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Xi YJ, Feng YG, Bai YQ, Wen R, Zhang HY, Su QY, Guo Q, Li CY, Wang ZX, Pei L, Zhang SX, Wang JQ. Genetic prediction of modifiable lifestyle factors for erectile dysfunction. Sex Med 2024; 12:qfae010. [PMID: 38505341 PMCID: PMC10949036 DOI: 10.1093/sexmed/qfae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/28/2024] [Accepted: 02/08/2024] [Indexed: 03/21/2024] Open
Abstract
Background The causal relationship between certain lifestyle factors and erectile dysfunction (ED) is still uncertain. Aim The study sought to investigate the causal effect of 9 life factors on ED through 2-sample single-variable Mendelian randomization (SVMR) and multivariable Mendelian randomization (MVMR). Methods Genetic instruments to proxy 9 risk factors were identified by genome-wide association studies. The genome-wide association studies estimated the connection of these genetic variants with ED risk (n = 223 805). We conducted SVMR, inverse variance-weighting, Cochran's Q, weighted median, MR-Egger, MR-PRESSO (Mendelian Randomization Pleiotropy RESidual Sum and Outlier), and MVMR analyses to explore the total and direct relationship between life factors and ED. Outcomes The primary outcome was defined as self or physician-reported ED, or using oral ED medication, or a history of surgery related to ED. Results In SVMR analyses, suggestive associations with increased the risk of ED were noted for ever smoked (odds ratio [OR], 5.894; 95% confidence interval [CI], 0.469 to 3.079; P = .008), alcohol consumption (OR, 1.495; 95% CI, 0.044 to 0.760; P = .028) and body mass index (BMI) (OR, 1.177; 95% CI, 0.057 to 0.268; P = .003). Earlier age at first intercourse was significantly related to reduced ED risk (OR, 0.659; 95% CI, -0.592 to -0.244; P = 2.5 × 10-6). No strong evidence was found for the effect of coffee intake, time spent driving, physical activity, and leisure sedentary behaviors on the incidence of ED (All P > .05). The result of MVMR analysis for BMI (OR, 1.13; 95% CI, 1.01 to 1.25; P = .045) and earlier age at first intercourse (OR, 0.77; 95% CI, 0.56 to 0.99; P = .018) provided suggestive evidence for the direct impact on ED, while no causal factor was detected for alcoholic drinks per week and ever smoked. Clinical implications This study provides evidence for the impact of certain modifiable lifestyle factors on the development of ED. Strengths and limitations We performed both SVMR and MVMR to strengthen the causal relationship between exposures and outcomes. However, the population in this study was limited to European ancestry. Conclusion Ever smoked, alcoholic drinks per week, BMI, and age first had sexual intercourse were causally related to ED, while the potential connection between coffee intake, physical activity, recreational sedentary habits, and increased risk of ED needs to be further confirmed.
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Affiliation(s)
- Yu-Jia Xi
- Department of Urology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, China
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province 030001, China
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province 030001, China
| | - Yi-Ge Feng
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province 030001, China
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province 030001, China
| | - Ya-Qi Bai
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province 030001, China
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province 030001, China
| | - Rui Wen
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province 030001, China
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province 030001, China
| | - He-Yi Zhang
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province 030001, China
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province 030001, China
| | - Qin-Yi Su
- Department of Urology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, China
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province 030001, China
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province 030001, China
| | - Qiang Guo
- Department of Urology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Cheng-Yong Li
- Department of Urology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Zhen-Xing Wang
- Department of Urology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Liang Pei
- Department of Urology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Sheng-Xiao Zhang
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province 030001, China
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province 030001, China
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Jing-Qi Wang
- Department of Urology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, China
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Abdelwahab KM, Eldery MS, Desoky E, El-Babouly IM, Taha K, Saber S, Seleem MM. Role of shear wave elastography (SWE) in erectile dysfunction patients for evaluation of daily tadalafil treatment outcome. Andrologia 2022; 54:e14359. [PMID: 35019157 DOI: 10.1111/and.14359] [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: 10/22/2021] [Revised: 12/16/2021] [Accepted: 12/18/2021] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to evaluate and anticipate the outcome of daily use of tadalafil in patients with erectile dysfunction using elastography. 183 volunteers and 183 patients with erectile dysfunction were included. Pretreatment SWE readings for our patients were calculated with a linear probe. IIEF score Q was measured once at the start of the study for volunteers and twice for patients, one prior to the start of tadalafil administration and the other on one year of 5 mg daily tadalafil after the second post-washout (one month post-treatment stopped). There was no significant difference between patients and volunteers in mean age or risk factors except in SWE values as mean SWE of volunteers was 14.03 ± 1.54 kpasc, while mean SWE of patients was 21.278 ± 8.228 kpasc. The presence of comorbid diabetes, severe disease and pre-SWE ≥23.635 was significantly associated with poor outcome. We conclude that penile SWE could be useful to select probable good responders for a continuous tadalafil use, thus avoiding the unnecessary cost and time in non-responders.
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Affiliation(s)
| | | | - Esam Desoky
- Urology Department, Zagazig University, Zagazig, Egypt
| | | | - Kareem Taha
- Radiodiagnosis Department, Zagazig University, Zagazig, Egypt
| | - Sameh Saber
- Radiodiagnosis Department, Zagazig University, Zagazig, Egypt
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Stark BA, Obedin-Maliver J, Shindel AW. Sexual Wellness in Cisgender Lesbian, Gay, and Bisexual People. Urol Clin North Am 2021; 48:461-472. [PMID: 34602168 DOI: 10.1016/j.ucl.2021.06.005] [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] [Indexed: 12/12/2022]
Abstract
Cisgender sexual minority persons have sexual wellness needs that go well beyond disease prevention. Despite historical asymmetries in research and clinical attention to sexual wellness in cisgender lesbian, gay, and bisexual persons, a growing body of evidence exists on how to optimally care for these populations. Additional research and development is warranted.
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Affiliation(s)
- Brett A Stark
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 490 Illinois Street, 10th Floor, Box 0132, San Francisco, CA 94158, USA
| | - Juno Obedin-Maliver
- Department of Obstetrics and Gynecology, Stanford University, 1701 Page Mill Road, Palo Alto, CA 94304, USA
| | - Alan W Shindel
- Department of Urology, University of California, San Francisco, 400 Parnassus Avenue, Suite A-610, San Francisco, CA 94143-0738, USA.
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Pharmacology and perspectives in erectile dysfunction in man. Pharmacol Ther 2020; 208:107493. [PMID: 31991196 DOI: 10.1016/j.pharmthera.2020.107493] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 11/05/2019] [Indexed: 12/15/2022]
Abstract
Penile erection is a perfect example of microcirculation modulated by psychological factors and hormonal status. It is the result of a complex neurovascular process that involves the integrative synchronized action of vascular endothelium; smooth muscle; and psychological, neuronal, and hormonal systems. Therefore, the fine coordination of these events is essential to maintain penile flaccidity or allow erection; an alteration of these events leads to erectile dysfunction (ED). ED is defined as the consistent or recurrent inability of a man to attain and/or maintain a penile erection sufficient for sexual activity. A great boost to this research field was given by commercialization of phosphodiesterase-5 (PDE5) inhibitors. Indeed, following the discovery of sildenafil, research on the mechanisms underlying penile erection has had an enormous boost, and many preclinical and clinical papers have been published in the last 10 years. This review is structured to provide an overview of the mediators and peripheral mechanism(s) involved in penile function in men, the drugs used in therapy, and the future prospective in the management of ED. Indeed, 30% of patients affected by ED are classified as "nonresponders," and there is still an unmet need for therapeutic alternatives. A flowchart suggesting the guidelines for ED evaluation and the ED pharmacological treatment is also provided.
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Huang X, Fu W, Zhang H, Li H, Li X, Yang Y, Wang F, Gao J, Zheng P, Fu H, Chapman S, Ding D. Why are male Chinese smokers unwilling to quit? A multicentre cross-sectional study on smoking rationalisation and intention to quit. BMJ Open 2019; 9:e025285. [PMID: 30782929 PMCID: PMC6368028 DOI: 10.1136/bmjopen-2018-025285] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/29/2018] [Accepted: 12/13/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE We aimed to describe the rationalisation beliefs endorsed by Chinese male smokers and to examine the association between rationalisation and the intention to quit. SETTING Questionnaires were conducted among male smokers in three cities (Shanghai, Nanning and Mudanjiang) which represent different geographical locations, economic development levels and legislative status of tobacco control in China. DESIGN AND PARTICIPANTS It was a multicentre cross-sectional survey involved a total of 3710 male smokers over 18 years. OUTCOME MEASURES Primary outcomes were intention to quit, smoking rationalisation scores and sub scores in six dimensions. Smoking rationalisation was assessed using a newly developed Chinese rationalisation scale. Multivariable logistic regression was performed to examine the relationship between rationalisation and intention to quit. RESULTS On average, smokers scored 3.3 out of 5 on the smoking rationalisation scale. With a one point increase in total rationalisation scale, the odds for intention to quit in the next 6 months decreased by 48% (OR=0.52, 95% CI: 0.44 to 0.61; p<0.001). Separate logistic regressions for six subscales of rationalisation shown consistent inverse associations with intention to quit (all p values <0.001). Believing that smoking was socially acceptable was the strongest predictor (OR=0.62, 95% CI: 0.55 to 0.71; p<0.001). CONCLUSIONS Rationalisation beliefs could be important barriers to smoking cessation. Some beliefs have stronger association with quit intention than others. Eroding rationalisation beliefs endorsed by smokers is a potential strategy for smoking cessation intervention.
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Affiliation(s)
- Xinyuan Huang
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Wenjie Fu
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Haiying Zhang
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Hong Li
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Xiaoxia Li
- School of Public Health, Mudanjiang Medical University, Mudanjiang, China
| | - Yong Yang
- School of Public Health, Mudanjiang Medical University, Mudanjiang, China
| | - Fan Wang
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Junling Gao
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Pinpin Zheng
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Hua Fu
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Simon Chapman
- Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ding Ding
- Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
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Safavy S, Kilday PS, Slezak JM, Abdelsayed GA, Harrison TN, Jacobsen SJ, Chien GW. Effect of a Smoking Cessation Program on Sexual Function Recovery Following Robotic Prostatectomy at Kaiser Permanente Southern California. Perm J 2018; 21:16-138. [PMID: 28488986 DOI: 10.7812/tpp/16-138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The association between cigarette smoking and erectile dysfunction has been well established. Studies demonstrate improvements in erectile rigidity and tumescence as a result of smoking cessation. Radical prostatectomy is also associated with worsening of erectile function secondary to damage to the neurovascular bundles. To our knowledge, no previous studies have examined the relationship between smoking cessation after prostate cancer diagnosis and its effect on sexual function following robotic prostatectomy. We sought to demonstrate the utility of a smoking cessation program among patients with prostate cancer who planned to undergo robotic prostatectomy at Kaiser Permanente Southern California. METHODS All patients who underwent robotic prostatectomy between March 2011 and April 2013 with known smoking status were included, and were followed-up through November 2014. All smokers were offered the smoking cessation program, which included wellness coaching, tobacco cessation classes, and pharmacotherapy. Patients completed the Expanded Prostate Cancer Index Composite-26 (EPIC-26) health-related quality-of-life (HR-QOL) survey at baseline and postoperatively at 1, 3, 6, 12, 18, and 24 months. There were 2 groups based on smoking status: Continued smoking vs quitting group. Patient's age, Charlson Comorbidity Score, body mass index, educational level, median household income, family history of prostate cancer, race/ethnicity, language, nerve-sparing status, and preoperative/postoperative clinicopathology and EPIC-26 HR-QOL scores were examined. A linear regression model was used to predict sexual function recovery. RESULTS A total of 139 patients identified as smokers underwent the smoking cessation program and completed the EPIC-26 surveys. Fifty-six patients quit smoking, whereas 83 remained smokers at last follow-up. All demographics and clinicopathology were matched between the 2 cohorts. Smoking cessation, along with bilateral nerve-sparing status, were the only 2 modifiable factors associated with improved sexual function after prostatectomy (6.57 points, p = 0.0226 and 8.97 points, p = 0.0485, respectively). CONCLUSION In the setting of robotic prostatectomy, perioperative smoking cessation is associated with a significant improvement in long-term sexual functional outcome when other factors are adjusted.
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Affiliation(s)
- Seena Safavy
- Urologist at the Los Angeles Medical Center in CA.
| | | | - Jeff M Slezak
- Research Manager in Biostatistics for the Southern California Permanente Medical Group in Pasadena.
| | | | - Teresa N Harrison
- Research Manager in Biostatistics for the Southern California Permanente Medical Group in Pasadena.
| | - Steven J Jacobsen
- Director of Research in the Department of Research and Evaluation for Kaiser Permanente Southern California in Pasadena.
| | - Gary W Chien
- Director of the Urology Residency Program at the Los Angeles Medical Center in CA.
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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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DeLay KJ, Haney N, Hellstrom WJ. Modifying Risk Factors in the Management of Erectile Dysfunction: A Review. World J Mens Health 2016; 34:89-100. [PMID: 27574592 PMCID: PMC4999494 DOI: 10.5534/wjmh.2016.34.2.89] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/20/2016] [Indexed: 12/16/2022] Open
Abstract
Erectile dysfunction (ED) is prevalent among men and its presence is often an indicator of systemic disease. Risk factors for ED include cardiovascular disease, hypertension, diabetes mellitus (DM), tobacco use, hyperlipidemia, hypogonadism, lower urinary tract symptoms, metabolic syndrome, and depression. Addressing the modifiable risk factors frequently improves a patient's overall health and increases lifespan. The literature suggests that smoking cessation, treatment of hyperlipidemia, and increasing physical activity will improve erectile function in many patients. How the treatment of DM, depression, and hypogonadism impacts erectile function is less clear. Clinicians need to be aware that certain antihypertensive agents can adversely impact erectile function. The treatment of men with ED needs to address the underlying risk factors to ameliorate the disease process.
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Affiliation(s)
- Kenneth J DeLay
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Nora Haney
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Wayne Jg Hellstrom
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
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Diehl A, Pillon SC, dos Santos MA, Rassool GH, Laranjeira R. Sexual Dysfunction and Sexual Behaviors in a Sample of Brazilian Male Substance Misusers. Am J Mens Health 2016; 10:418-27. [DOI: 10.1177/1557988315569298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The aim of this study was to evaluate the potential relationship between self-reported sexual dysfunction, sexual behavior, and severity of addiction of drug users. A cross-sectional design study was conducted at an inpatient addiction treatment unit in Sao Paulo, Brazil, with a sample of 508 male drug users. Sociodemographic data, sexual behavior, and severity of dependence were evaluated.The prevalence of sexual dysfunction was 37.2% and premature ejaculation was 63.8%. Men with sexual dysfunction presented from moderate to severe level of alcohol, tobacco, and other drugs of dependence. The findings from this study are particularly relevant identifying those sociodemographic factors, severity of drug use, and sexual behavior are related to men who experience sexual dysfunction. Health promotion and motivational interventions on sexual health targeted to male drug users can contribute in reducing these at-risk behaviors. More interdisciplinary research is desirable in future in considering men’s sexual health.
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Oyelade BO, Jemilohun AC, Aderibigbe SA. Prevalence of erectile dysfunction and possible risk factors among men of South-Western Nigeria: a population based study. Pan Afr Med J 2016; 24:124. [PMID: 27642462 PMCID: PMC5012735 DOI: 10.11604/pamj.2016.24.124.8660] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/07/2016] [Indexed: 11/11/2022] Open
Abstract
Introduction Erectile dysfunction (ED) is currently one of the most common sexual dysfunctions worldwide but it is usually underestimated because it is not a life threatening condition. The associated stigma makes men who have it to suffer in silence. This study was conducted to determine the prevalence of erectile dysfunction and the possible associated risk factors among Nigerian men. Methods The study was a descriptive cross-sectional population based survey among men aged 30-80 years in Ogbomoso, South-west, Nigeria. A multistage random sampling method was used. The instrument used was the International Index of Erectile Function Questionnaire-5 (IIEF-5). Unadjusted odds ratios of possible risk factors were calculated by univariate analyses. Binary logistic regression analysis was used to eliminate the effect of possible confounders on the risk factors to get the adjusted odds ratios. Results The general prevalence of ED in this study was 58.9%. Sixty-seven (47.2%), 16 (11.3%) and 59(41.5%) respondents had mild, moderate and severe ED respectively. Age, hypertension, use of anti-hypertensive drugs, diabetes mellitus and heart disease all had significant unadjusted associations with ED, but their adjusted associations were not statistically significant. Diabetes mellitus maintained a positive statistically significant relationship with ED after adjustment for potential confounders [OR= 8.31(95% CI 1.02 - 67.65), P= 0.048]. Conclusion The prevalence of ED is high among south-western Nigeria male adults. Physicians, especially primary care ones, need to pay more attention to the sexual history of their patients in order to diagnose and manage ED more frequently.
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Affiliation(s)
| | - Abiodun Christopher Jemilohun
- Department of Medicine, Ladoke Akintola University of Technology/LAUTECH Teaching Hospital, Ogbomoso, Oyo State, Nigeria
| | - Sunday Adedeji Aderibigbe
- Department of Community Medicine, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria
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Özmen S, Dülger S, Çoban S, Özmen ÖA, Güzelsoy M, Dikiş ÖŞ, Akdeniz Ö. Olfactory and erectile dysfunction association in smoking and non-smoking men. Physiol Behav 2016; 160:1-5. [PMID: 27037193 DOI: 10.1016/j.physbeh.2016.03.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 03/22/2016] [Accepted: 03/23/2016] [Indexed: 10/22/2022]
Abstract
The studies evaluating the effect of smoking on olfaction reveals opposite results. In vitro and animal studies and epidemiological evidence from volunteers and patients, demonstrated the association between olfaction and erectile functions. In smoking man the reduction of olfactory acuity could adversely affect sexuality. The aim of the present study was to investigate the relationship between erectile dysfunction (ED) and olfactory dysfunction (OD) by comparing a group of healthy adult men with a group of smoking adult men. This prospective study involved 62 volunteers, who were recruited and divided into two groups; one consisted of 35 smoking adult men, and the other included 27 healthy non-smoking men. All participants in both groups were examined in detail for any condition with the potential to cause OD. They all had a normal genitourinary system suffered from no circulatory diseases, diabetes mellitus, hypertension, coronary artery disease nor hyperlipidemia; they had no history of medication affecting genitourinary system. Butanol threshold test and sniffin' stick® (Burghart, Wedel; Germany) screening test was used to asses olfactory functions in both groups. Participants' sexual desire was assessed using an International Index of Erectile Function (IIEF-5) scale. The means of sniffin' sticks scores, butanol threshold scores and IIEF-5 scores were statistically higher in non-smoking group. Butanol threshold scores and sniffin' sticks scores are correlated statistically with IIEF-5 in non-smoking and smoking groups. This study found an association between olfaction and erectile function in smoking and non-smoking men. As far as we know this study is the third published study to show the relationship olfactory and erectile function. In the future studies electrophysiological olfactory methods could be used to confirm in large cohorts the results obtained by the psychophysical approach.
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Affiliation(s)
- Süay Özmen
- Bursa Yüksek İhtisas Education and Research Hospital, Otorhinolaryngology Clinic, Bursa, Turkey.
| | - Seyhan Dülger
- Bursa Yüksek İhtisas Education and Research Hospital, Chest Diseases Clinic, Bursa, Turkey
| | - Soner Çoban
- Bursa Yüksek İhtisas Education and Research Hospital, Urology Clinic, Bursa, Turkey
| | - Ömer Afşın Özmen
- Uludağ University Medical Faculty, Department Of Otorhinolaryngology, Bursa, Turkey
| | - Muhammed Güzelsoy
- Bursa Yüksek İhtisas Education and Research Hospital, Urology Clinic, Bursa, Turkey
| | - Özlem Şengören Dikiş
- Bursa Yüksek İhtisas Education and Research Hospital, Chest Diseases Clinic, Bursa, Turkey
| | - