Applications of artificial intelligence in the diagnosis and prediction of erectile dysfunction: a narrative review

Artificial intelligence in andrology - fact or fiction: essential takeaway for busy clinicians

ABSTRACT

Artificial intelligence (AI) is revolutionizing the current approach to medicine. AI uses machine learning algorithms to predict the success of therapeutic procedures or assist the clinician in the decision-making process. To date, machine learning studies in the andrological field have mainly focused on prostate cancer imaging and management. However, an increasing number of studies are documenting the use of AI to assist clinicians in decision-making and patient management in andrological diseases such as varicocele or sexual dysfunction. Additionally, machine learning applications are being employed to enhance success rates in assisted reproductive techniques (ARTs). This article offers the clinicians as well as the researchers with a brief overview of the current use of AI in andrology, highlighting the current state-of-the-art scientific evidence, the direction in which the research is going, and the strengths and limitations of this approach.

Frequently asked questions on erectile dysfunction: evaluating artificial intelligence answers with expert mentorship

The present study assessed the accuracy of artificiaI intelligence-generated responses to frequently asked questions on erectile dysfunction. A cross-sectional analysis involved 56 erectile dysfunction-related questions searched on Google, categorized into nine sections: causes, diagnosis, treatment options, treatment complications, protective measures, relationship with other illnesses, treatment costs, treatment with herbal agents, and appointments. Responses from ChatGPT 3.5, ChatGPT 4, and BARD were evaluated by two experienced urology experts using the F1 and global quality scores (GQS) for accuracy, relevance, and comprehensibility. ChatGPT 3.5 and ChatGPT 4 achieved higher GQS than BARD in categories such as causes (4.5 ± 0.54, 4.5 ± 0.51, 3.15 ± 1.01, respectively, p < 0.001), treatment options (4.35 ± 0.6, 4.5 ± 0.43, 2.71 ± 1.38, respectively, p < 0.001), protective measures (5.0 ± 0, 5.0 ± 0, 4 ± 0.5, respectively, p = 0.013), relationships with other illnesses (4.58 ± 0.58, 4.83 ± 0.25, 3.58 ± 0.8, respectively, p = 0.006), and treatment with herbal agents (3 ± 0.61, 3.33 ± 0.83, 1.8 ± 1.09, respectively, p = 0.043). F1 scores in categories: causes (1), diagnosis (0.857), treatment options (0.726), and protective measures (1), indicated their alignment with the guidelines. There was no significant difference between ChatGPT 3.5 and ChatGPT 4 regarding answer quality, but both outperformed BARD in the GQS. These results emphasize the need to continually enhance and validate AI-generated medical information, underscoring the importance of artificiaI intelligence systems in delivering reliable information on erectile dysfunction.

Correlation between visceral fat metabolism score and erectile dysfunction: a cross-sectional study from NHANES 2001-2004

Backgrounds

The factors associated with erectile dysfunction (ED) are diverse, and obesity is a significant component. Metabolic Score for Visceral Fat (METS-VF) can assess obesity more accurately than body mass index (BMI). However, the association between METS-VF and ED remains unclear.

Objective

This study aimed to investigate the association between the METS-VF and ED using National Health and Nutrition Examination Survey (NHANES) 2001-2004 data.

Methods

Data were sourced from NHANES 2001-2004. The relationship between METS-VF and ED was analyzed using multivariate logistic regression, followed by subgroup analyses to identify sensitive populations. Nonlinear correlation was evaluated through smoothed curve fitting, and a threshold effect analysis validated the findings. Comparative logistic regression of the Receiver Operating Characteristic (ROC) curve assessed the diagnostic capability of METS-VF against the classical obesity index for ED.

Results

The study enrolled 3625 participants, of whom 961 self-reported ED history and 360 reported severe ED. After adjusting for confounders, METS-VF exhibited a positive association with asthma prevalence (OR= 3.47, 95% CI: 2.83, 14.24). Stratification based on median METS-VF revealed higher ED prevalence in participants with elevated METS-VF (OR= 2.81,95% CI:2.32, 3.41). Nonlinear correlation was observed, with a significant association between METS-VF and ED when METS-VF exceeded 6.63. Subgroup analysis highlighted a stronger correlation in participants aged 50-85 years, Caucasians, hypertensive individuals, diabetics, and those with coronary heart disease. Sensitivity analysis using severe ED as the outcome reaffirmed the nonlinear positive association with METS-VF (OR=3.86, 95% CI:2.80,5.33), particularly when METS-VF surpassed 6.68.

Conclusion

Elevated METS-VF was nonlinearly correlated with increased ED incidence. Individuals with METS-VF above 6.63 should be vigilant about heightened ED risk. Special attention should be given to participants aged 50-85 years, Caucasians, hypertensive individuals, diabetics, and those with coronary heart disease.

Advances in physical diagnosis and treatment of male erectile dysfunction

Erectile dysfunction (ED) is the most common male sexual dysfunction by far and the prevalence is increasing year after year. As technology advances, a wide range of physical diagnosis tools and therapeutic approaches have been developed for ED. At present, typical diagnostic devices include erection basic parameter measuring instrument, erection hardness quantitative analysis system, hemodynamic testing equipment, nocturnal erection measuring instrument, nerve conduction testing equipment, etc. At present, the most commonly used treatment for ED is pharmacological therapy represented by phosphodiesterase five inhibitors (PDE5i). As a first-line drug in clinical, PDE5i has outstanding clinical effects, but there are still some problems that deserve the attention of researchers, such as cost issues and some side effects, like visual disturbances, indigestion, myalgia, and back pain, as well as some non-response rates. Some patients have to consider alternative treatments. Moreover, the efficacy in some angiogenic EDs (diabetes and cardiovascular disease) has not met expectations, so there is still a need to continuously develop new methods that can improve hemodynamics. While drug have now been shown to be effective in treating ED, they only control symptoms and do not restore function in most cases. The increasing prevalence of ED also makes us more motivated to find safer, more effective, and simpler treatments. The exploration of relevant mechanisms can also serve as a springboard for the development of more clinically meaningful physiotherapy approaches. Therefore, people are currently devoted to studying the effects of physical therapy and physical therapy combined with drug therapy on ED. We reviewed the diagnosis of ED and related physical therapy methods, and explored the pathogenesis of ED. In our opinion, these treatment methods could help many ED patients recover fully or partially from ED within the next few decades.

The Association Between 2, 4-Dichlorophenoxyacetic Acid and Erectile Dysfunction

Background

2, 4-dichlorophenoxyacetic acid (2,4-D) is one of the most frequently used herbicides in the world, and it has been linked with low testosterone; however, studies regarding its effect on erectile function are limited. The current study aimed to determine the association between the 2,4-D exposure and erectile dysfunction (ED) in men from the National Health and Nutrition Examination Survey (NHANES).

Methods

We analyzed data for urinary 2,4-D levels from 1,311 men (>20 years of age) in the NHANES 2001–2004. ED was assessed by a single, validated survey question. Multivariable logistic regression analysis utilizing sampling weights was performed to determine the relationship between 2,4-D exposure and ED.

Results

Multivariable logistic regression models demonstrated no statistically significant association between 2,4-D exposure and ED after full adjustment [odds ratio (OR) 1.02; 95% CI 0.77–1.36; P = 0.882)]. Men in the 2,4-D quartile 4 groups were not associated with an increased risk of ED (OR 1.13; 95% CI 0.74–1.75; P for trend = 0.481). Furthermore, the association between urinary 2,4-D level and ED was not significant in the subgroup analysis stratified by age, BMI, cardiovascular disease, hypertension, diabetes, and high cholesterol.

Conclusion

We demonstrated that there was no association between 2,4-D exposure and ED. Further studies are warranted to corroborate our results.