Hospital of Jiashan, Zhejiang, China
| | - Qun-Feng Liang
- Department of Reproductive Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - Jian-Hui Li
- Department of Reproductive Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - Shu-Cheng Zhang
- Department of Cell Biology, National Research Institute of Family Planning, Beijing, China
| | - Xiao-Hua Yu
- Department of Urology, The First People's Hospital of Jiashan, Zhejiang, China
| | - Jing Zhao
- Department of Cardiology, the key Laboratory of Cardiovascular Disease, The First Hospital of Lanzhou University, Lanzhou, China
| | - Guo-Qing Liang
- Department of Urology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
| | - Hui-Juan Shi
- Department of Reproductive Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - Wei-Jin Zhou
- Department of Reproductive Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - Qian-Xi Zhu
- Department of Reproductive Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China.
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Wang JZ, Le S, Alexanian C, Boddu S, Merleev A, Marusina A, Maverakis E. No Causal Link between Phosphodiesterase Type 5 Inhibition and Melanoma. World J Mens Health 2018; 37:313-321. [PMID: 30350485 PMCID: PMC6704303 DOI: 10.5534/wjmh.180050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 06/18/2018] [Indexed: 01/15/2023] Open
Abstract
Purpose To examine the association between phosphodiesterase type 5 (PDE5) inhibitor use and melanoma by 1) conducting a systematic review of observational studies; and 2) determining if low PDE5A gene expression in human melanoma correlated with decreased overall survival. Materials and Methods A systematic search of observational studies examining the association between PDE5 inhibitor use and melanoma was performed through ClinicalTrials.gov, the Cochrane Library, EMBASE, PubMed, and Web of Science databases, and seven eligible studies were identified. PDE5A gene expression was analyzed with RNA sequencing data from 471 human melanoma samples obtained from The Cancer Genome Atlas. Results Four studies reported a positive association between PDE5 inhibitor use and melanoma, and three studies found no correlation. RNA sequencing data analysis revealed that under-expression of the PDE5A gene did not impact clinical outcomes in melanoma. Conclusions There is currently no evidence to suggest that PDE5 inhibition in patients causes increased risk for melanoma. The few observational studies that demonstrated a positive association between PDE5 inhibitor use and melanoma often failed to account for major confounders. Nonetheless, the substantial evidence implicating PDE5 inhibition in the cyclic guanosine monophosphate (cGMP)-mediated melanoma pathway warrants further investigation in the clinical setting.
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Affiliation(s)
- Jenny Z Wang
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Stephanie Le
- Department of Dermatology, University of California Davis Medical Center, Sacramento, CA, USA
| | | | - Sucharita Boddu
- Department of Dermatology, University of California Davis Medical Center, Sacramento, CA, USA
| | - Alexander Merleev
- Department of Dermatology, University of California Davis Medical Center, Sacramento, CA, USA
| | - Alina Marusina
- Department of Dermatology, University of California Davis Medical Center, Sacramento, CA, USA
| | - Emanual Maverakis
- Department of Dermatology, University of California Davis Medical Center, Sacramento, CA, USA.
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18
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Nimrouzi M, Jaladat AM, Zarshenas MM. A panoramic view of medicinal plants traditionally applied for impotence and erectile dysfunction in Persian medicine. J Tradit Complement Med 2018; 10:7-12. [PMID: 31956553 PMCID: PMC6957810 DOI: 10.1016/j.jtcme.2017.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 08/09/2017] [Accepted: 08/10/2017] [Indexed: 12/28/2022] Open
Abstract
Erectile dysfunction (ED) and impotence are common male sexual problems, and they are highly prevalent in male adults with a history of hypertension or diabetes mellitus. This review aims to bring together the standpoints of the early Persian physicians on these disorders and to identify the respective medication in comparison with conventional contemporary medicine. The main medical and pharmaceutical manuscripts of traditional Persian medicine (TPM) are from 9th-18th century AD. Besides the medieval findings, the current knowledge on ED and impotence, and the related effects of the cited medicinal herbs were studied. In the medieval and traditional literature, male potency is called bāh. According to the TPM approaches, the first step in the mitigation of impotence focuses on the treatment of the main body organs including the heart, brain, and liver. The TPM approaches for diagnosis and treatment include the evaluation of the quality of semen, sexual habit, and quality of urine. The treatment strategies in TPM involve lifestyle modification and prescription of natural medicaments. Many medicinal herbs have been traditionally used for the mitigation of impotency. There could be numerous possibilities for bringing out new natural medicaments with aphrodisiac effects supported by the early medical literature.
