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Zhang X, Zhu Z, Tang G. Global prevalence of erectile dysfunction and its associated risk factors among men with type 1 diabetes: a systematic review and meta-analysis. Int J Impot Res 2024; 36:365-374. [PMID: 38396263 DOI: 10.1038/s41443-024-00855-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
Various observational studies have examined the prevalence and determinants of erectile dysfunction (ED) in men with type 1 diabetes across different geographical areas. Nevertheless, a comprehensive systematic review and meta-analysis to consolidate the worldwide prevalence and risk factors remains lacking. Hence, the primary study objective was to perform an extensive systematic review and meta-analysis that specifically examined ED prevalence and determinants in men with type 1 diabetes. A thorough exploration was conducted by examining electronic databases, such as PubMed, Embase, and Web of Science. The general ED prevalence and a 95% confidence interval (CI) in men with type 1 diabetes were summarized. The relevant risk factors were analyzed by deriving a comprehensive odds ratio (OR) from merging the ORs using fixed- or random-effects models. The sources of heterogeneity were investigated using subgroup analyses and meta-regression. This systematic review and meta-analysis included 19 articles involving 3788 men with type 1 diabetes. The meta-analysis revealed that men with type 1 diabetes had a combined ED prevalence of 42.5% (95% CI: 34.3%-50.8%). This prevalence showed significant heterogeneity (I2 = 96.2%, P < 0.01). Meta-regression revealed that age (P = 0.016) and type 1 diabetes duration (P = 0.004) were significant causes of heterogeneity. Furthermore, the ED risk in men with type 1 diabetes was significantly influenced by age, type 1 diabetes duration, body mass index, glycated hemoglobin (HbA1c), retinopathy, and smoking habits (all P < 0.05). In summary, this systematic review and meta-analysis revealed a significant prevalence of ED in men with type 1 diabetes, highlighting the importance of clinicians addressing concerns regarding ED in this specific group of individuals.
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Affiliation(s)
- Xiaolong Zhang
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
| | - Zhirong Zhu
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
| | - Guiliang Tang
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
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Hadisuyatmana S, Boyd JH, Efendi F, Malik G, Bauer M, Reisenhofer S. Non-medical and non-invasive interventions for erectile dysfunction in men with type 2 diabetes mellitus: A scoping review. Heliyon 2023; 9:e15778. [PMID: 37187905 PMCID: PMC10176068 DOI: 10.1016/j.heliyon.2023.e15778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 04/20/2023] [Accepted: 04/20/2023] [Indexed: 05/17/2023] Open
Abstract
Background Erectile dysfunction (ED) often affects men with type 2 diabetes mellitus (T2DM) due to microvascular damage. However, medical interventions are not always appropriate. Aim This scoping review aimed to answer the following question: What evidence is available about the effects of non-medical and non-invasive healthcare interventions to improve ED in men with T2DM? Method Potential studies were collected from the Cumulative Index to Nursing and Allied Health Literature via EBSCO, Embase via Ovid, MEDLINE via Ovid, Web of Science, PubMed, ProQuest, and PsycINFO via Ovid. Findings From 2,611 identified titles, 17 studies, including 11 interventional and 6 observational studies, were included. Four main alternatives to medical interventions were identified from the included studies. Amongst these, four studies recommended patient education on lifestyle modification, twelve studies encouraged dietary changes and physical activities, two studies emphasized the use of vacuum erectile device, and three studies suggested the application of low-intensity extracorporeal shockwave therapy by healthcare professionals. Discussion Dietary modification and physical activities were promoted as effective interventions to help maintaining the erectile function in men with T2DM. Several methods of patient education were identified as the approach to facilitate lifestyle modification in men with T2DM-associated ED. The positive outcomes of this review support early ED screening to help preventing T2DM complications such as ED in men. Further, T2DM management is a shared responsibility between the men and healthcare professionals. Despite the success of Vacuum Erectile Device and Low-intensity Extracorporeal Shockwave Therapy in regaining erectile function, further research is needed in this area based on the recommendations of the American Urological Association. Moreover, the health and quality of life of men with T2DM must be improved.
