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De Guzman S, Jiang YH, Dee V. Reliability and Validity Evidence for Brief Sexual Attitudes Scale Among Filipino Men: A Confirmatory Factor Analysis. J Nurs Meas 2024; 32:165-173. [PMID: 37348880 DOI: 10.1891/jnm-2022-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Background and Purpose: It is essential to address sexual health to ensure quality of life and sexual well-being; however, studies to measure sexual attitudes remain scarce. This study aimed to find reliability and validity evidence of the Brief Sexual Attitudes Scale (BSAS) using confirmatory factor analysis (CFA) among Filipino men. Methods: A cross-sectional study was conducted. Results: BSAS shows coefficient alpha of 0.90. CFA demonstrates goodness of fit (adjusted goodness-of-fit index = .82; goodness-of-fit index = .86; comparative fit index = .91; incremental fit index = .91; expected cross-validation index = 2.27; root mean square error of approximation = .08; [χ2 (213) = 927.45, p ≤ .001], χ2/df ratio = 4.35). Conclusions: BSAS is a valid and reliable questionnaire to assess sexual attitudes among Filipino men. Further research is needed to evaluate sexual attitudes in the promotion of sexual health across cultures.
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Affiliation(s)
| | - Ying Hong Jiang
- School of Education, Azusa Pacific University, Azusa, CA, USA
| | - Vivien Dee
- School of Nursing, Azusa Pacific University, Azusa, CA, USA
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2
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Fotinos K, Sansone A, Greifenberger A, Katzman MA, Jannini TB, Reisman Y, Limoncin E, Jannini EA. Pornography and sexual function in the post-pandemic period: a narrative review from psychological, psychiatric, and sexological perspectives. Int J Impot Res 2024:10.1038/s41443-023-00812-3. [PMID: 38184709 DOI: 10.1038/s41443-023-00812-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 01/08/2024]
Abstract
The COVID-19 pandemic and lockdowns had significant impacts on sexual functioning and behavior. Partnered sexual activity decreased overall, while solo sex activities such as masturbation and pornography consumption increased exponentially. Given the ongoing debate about the effects of pornography on sexual function, it was prudent to consider how the increase in porn consumption during the pandemic might have impacted sexual function in the post-pandemic period. Results indicated that despite the increased rates of use during lockdowns, there remains no evidence supporting the relationship between sexual dysfunction and porn use during and following the pandemic period. On the contrary, pornography consumption and solo sex activities offered an alternative to conventional sexual behavior during a highly stressful period and were found to have positive effects of relieving psychosocial stress otherwise induced by the pandemic. Specifically, those who maintained an active sexual life experienced less anxiety and depression, and greater relational health than those who were not sexually active. It is important to consider factors including frequency, context, and type of consumption when analyzing the impact of pornography on sexual function. While excessive use can have negative effects, moderate use can be a natural and healthy part of life.
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Affiliation(s)
- Kathryn Fotinos
- Course of Clinical Psychosexology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
- Stress Trauma Anxiety Rehabilitation Treatment (S.T.A.R.T.) Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada
| | - Andrea Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Alexandria Greifenberger
- Stress Trauma Anxiety Rehabilitation Treatment (S.T.A.R.T.) Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada
| | - Martin A Katzman
- Stress Trauma Anxiety Rehabilitation Treatment (S.T.A.R.T.) Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada
- Adler Graduate Professional School, Toronto, ON, Canada
- Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada
| | - Tommaso B Jannini
- School of Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | | | - Erika Limoncin
- Course of Clinical Psychosexology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.
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Wu X, Zhang Y, Zhang W, Liu G, Jiang H, Huang H, Zhang X. The relationship between serum 25‐hydroxy vitamin D and arteriogenic erectile dysfunction. Andrologia 2022; 54:e14568. [DOI: 10.1111/and.14568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Xu Wu
- Department of Urology the First Affiliated Hospital of Anhui Medical University Anhui China
| | - Yuyang Zhang
- Department of Urology the First Affiliated Hospital of Anhui Medical University Anhui China
| | - Wei Zhang
- Department of Urology the First Affiliated Hospital of Anhui Medical University Anhui China
| | - Guodong Liu
- Department of Urology the First Affiliated Hospital of Anhui Medical University Anhui China
| | - Hui Jiang
- Department of Urology Peking University First Hospital Beijing China
| | - Houbao Huang
- Department of Urology The first Affiliated Hospital of Wannan Medical College Wuhu China
| | - Xiansheng Zhang
- Department of Urology the First Affiliated Hospital of Anhui Medical University Anhui China
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Antonio L, Wu FCW, Moors H, Matheï C, Huhtaniemi IT, Rastrelli G, Dejaeger M, O’Neill TW, Pye SR, Forti G, Maggi M, Casanueva FF, Slowikowska-Hilczer J, Punab M, Tournoy J, Vanderschueren D, Forti G, Petrone L, Corona G, Rastrelli G, Maggi (Florence) M, Vanderschueren D, Tournoy J, Borghs H, Antonio (Leuven) L, Kula K, Slowikowska-Hilczer J, Walczak-Jedrzejowska (Łódz) R, Huhtaniemi (London) I, Giwercman (Malmö) A, Wu F, Silman A, O’Neill T, Finn J, Pye (Manchester) S, Casanueva F, Crujeiras (Santiago) AB, Bartfai G, Földesi I, Fejes (Szeged) I, Punab M, Korrovitz (Tartu) P. Erectile dysfunction predicts mortality in middle-aged and older men independent of their sex steroid status. Age Ageing 2022; 51:6568537. [PMID: 35429269 DOI: 10.1093/ageing/afac094] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/21/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND erectile dysfunction is associated with mortality, whereas the association between low testosterone (T) and higher mortality remains controversial. Sexual dysfunction and low T often coexist, but the relative importance of sexual symptoms versus low T in predicting mortality is not known. We studied the interrelationships between sex steroids and sexual symptoms with all-cause mortality in a large prospective cohort of European men. DESIGN survival status was assessed in 1,788 community-dwelling men, aged 40-79, who participated in the European Male Ageing Study (EMAS). Sexual symptoms were evaluated via a validated questionnaire (EMAS-SFQ). Sex steroids were measured by mass spectrometry. Cox proportional hazard models were used to study the association between hormones, sexual symptoms and mortality. RESULTS about 420 (25.3%) men died during a mean follow-up of 12.6 ± 3.1 years. Total T levels were similar in both groups, but free T was lower in those who died. Men with three sexual symptoms (erectile dysfunction, reduced morning erections and lower libido) had a higher mortality risk compared with men with none of these symptoms (adjusted hazard ratio (HR) and 95% confidence intervals: 1.75 (1.28-2.40, P = 0.001)). Particularly, erectile dysfunction and poor morning erections, but not lower libido, were associated with increased mortality (HR 1.40 (1.13-1.74, P = 0.002), 1.28 (1.04-1.59, P = 0.023) and 1.12 (0.90-1.39, P = 0.312), respectively). Further adjusting for total T, free T or oestradiol did not influence the observed risk. CONCLUSIONS sexual symptoms, in particular erectile dysfunction, predict all-cause mortality independently of sex steroids and can be an early warning sign of a poor health status.
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Affiliation(s)
- Leen Antonio
- Department of Chronic Diseases and Metabolism, KU Leuven, Laboratory of Clinical and Experimental Endocrinology, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Frederick C W Wu
- Andrology Research Unit, Centre for Endocrinology & Diabetes, Institute of Human Development, The University of Manchester, Manchester, UK
| | - Hannes Moors
- Department of Public Health and Primary Care, KU Leuven, Laboratory of Gerontology and Geriatrics, Leuven, Belgium
- Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium
| | - Cathy Matheï
- Department of Public Health and Primary Care, KU Leuven, Academic Center for General Practice, Leuven, Belgium
| | - Ilpo T Huhtaniemi
- Institute of Reproductive and Developmental, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Giulia Rastrelli
- Andrology, Women’s Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
| | - Marian Dejaeger
- Department of Public Health and Primary Care, KU Leuven, Laboratory of Gerontology and Geriatrics, Leuven, Belgium
- Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium
| | - Terence W O’Neill
- Centre for Epidemiology Versus Arthritis, The University of Manchester & NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Stephen R Pye
- Centre for Epidemiology Versus Arthritis, The University of Manchester & NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Gianni Forti
- Andrology, Women’s Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
| | - Mario Maggi
- Endocrinology Unit, University of Florence, Florence, Italy
| | - Felipe F Casanueva
- Department of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (CHUS); CIBER de Fisiopatología Obesidad y Nutricion (CB06/03), Instituto Salud Carlos III, Santiago de Compostela, Spain
| | | | - Margus Punab
- Andrology Centre, Tartu University Hospital, Tartu, Estonia
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Jos Tournoy
- Department of Public Health and Primary Care, KU Leuven, Laboratory of Gerontology and Geriatrics, Leuven, Belgium
- Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium
| | - Dirk Vanderschueren
- Department of Chronic Diseases and Metabolism, KU Leuven, Laboratory of Clinical and Experimental Endocrinology, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
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Interactions between erectile dysfunction, cardiovascular disease and cardiovascular drugs. Nat Rev Cardiol 2022; 19:59-74. [PMID: 34331033 DOI: 10.1038/s41569-021-00593-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 02/06/2023]
Abstract
Sexual health has a fundamental role in overall health and well-being, and a healthy and dynamic sex life can make an important contribution to a good quality of life. Sexual dysfunction, and especially erectile dysfunction (ED) in men, is highly prevalent in patients with cardiovascular disease (CVD). CVD and ED have shared risk factors and pathophysiological links, such as endothelial dysfunction, inflammation and low plasma testosterone levels. ED has been shown to be an independent and early harbinger of future CVD events, providing an important window to initiate preventive measures. Therefore, screening and diagnosing ED is essential for the primary and secondary prevention of CVD because the assessment of ED offers an easy and low-cost prognostic tool that is an alternative to other investigational cardiovascular biomarkers. Moreover, ED is a major contributing factor to the discontinuation of, or poor adherence to, cardiovascular therapy. Cardiovascular drugs have divergent effects on erectile function, with diuretics and β-blockers having the worst profiles, and renin-angiotensin-aldosterone system inhibitors and nebivolol having the best profiles. Pharmacological treatment of ED has an equivocal effect on the risk of CVD, suggesting a complex interaction between ED and drugs for CVD. In this Review, we discuss how sexual function could be incorporated into the patient history taken by physicians treating individuals with CVD, not merely as part of the diagnostic work-up but as a means to pursue tangible and essential benefits in quality of life and cardiovascular outcomes.
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Irfan M, Hussain NHN, Noor NM, Mohamed M, Sidi H, Ismail SB. Epidemiology of Male Sexual Dysfunction in Asian and European Regions: A Systematic Review. Am J Mens Health 2021; 14:1557988320937200. [PMID: 32623948 PMCID: PMC7338652 DOI: 10.1177/1557988320937200] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Male sexual dysfunctions (MSDs) often remain undiagnosed and untreated in Asia
compared to Europe due to conservative cultural and religious beliefs,
socioeconomic conditions, and lack of awareness. There is a tendency for the use
of traditional medicines and noncompliance with and reduced access to modern
healthcare. The present systematic review compared the incidence and factors of
MSD in European and Asian populations. English language
population/community-based original articles on MSDs published in MEDLINE from
2008 to 2018 were retrieved. A total of 5392 studies were retrieved, of which 50
(25 Asian and 25 European) were finally included in this review. The prevalence
of erectile dysfunction (ED) (0%–95.0% vs. 0.9%–88.8%), low satisfaction
(3.2%–37.6% vs. 4.1%–28.3%), and hypoactive sexual desire disorder (HSDD)
(0.7%–81.4 vs. 0%–65.5%) was higher in Asian than in European men, whereas the
prevalence of anorgasmia (0.4% vs. 3%–65%) was lower in Asian than in European
men. Age was an independent positive factor of MSD. In European men over 60
years old, the prevalence of premature ejaculation (PE) decreased. The
prevalence of MSD was higher in questionnaires than in interviews. The
significant factors were age, single status, low socioeconomic status, poor
general health, less physical activity, cardiovascular diseases, diabetes,
obesity, lower urinary tract symptoms, prostatitis, anxiety, depression and
alcohol, tobacco, and drug use. The prevalence of MSD differed slightly in Asian
and European men. There is a need to conduct large studies on the various Asian
populations for the effective management of MSD.
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Affiliation(s)
- Muhammad Irfan
- Women's Health Development Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan
| | - Nik Hazlina Nik Hussain
- Women's Health Development Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Norhayati Mohd Noor
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Hatta Sidi
- Department of Psychiatry, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Shaiful Bahari Ismail
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Roy N, Rosas SE. Erectile dysfunction and coronary artery calcification in incident dialysis patients. J Nephrol 2021; 34:1521-1529. [PMID: 33683674 DOI: 10.1007/s40620-021-00994-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/05/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Erectile dysfunction, which has been associated with mortality in the general population, is common in individuals on hemodialysis. Our aim was to determine the relationship between erectile dysfunction, coronary artery calcification and mortality in incident hemodialysis patients. MATERIALS AND METHODS A prospective cohort of incident adult dialysis patients with no history of coronary artery disease underwent coronary artery calcification measurement by ECG-triggered multi-slice computed tomography (MSCT) scan at baseline and at least 12 months later. Erectile dysfunction was determined using the 15-item validated International Index of Erectile Function (IIEF-15) questionnaire. RESULTS Erectile dysfunction was prevalent in 83% of patients, with 43% classified as severe erectile dysfunction, 22.4% as moderate erectile dysfunction, and 17.2% as mild erectile dysfunction. The median (IQR) coronary artery calcification score was 43.4 (0.25-353.8) for those with erectile dysfunction and 0 (0-0) for those without erectile dysfunction (p = 0.007). More than half (55.6%) of the patients with erectile dysfunction experienced progression of coronary artery calcification compared to 14.3% of patients without erectile dysfunction (p = 0.05). Mortality was 21% during an average follow-up of 5.2 (1.3) years. Twenty-three percent of patients with erectile dysfunction died compared to 10% of people without erectile dysfunction (p = 0.4). Erectile dysfunction was not significantly associated with mortality [HR 1.2 (1.3), p = 0.87]. CONCLUSIONS Erectile dysfunction is common in individuals who start dialysis. It is significantly associated with an increased coronary artery calcification score, however, it is not associated with increased mortality in incident dialysis patients with no history of coronary artery disease.
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Affiliation(s)
- Neil Roy
- Kidney and Hypertension Unit, Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA.,Harvard Medical School, Boston, MA, USA
| | - Sylvia Eleni Rosas
- Kidney and Hypertension Unit, Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA. .,Harvard Medical School, Boston, MA, USA.
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Culha MG, Atalay HA, Canat HL, Alkan I, Ozbir S, Can O, Otunctemur A. The relationship between erectile dysfunction severity, mean platelet volume and vitamin D levels. Aging Male 2020; 23:173-178. [PMID: 29616850 DOI: 10.1080/13685538.2018.1459544] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: The aim of this study was to evaluate the relationship between mean platelet volume (MPV) and vitamin D levels according to ED severity.Methods: Between October 2015 and September 2017, patients who applied to the andrology outpatient clinic with an ED complaint were retrospectively reviewed. Patients with diabetes, hypertension, hyperlipidemia, malignancy, late-onset hypogonadism and smokers were not included in the study. The International Erectile Function Index-Erectile Function (IIEF-EF) questionnaire was used to assess the levels of erectile function. According to this scoring system, patients were divided into two groups. IIEF score: between 17 and 25 = mild ED (Group 1) and IIEF score between 16 and 0 = moderate-severe ED (Group 2). Blood samples of the patients were taken from antecubital vein and MPV and 25-hydroxyvitamin D [25(OH)D] levels were evaluated.Results: Ninety patients were included in the study (Group 1: n = 41, Group 2: n = 49). The mean age of the patients was 41.07 ± 8.56 and the mean body mass index (BMI) was 27.59 ± 3.91. 25(OH)D levels were found to be statistically lower in Group 2 (18.85 ± 6.09; 13.98 ± 7.10; p = .001). MPV levels were found to be statistically higher in Group 2 (10.05 ± 0.81; 10.78 ± 1.16; p = .001). Correlation between IIEF-EF scores and 25(OH)D levels was positive (p = .03, r = 0.22). There was negative correlation between IIEF-EF scores and MPV and between 25(OH)D levels and MPV levels [p = .003 for IIEF-EF/MPV, p = .04, r = -0.23 for 25(OH)D/MPV].Conclusion: There is a significant positive correlation between ED severity and 25(OH)D levels and there is a significant negative correlation between ED severity and MPV levels.
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Affiliation(s)
- Mehmet Gokhan Culha
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
| | - Hasan Anil Atalay
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
| | - Halil Lutfi Canat
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
| | - Ilter Alkan
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
| | - Sait Ozbir
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
| | - Osman Can
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
| | - Alper Otunctemur
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
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Jiann BP, Chin CW. A cross-sectional observation to investigate subsequent cardiovascular diseases in Taiwanese men with erectile dysfunction. FORMOSAN JOURNAL OF SURGERY 2020. [DOI: 10.4103/fjs.fjs_29_19] [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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Chang CH, Chueh SCJ, Wu VC, Chen L, Lin YH, Hu YH, Wu KD, Tsai YC. Risk of severe erectile dysfunction in primary hyperaldosteronism: A population-based propensity score matching cohort study. Surgery 2018; 165:622-628. [PMID: 30473204 DOI: 10.1016/j.surg.2018.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 08/24/2018] [Accepted: 08/27/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND An elevated plasma aldosterone level has been reported as an independent risk factor for severe erectile dysfunction in men. The aim of this study was to explore whether primary hyperaldosteronism patients experience erectile dysfunction after targeted treatment. METHODS We conducted a population-based cohort study of men with newly identified primary hyperaldosteronism/aldosterone-producing adenoma from January 1, 1997, to December 31, 2009. Men with essential hypertension and normotension were matched to the primary hyperaldosteronism group according to propensity score matching. RESULTS We identified 1,067 men with primary hyperaldosteronism (mean age, 46.7 ± 12.8 years) and matched them with the same number of men with essential hypertension or normotension. During the mean follow-up interval of 5.4 years, the incident rates of total erectile dysfunction were 5.7, 3.9, and 3.1 per 1,000 person-years for the primary hyperaldosteronism, essential hypertension, and normotension groups, respectively. Men with primary hyperaldosteronism exhibited a higher risk of erectile dysfunction compared with men with normotension (competing risks hazard ratio, 1.83), and no difference was seen in comparison with men who have essential hypertension. After adrenalectomy, men who have primary hyperaldosteronism had a higher risk of exhibiting severe erectile dysfunction compared with men who have essential hypertension (competing risks hazard ratio, 2.44) or normotension (competing risks hazard ratio, 2.90). CONCLUSION Men with primary hyperaldosteronism reported a higher incidence of severe erectile dysfunction than normotension controls despite targeted treatment. The risk of severe erectile dysfunction increased after men who have primary hyperaldosteronism underwent adrenalectomy. This result raises the possibility of severe erectile dysfunction after adrenalectomy and calls for a prospective large-scale study of men who have aldosterone-producing adenoma regarding their erectile function both before and after adrenalectomy.
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Affiliation(s)
- Chia-Hui Chang
- Division of Endocrine and Metabolism, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei
| | - Shih-Chieh J Chueh
- Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei; Cleveland Clinic Lerner College of Medicine and Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
| | - Vin-Cent Wu
- Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei; Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Likwang Chen
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Yen-Hung Lin
- Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Hui Hu
- Division of Endocrine and Metabolism, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan; Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei
| | - Kwan-Dun Wu
- Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei; Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yao-Chou Tsai
- Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei; Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan.
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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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Matsuura T, Abe T, Onoda M, Ikarashi D, Sugimura J, Komaki T, Sasaki N, Takasawa Y, Kato T, Yoshioka K, Ehara S, Obara W. Pelvic Artery Calcification Score Is a Marker of Vascular Calcification in Male Hemodialysis Patients. Ther Apher Dial 2018; 22:509-513. [DOI: 10.1111/1744-9987.12668] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/02/2017] [Accepted: 12/27/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Tomohiko Matsuura
- Department of Urology; Iwate Medical University School of Medicine; Morioka Japan
| | - Takaya Abe
- Department of Urology; Iwate Medical University School of Medicine; Morioka Japan
| | - Mitsutaka Onoda
- Department of Urology; Iwate Medical University School of Medicine; Morioka Japan
| | - Daiki Ikarashi
- Department of Urology; Iwate Medical University School of Medicine; Morioka Japan
| | - Jun Sugimura
- Department of Urology; Iwate Medical University School of Medicine; Morioka Japan
| | | | | | | | | | - Kunihiro Yoshioka
- Department of Radiology; Iwate Medical University School of Medicine; Morioka Japan
| | - Shigeru Ehara
- Department of Radiology; Iwate Medical University School of Medicine; Morioka Japan
| | - Wataru Obara
- Department of Urology; Iwate Medical University School of Medicine; Morioka Japan
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Hsu B, Hirani V, Naganathan V, Blyth FM, Le Couteur DG, Seibel MJ, Waite LM, Handelsman DJ, Cumming RG. Sexual Function and Mortality in Older Men: The Concord Health and Ageing in Men Project. J Gerontol A Biol Sci Med Sci 2017; 72:520-527. [PMID: 27252309 DOI: 10.1093/gerona/glw101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 05/17/2016] [Indexed: 12/12/2022] Open
Abstract
Background The longitudinal association between progressive temporal change in sexual (dys)function and mortality in older men. Methods Community-dwelling men aged 70 years and older from the Concord Health and Ageing in Men Project were assessed at baseline (2005-2007, n = 1,705), 2-years follow-up (n = 1,367), and 5-years follow-up (n = 958). Self-reported sexual function (erectile function and sexual activity) using standardized questions were analyzed by generalized estimating equations to examine the longitudinal prediction of mortality according to change in sexual function across three time-points. Results Men reported to have erectile dysfunction increased from 64% to 80%, and to be sexually inactive increased from 56% to 59% over the course follow-up. In univariate analyses, erectile dysfunction (hazard ratio: 2.02, 95% confidence interval [CI]: 1.45-2.81) or having no sexual activity (hazard ratio: 2.31, 95% CI: 1.82-2.93) at baseline predicted increased mortality over the subsequent 7 years. Models adjusted for multivariate and major reproductive hormones had negligible impact on mortality prediction, but neither statistically significantly predicted mortality after adjusting for depression. Similarly, change in erectile dysfunction over time was associated with mortality over 7 years in univariate (odds ratio: 1.69, 95% CI: 1.34-2.14) and multivariate analysis, including hormones, but not after adjusting for depression (odds ratio: 1.24, 95% CI: 0.95-1.62). Change in sexual activity was associated with mortality over 7 years in univariate analysis (odds ratio: 2.37, 95% CI: 1.33-4.20) but not after adjusting for age (odds ratio: 1.45, 95% CI: 0.79-2.64). Conclusions Our analyses suggest sexual dysfunction was not an independent risk factor of, but rather may be a biomarker for, all-cause mortality in older men.
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Affiliation(s)
- Benjumin Hsu
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia.,School of Public Health, University of Sydney, New South Wales, Australia.,Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales Australia
| | - Vasant Hirani
- School of Public Health, University of Sydney, New South Wales, Australia.,Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales Australia.,School of Life and Environmental Sciences Charles Perkins Centre, University of Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia
| | - Fiona M Blyth
- Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia
| | - David G Le Couteur
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia.,Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia
| | - Markus J Seibel
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia
| | - Louise M Waite
- Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia
| | - Robert G Cumming
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia.,School of Public Health, University of Sydney, New South Wales, Australia.,Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales Australia
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14
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Silva AB, Sousa N, Azevedo LF, Martins C. Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis. Br J Sports Med 2016; 51:1419-1424. [DOI: 10.1136/bjsports-2016-096418] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2016] [Indexed: 12/31/2022]
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15
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Vitamin D deficiency is independently associated with greater prevalence of erectile dysfunction: The National Health and Nutrition Examination Survey (NHANES) 2001-2004. Atherosclerosis 2016; 252:61-67. [PMID: 27505344 DOI: 10.1016/j.atherosclerosis.2016.07.921] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 07/07/2016] [Accepted: 07/26/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Erectile dysfunction (ED) and atherosclerotic cardiovascular disease (ASCVD) share many common risk factors, and vascular ED is a marker for increased ASCVD risk. Low 25-hydroxyvitamin D [25(OH)D] concentrations have been associated with increased ASCVD risk, but less is known regarding the relationship of low 25(OH)D with ED. We determined whether 25(OH)D deficiency is associated with ED independent of ASCVD risk factors. METHODS We performed cross-sectional analyses of 3390 men aged ≥20 years free of ASCVD who participated in NHANES 2001-2004. Serum 25(OH)D was measured by the DiaSorin radioimmunoassay; deficiency was defined as levels <20 ng/ml (<50 nmol/L). Self-reported ED, assessed by a single validated question, was defined as men who reported being "never" or "sometimes able" to maintain an erection. We assessed the relationship between 25(OH)D deficiency and ED prevalence using adjusted Poisson regression methods. RESULTS After accounting for NHANES sampling, the weighted prevalence of 25(OH)D deficiency and of ED were 30% and 15.2%, respectively. 25(OH)D levels were lower in men with vs. those without ED (mean 22.8 vs 24.3 ng/mL, respectively; p = 0.0005). After adjusting for lifestyle variables, comorbidities, and medication use, men with 25(OH)D deficiency had a higher prevalence of ED compared to those with levels ≥30 ng/ml (Prevalence Ratio 1.30, 95% CI 1.08-1.57). CONCLUSION In this cross-sectional analysis of a representative sample of U.S. men, vitamin D deficiency was associated with an increased prevalence of ED independent of ASCVD risk factors. Additional research is needed to evaluate whether treating vitamin D deficiency improves erectile function.
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Loprinzi PD, Nooe A. Erectile Dysfunction and Mortality in a National Prospective Cohort Study. J Sex Med 2015; 12:2130-3. [PMID: 26559652 DOI: 10.1111/jsm.13032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Emerging work has shown erectile dysfunction (ED) to be an important indicator of cardiovascular risk via its shared pathophysiology. Yet limited research has examined if a direct relationship between ED and mortality risk exists. AIM The purpose of this brief report was to better define the relationship between ED and mortality risk. METHODS Prevalent ED was assessed with the question: "How would you describe your ability to get and keep an erection adequate for satisfactory intercourse?" Participant data from the population-based 2003-2004 National Health and Nutrition Examination Survey (NHANES) was linked to death certificates from the National Death Index for mortality assessment. MAIN OUTCOME MEASURES Increased risk of premature all-cause mortality among those with ED (vs. those without). RESULTS Of 1,790 adult men providing complete data (age range: 20-85 years; mean = 45.4 year), with 557 having ED, over a 93-month follow-up, 244 deceased over this time. After adjustments, those with ED (vs. those without) had a 70% increased risk of premature all-cause mortality (hazards ratio = 1.70; 95% confidence interval; 1.01-2.85; P = 0.04). CONCLUSIONS ED is associated with increased premature mortality risk. The present findings have major public health and clinical implications in that ED is a strong indicator of premature mortality. Therefore, patients with ED should be screened and possibly treated for complications that may increase the risk of premature death.
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Affiliation(s)
- Paul D Loprinzi
- Center for Health Behavior Research, School of Applied Sciences, The University of Mississippi, University, MS, USA
| | - Allison Nooe
- Department of Health, Exercise Science and Recreation Management, School of Applied Sciences, The University of Mississippi, University, MS, USA
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