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Affiliation(s)
- Majid Nimrouzi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Traditional Persian Medicine, Shiraz School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir-Mohammad Jaladat
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Traditional Persian Medicine, Shiraz School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad M. Zarshenas
- Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Corresponding author. Department of Phytopharmaceuticals (Traditional Pharmacy), school of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
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Punjani N, Flannigan R, Oliffe JL, McCreary DR, Black N, Goldenberg SL. Unhealthy Behaviors Among Canadian Men Are Predictors of Comorbidities: Implications for Clinical Practice. Am J Mens Health 2018; 12:2183-2193. [PMID: 30222015 PMCID: PMC6199435 DOI: 10.1177/1557988318799022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Men's poor health behaviors are an increasingly prevalent issue with long-term consequences. This study broadly samples Canadian men to obtain information regarding health behaviors as a predictor of downstream medical comorbidities. A survey of Canadian men included questions regarding demographics, comorbidities, and health behaviors (smoking and alcohol consumption, sleep and exercise behaviors, and dietary habits). Health behaviors were classified as either healthy or unhealthy based upon previous studies and questionnaire thresholds. Multivariate regression was performed to determine predictors for medical comorbidities. The 2,000 participants were aged 19-94 (median 48, interquartile range 34-60). Approximately half (47.4%) were regular smokers, 38.7% overused alcohol, 53.9% reported unhealthy sleep, 48.9% had low levels of exercise, and 61.8% had unhealthy diets. On multivariate analysis, regular smoking predicted heart disease (OR 2.08, p < .01), elevated cholesterol (OR 1.35, p = .02), type 2 diabetes (OR 1.57, p = .02), osteoarthritis (OR 1.43, p = .04), and depression (OR 1.62, p < .01). Alcohol overuse predicted hypertension (OR 1.40, p < .01) and protected against type 2 diabetes (OR 0.61, p < .01). Unhealthy sleep predicted hypertension (OR 1.46, p < .01), erectile dysfunction (OR 1.50, p = .04), and depression (OR 1.87, p < .01). Low levels of exercise predicted hypertension (OR 1.30, p = .03) and elevated cholesterol (OR 1.27, p = .05). Finally, unhealthy diet predicted depression (OR 1.65, p < .01). This study confirms the association of poor health behaviors and comorbidities common to middle-aged and older men. The results emphasize the potential scope of targeted gender-sensitized public awareness campaigns and interventions to reduce common male disease, morbidity, and mortality.
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Affiliation(s)
- Nahid Punjani
- Division of Urology, Western University, London, ON, Canada
| | - Ryan Flannigan
- Weill Cornell Medicine, Department of Urology, Male Reproduction & Microsurgery, New York, NY, USA
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
- Canadian Men’s Health Foundation, Vancouver, BC, Canada
| | - John L. Oliffe
- Canadian Men’s Health Foundation, Vancouver, BC, Canada
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | | | - Nick Black
- Intensions Consulting, Vancouver, BC, Canada
| | - S. Larry Goldenberg
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
- Canadian Men’s Health Foundation, Vancouver, BC, Canada
- S. Larry Goldenberg, CM, OBC, MD, FRCSC, FACS, FCAHS, Department of Urologic Sciences, University of British Columbia, 2775 Laurel Street, 6th floor, Vancouver, BC V5Z1M9, Canada.
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20
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Shin YS, Karna KK, Choi BR, Park JK. Finasteride and Erectile Dysfunction in Patients with Benign Prostatic Hyperplasia or Male Androgenetic Alopecia. World J Mens Health 2018; 37:157-165. [PMID: 30209896 PMCID: PMC6479090 DOI: 10.5534/wjmh.180029] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 05/08/2018] [Accepted: 05/23/2018] [Indexed: 12/21/2022] Open
Abstract
Finasteride is primarily used to treat benign prostatic hyperplasia (BPH) and male androgenetic alopecia (MAA). Five-alpha reductase inhibitors (5α-RIs) could induce male sexual dysfunction due to their effects on testosterone and dihydrotestosterone. There is evidence suggesting that 5α-RIs may independently increase the risk of erectile dysfunction (ED). However, many investigators believe that side effects of 5α-RIs will disappear with continuous treatment. Considerable controversy exists regarding the severity and persistence of side effects of finasteride on ED. The aim of this review was to summarize current research studies on finasteride associated with ED. The search strategy used each term of finasteride and ED against PubMed database to identify related studies. ED data reported from available trials for finasteride were summarized and reviewed. Although there is not enough evidence to prove the relationship between finasteride and ED, most studies in this review found that finasteride for BPH was correlated with ED. However, most studies included in this review revealed that finasteride for MAA was not correlated with ED. On the other hand, some studies reported side effects of finasteride associated with sexual dysfunction, including ED, male infertility, ejaculation problem, and loss of libido, even in MAA patients. Well-designed randomized controlled trials are needed to further determine the mechanism and effects of finasteride on ED. However, physicians should discuss with their patients possible long-term effects of finasteride on sexual function, although we do not have evidence showing that adverse events of sexual dysfunction are absolutely associated with 5α-RIs.
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Affiliation(s)
- Yu Seob Shin
- Department of Urology, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute and Clinical Trial Center of Medical Device of Chonbuk National University Hospital, Jeonju, Korea
| | - Keshab Kumar Karna
- Department of Urology, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute and Clinical Trial Center of Medical Device of Chonbuk National University Hospital, Jeonju, Korea
| | - Bo Ram Choi
- Department of Urology, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute and Clinical Trial Center of Medical Device of Chonbuk National University Hospital, Jeonju, Korea
| | - Jong Kwan Park
- Department of Urology, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute and Clinical Trial Center of Medical Device of Chonbuk National University Hospital, Jeonju, Korea.
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Fan Y, Hu B, Man C, Cui F. Erectile dysfunction and risk of cardiovascular and all-cause mortality in the general population: a meta-analysis of cohort studies. World J Urol 2018; 36:1681-1689. [PMID: 29725807 DOI: 10.1007/s00345-018-2318-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 04/27/2018] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Studies on the association of erectile dysfunction (ED) with cardiovascular or all-cause mortality have yielded conflicting findings. We conducted this meta-analysis to evaluate the association of ED with cardiovascular or all-cause mortality in the general population. METHODS Pubmed and Embase databases were searched for prospective studies that evaluated the association of ED with cardiovascular or all-cause mortality in the general population up to 15 December, 2017. The overall combined risk ratio (RR) and 95% confidence intervals (CI) were pooled for the men with or without ED. RESULTS A total of 7 studies involving 111,440 participants were included in the meta-analysis. When compared to the men with or without ED, the overall pooled RR was 1.24 (95% CI 1.11-1.39) for all-cause mortality and 1.11 (95% CI 0.92-1.35) for cardiovascular mortality. Subgroup analyses indicated that only men with severe ED significantly increased all-cause mortality risk (RR 1.58; 95% CI 1.37-1.82), but not in the mild (RR 1.07; 95% CI 0.93-1.24) ED and the moderate (RR 1.16; 95% CI 1.00-1.35) ED. CONCLUSIONS This meta-analysis suggests that severe ED is significantly associated with increased all-cause mortality in the general population. However, the association of ED with cardiovascular mortality should be further investigated.
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Affiliation(s)
- Yu Fan
- Cancer Institute, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, 212002, Jiangsu, China
| | - Binbin Hu
- Cancer Institute, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, 212002, Jiangsu, China
| | - Changfeng Man
- Cancer Institute, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, 212002, Jiangsu, China
| | - Feilun Cui
- Department of Urology Surgery, The Affiliated People's Hospital, Jiangsu University, No. 8 Dianli Road, Zhenjiang, 212002, Jiangsu, China.
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Abstract
Infertility affects up to 12% of all men, and sexual dysfunction occurs frequently in men of reproductive age, causing infertility in some instances. In infertile men, hypoactive sexual desire and lack of sexual satisfaction are the most prevalent types of sexual dysfunction, ranging from 8.9% to 68.7%. Erectile dysfunction and/or premature ejaculation, evaluated with validated tools, have a prevalence of one in six infertile men, and orgasmic dysfunction has a prevalence of one in ten infertile men. In addition, infertile men can experience a heavy psychological burden. Infertility and its associated psychological concerns can underlie sexual dysfunction. Furthermore, general health perturbations can lead to male infertility and/or sexual dysfunction. Erectile dysfunction and male infertility are considered proxies for general health, the former underlying cardiovascular disorders and the latter cancerous and noncancerous conditions. The concept that erectile dysfunction in infertile men might be an early marker of poor general health is emerging. Finally, medications used for general health problems can cause sperm abnormalities and sexual dysfunction. The treatment of some causes of male infertility might improve semen quality and reverse infertility-related sexual dysfunction. In infertile men, an investigation of sexual, general, and psychological health status is advisable to improve reproductive problems and general health.
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Affiliation(s)
- Francesco Lotti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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García-Cruz E, Carrión A, Ajami T, Álvarez M, Correas MÁ, García B, García JV, González C, Portillo JA, Romero-Otero J, Simón C, Torremadé J, Vigués F, Alcaraz A. The Patient's Comorbidity Burden Correlates with the Erectile Dysfunction Severity. Actas Urol Esp 2018. [PMID: 28641871 DOI: 10.1016/j.acuro.2017.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To explore the potential relationship between erectile dysfunction (ED), low testosterone levels, and the Charlson Comorbidity Index (CCI). MATERIAL AND METHODS Cross-sectional study on patients referred to the andrology unit in 7 Spanish centers. The ED was diagnosed and graded using the International Index of Erectile Function (IIEF-5) score. Total testosterone, the prevalence of each comorbidity, and the CCI were compared between patients with different grades of ED. Besides, the correlation between total testosterone and the CCI score, the influence of each comorbidity, and the ED severity on the CCI was assessed in a multiple linear regression. RESULTS The study included 430 men with a mean age of 61 years. The mean CCI was 3.5, and mean total testosterone 15.2 nmol/L; 389 (91%) subjects had some grade of ED: 97 (23%) mild, 149 (35%) mild-to-moderate, 86 (20%) moderate, and 57 (13%) severe. The increase in ED severity was significantly associated with a decrease in total testosterone (P=.002), and an increase in the CCI score (P<.001). Testosterone levels were significantly lower in patients with obesity, diabetes, hypercholesterolemia, and hypertriglyceridemia (P<.05). However, only the prevalence of diabetes and hypertension was significantly associated with the severity of ED. The multivariate analysis including variables related to all assessed comorbidities, total testosterone levels, and the DE severity significantly predicted the CCI score (P<.001, R2=.426). The severity of ED significantly contributed to this model (P=.011), but total testosterone did not (P=.204). CONCLUSIONS The CCI is significantly associated with the ED severity, but it shows a weak correlation with the testosterone levels.
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Affiliation(s)
- E García-Cruz
- Departamento de Urología, Hospital Plató, Barcelona, España; Departamento of Urología, Hospital Clínic de Barcelona, Barcelona, España.
| | - A Carrión
- Departamento of Urología, Hospital Clínic de Barcelona, Barcelona, España
| | - T Ajami
- Departamento of Urología, Hospital Clínic de Barcelona, Barcelona, España
| | - M Álvarez
- Deparatmento de Urología, Hospital Universitario Infanta Sofía, Madrid, España
| | - M Á Correas
- Departamento de Urología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - B García
- Unidad de Urología, Hospital Universitario 12 de Octubre, Madrid, España
| | - J V García
- Departamento de Urología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, España; Departamento de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - C González
- Departamento de Urología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, España; Departamento de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - J A Portillo
- Departamento de Urología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - J Romero-Otero
- Unidad de Urología, Hospital Universitario 12 de Octubre, Madrid, España
| | - C Simón
- Departamento de Urología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, España; Departamento de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - J Torremadé
- Departamento de Urología, Hospital de Bellvitge, Barcelona, España
| | - F Vigués
- Departamento de Urología, Hospital de Bellvitge, Barcelona, España
| | - A Alcaraz
- Departamento of Urología, Hospital Clínic de Barcelona, Barcelona, España
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SM = SM: The Interface of Systems Medicine and Sexual Medicine for Facing Non-Communicable Diseases in a Gender-Dependent Manner. Sex Med Rev 2017; 5:349-364. [DOI: 10.1016/j.sxmr.2017.04.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 04/23/2017] [Accepted: 04/30/2017] [Indexed: 12/11/2022]
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Huri HZ, Mat Sanusi ND, Razack AHA, Mark R. Association of psychological factors, patients' knowledge, and management among patients with erectile dysfunction. Patient Prefer Adherence 2016; 10:807-23. [PMID: 27257374 PMCID: PMC4874731 DOI: 10.2147/ppa.s99544] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Erectile dysfunction (ED) is one of the most common health problems in men. ED can significantly affect a man's psychological well-being and overall health. PURPOSE To investigate the association of psychological factors, patients' knowledge, and management among ED patients. PATIENTS AND METHODS A total of 93 patients with an age range from 31 to 81 years who have undergone treatment for ED were included in this study. RESULTS It was found that the feeling of blame (P=0.001), guilt (P=0.001), anger or bitterness (P=0.001), depression (P=0.001), feeling like a failure (P=0.001), and the feeling of letting down a partner during intercourse (P=0.001) were significantly associated with ED. Age was also found to be significantly associated with patients' psychological scale (P=0.004). In addition, the majority of patients in this study practice the right method of administration of ED therapy. However, no significant correlation was found between patients' knowledge of ED therapy and demographic characteristics. CONCLUSION This study concluded that ED does affect psychological well-being of people. In addition, patient's knowledge about ED and its management is also crucial in ensuring that the patient achieves optimal therapeutic outcomes from ED therapy.
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Affiliation(s)
- Hasniza Zaman Huri
- Department of Pharmacy, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
- Clinical Investigation Center, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | | | | - Raymond Mark
- Department of Pharmacy, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
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Ghanbari Afra L, Taghadosi M, Gilasi HR. Relationship Between Ischemic Heart Disease and Sexual Satisfaction. Glob J Health Sci 2015; 8:263-9. [PMID: 26234982 PMCID: PMC4803952 DOI: 10.5539/gjhs.v8n1p263] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 03/15/2015] [Indexed: 11/12/2022] Open
Abstract
AIM Ischemic heart disease is a life-threatening condition. Considerable doubts exist over the effects of this disease on patients' sexual activity and satisfaction. The aim of this study was to evaluate the relationship between ischemic heart disease and sexual satisfaction. METHODS In a retrospective cohort study, the convenience sample of 150 patients exposure with ischemic heart disease and 150 people without exposure it was drawn from Shahid Beheshti hospital, Kashan, Iran. Sampling was performed from March to September 2014. We employed the Larson's Sexual Satisfaction Questionnaire for gathering the data. Data were analyzed using descriptive statistics and Chi-square, t-test and linear regression analysis. RESULTS The means of sexual satisfaction in patients exposure with ischemic heart disease and among the subjects without exposure it were 101.47±13.42 and 100.91±16.52, respectively. There was no significant difference between the two groups regarding sexual satisfaction. However, sexual satisfaction was significantly correlated with gender and the use of cardiac medications (P value<0.05). CONCLUSION The level of sexual satisfaction in patients with exposure ischemic heart disease is similar to the people without exposure it. Moreover, the men and the patients who do not receive cardiac medications have higher levels of sexual satisfaction. Nurses who are providing care to patients with ischemic heart disease need to pay closer attention to patient education about sexual issues.
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Affiliation(s)
| | - Mohsen Taghadosi
- Department of Medical Surgical Nursing, Faculty of Nursing, Kashan University of Medical Sciences, Kashan, Iran.
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