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Affiliation(s)
- Setho Hadisuyatmana
- School of Psychology & Public Health, La Trobe University, Kingsbury Drive, Bundoora, Victoria, 3086, Australia
- Faculty of Nursing, Universitas Airlangga Indonesia, Kampus C Jln Mulyorejo, 60115, Surabaya, East Java, Indonesia
| | - James H. Boyd
- School of Psychology and Public Health, La Trobe University of Australia, Kingsbury Drive, Bundoora, Victoria, 3086, Australia
| | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga Indonesia, Kampus C Jln Mulyorejo, 60115, Surabaya, East Java, Indonesia
- Honorary Fellow at La Trobe University of Australia, Kampus C Jln Mulyorejo, 60115, Surabaya, East Java, Indonesia
| | - Gulzar Malik
- School of Nursing & Midwifery, La Trobe University of Australia, Kingsbury Drive, Bundoora, Victoria, 3086, Australia
| | - Michael Bauer
- School of Engineering, La Trobe University of Australia, Kingsbury Drive, Bundoora, Victoria, 3086, Australia
| | - Sonia Reisenhofer
- Bairnsdale Regional Health Service, Victoria, Australia, 122 Day St, Bairnsdale, VIC, 3875, Australia
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Pang K, Pan D, Xu H, Ma Y, Wang J, Xu P, Wang H, Zang G. Advances in physical diagnosis and treatment of male erectile dysfunction. Front Physiol 2023; 13:1096741. [PMID: 36699684 PMCID: PMC9868413 DOI: 10.3389/fphys.2022.1096741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/28/2022] [Indexed: 01/10/2023] Open
Abstract
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.
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Affiliation(s)
- Kun Pang
- Department of Urology, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, The Affiliated Xuzhou Hospital of Medical College of Southeast University, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou, Jiangsu, China
| | - Deng Pan
- Graduate School, Bengbu Medical College, Bengbu, Anhui, China
| | - Hao Xu
- Graduate School, Bengbu Medical College, Bengbu, Anhui, China
| | - Yuyang Ma
- Graduate School, Bengbu Medical College, Bengbu, Anhui, China
| | - Jingkai Wang
- Graduate School, Jiangsu University, Zhenjiang, Jiangsu Province, China
| | - Peng Xu
- Graduate School, Jiangsu University, Zhenjiang, Jiangsu Province, China
| | - Hailuo Wang
- Department of Urology, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, The Affiliated Xuzhou Hospital of Medical College of Southeast University, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou, Jiangsu, China
| | - Guanghui Zang
- Department of Urology, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, The Affiliated Xuzhou Hospital of Medical College of Southeast University, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou, Jiangsu, China,*Correspondence: Guanghui Zang,
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Defeudis G, Mazzilli R, Tenuta M, Rossini G, Zamponi V, Olana S, Faggiano A, Pozzilli P, Isidori AM, Gianfrilli D. Erectile dysfunction and diabetes: A melting pot of circumstances and treatments. Diabetes Metab Res Rev 2022; 38:e3494. [PMID: 34514697 PMCID: PMC9286480 DOI: 10.1002/dmrr.3494] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 09/03/2021] [Indexed: 02/06/2023]
Abstract
Diabetes mellitus (DM), a chronic metabolic disease characterised by elevated levels of blood glucose, is among the most common chronic diseases. The incidence and prevalence of DM have been increasing over the years. The complications of DM represent a serious health problem. The long-term complications include macroangiopathy, microangiopathy and neuropathy as well as sexual dysfunction (SD) in both men and women. Erectile dysfunction (ED) has been considered the most important SD in men with DM. The prevalence of ED is approximately 3.5-fold higher in men with DM than in those without DM. Common risk factors for the development of DM and its complications include sedentary lifestyle, overweight/obesity and increased caloric consumption. Although lifestyle changes may help improve sexual function, specific treatments are often needed. This study aims to review the definition and prevalence of ED in DM, the impact of DM complications and DM treatment on ED and, finally, the current and emerging therapies for ED in patients with DM.
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Affiliation(s)
- Giuseppe Defeudis
- Unit of Endocrinology and DiabetesDepartment of MedicineUniversity Campus Bio‐Medico di RomaRomeItaly
| | - Rossella Mazzilli
- Department of Clinical and Molecular MedicineSapienza University of RomeRomeItaly
| | - Marta Tenuta
- Department of Experimental MedicineSapienza University of RomeRomeItaly
| | - Giovanni Rossini
- Unit of Endocrinology and DiabetesDepartment of MedicineUniversity Campus Bio‐Medico di RomaRomeItaly
| | - Virginia Zamponi
- Department of Clinical and Molecular MedicineSapienza University of RomeRomeItaly
| | - Soraya Olana
- Department of Clinical and Molecular MedicineSapienza University of RomeRomeItaly
| | - Antongiulio Faggiano
- Department of Clinical and Molecular MedicineSapienza University of RomeRomeItaly
| | - Paolo Pozzilli
- Unit of Endocrinology and DiabetesDepartment of MedicineUniversity Campus Bio‐Medico di RomaRomeItaly
| | - Andrea M. Isidori
- Department of Experimental MedicineSapienza University of RomeRomeItaly
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De Rose AF, Mantica G, Bocca B, Szpytko A, Van der Merwe A, Terrone C. Supporting the role of penile trauma and micro-trauma in the etiology of Peyronie's disease. Prospective observational study using the electronic microscope to examine two types of plaques. Aging Male 2020; 23:740-745. [PMID: 30879382 DOI: 10.1080/13685538.2019.1586870] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES The etiopathogenesis of Peyronie's disease (PD) remains not clearly understood. The most accepted theory attributes the histological lesions of PD to the effects of trauma to the corpora cavernosum of the penis. The aim of our study is to verify whether similar histological features exist between these two tissues, providing new evidence in favor of the traumatic theory in the etiopathogenesis of Peyronie's disease. MATERIALS AND METHODS A prospective observational study was carried out at our institution from January 2013 to June 2018, involving patients having undergone surgery for PD and those with delayed surgery for penile trauma. Both excised PD and post-traumatic plaques were analyzed by blind pathologists with an 80kV potential acceleration electron microscope. RESULTS Five patients were identified with a post-traumatic plaque (Group 1) and therefore an equal number of PD patients were enrolled for Group 2. The ultrastructural characteristics of the two types of preparations were very similar. In all the samples we showed an inflammatory reaction of the structure of the tunica albuginea, a production of the disorganized extracellular matrix, a proliferation of inflammatory cells and fibroblasts. Furthermore, we have found an increase in the density and collagen deposits grouped in the extracellular space and within the fibroblasts. CONCLUSIONS These findings support the theory that attributes lesions and symptoms typical of PD to the effects of cavernous body trauma.
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Affiliation(s)
- Aldo Franco De Rose
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - Guglielmo Mantica
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
- Department of Urology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Bruna Bocca
- Department of Pathology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - Alexander Szpytko
- Department of Urology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - André Van der Merwe
- Department of Urology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Carlo Terrone
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
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Uçak S, Sivritepe R, Kara O, Sevim E, Ortaboz D, Küçük EV, Atay S, Baygül AÇ. Association between sarcopenia and erectile dysfunction in males with type II diabetes mellitus. Aging Male 2019; 22:20-27. [PMID: 29468915 DOI: 10.1080/13685538.2018.1441276] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The prevalence rates for both sarcopenia and erectile dysfunction (ED) gradually increase in middle-aged and elderly diabetic male population and they impair physical functioning, sexual functioning, and quality of life. The aim of the present study was to evaluate the sarcopenia in patients with diabetic ED. METHODS The study included 98 male patients with type II diabetes mellitus (DM) aged 18-80 years. Blood chemistry and hormone levels were obtained. The International Index of Erectile Function (IIEF-5) questionnaire was administered to the patients. The patients were divided into three groups according to the IIEF-5 score; a score of 5-10 points indicated severe ED, a score of 11-20 indicated moderate ED, and a score of 21-25 points indicated no ED. The muscle mass, handgrip strength, timed up and go test, upper mid-arm circumference, calf circumference, and body mass index were obtained. The statistical analysis was performed using MedCalc Statistical Software version 12.7.7. All parameters were compared between the three groups. RESULTS Of 98 patients included in the study, 84 patients had severe sarcopenia, 13 had moderate sarcopenia, while only one patient had normal muscle mass. The mean age was 56.59 ± 11.46 years. When patients were divided into three groups according to IIEF-5 score, 38 had severe ED, 39 had moderate ED, and 21 had no ED. There was a significant difference between the three groups in terms of handgrip strength, timed up and go test scores, upper mid-arm circumference, and calf circumference (p < .05 for all). CONCLUSIONS Although muscle mass remains unchanged, muscle strength and physical performance decrease in diabetic ED patients. Diabetic patients with severe and moderate ED have lower muscle strength and physical performance.
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Affiliation(s)
- Sema Uçak
- a Department of Internal Medicine , Health Sciences University Umraniye Education and Research Hospital , Istanbul , Turkey
| | - Rıdvan Sivritepe
- a Department of Internal Medicine , Health Sciences University Umraniye Education and Research Hospital , Istanbul , Turkey
| | - Oğuzhan Kara
- a Department of Internal Medicine , Health Sciences University Umraniye Education and Research Hospital , Istanbul , Turkey
| | - Ecem Sevim
- a Department of Internal Medicine , Health Sciences University Umraniye Education and Research Hospital , Istanbul , Turkey
| | - Damla Ortaboz
- a Department of Internal Medicine , Health Sciences University Umraniye Education and Research Hospital , Istanbul , Turkey
| | - Eyüp Veli Küçük
- b Department of Urology , Health Sciences University Umraniye Education and Research Hospital , Istanbul , Turkey
| | - Sabri Atay
- c Uğur Mumcu Family Health Center , Istanbul , Turkey
| | - Arzu Çalışgan Baygül
- d Department of Biostatistics and Medical Informatics , Beykent University Faculty of Medicine , Istanbul , Turkey
- e Medstats Analysis and Consulting Limited Company , Istanbul , Turkey
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Li J, Wang S, Qin F, Zhu M, You X, Wu C, Fu F, Yuan J. Reduction in Peyronie's-like plaque size using a vacuum erection device in a rat model of Peyronie's disease via the TGF-β/SMAD signalling pathway. Andrologia 2018; 50:e13051. [PMID: 29806152 DOI: 10.1111/and.13051] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/22/2018] [Accepted: 04/15/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Jinhong Li
- Andrology Laboratory; West China Hospital; Sichuan University; Chengdu China
- Department of Urology; Institute of Urology; West China Hospital; Sichuan University; Chengdu China
| | - Shuzhen Wang
- Laboratory of Infectious Disease and Vaccine; West China Hospital; Sichuan University; Chengdu China
| | - Feng Qin
- Andrology Laboratory; West China Hospital; Sichuan University; Chengdu China
| | - Mengli Zhu
- Andrology Laboratory; West China Hospital; Sichuan University; Chengdu China
| | - Xuanhe You
- Andrology Laboratory; West China Hospital; Sichuan University; Chengdu China
| | - Changjing Wu
- Andrology Laboratory; West China Hospital; Sichuan University; Chengdu China
| | - Fudong Fu
- Andrology Laboratory; West China Hospital; Sichuan University; Chengdu China
| | - Jiuhong Yuan
- Andrology Laboratory; West China Hospital; Sichuan University; Chengdu China
- Department of Urology; Institute of Urology; West China Hospital; Sichuan University; Chengdu China
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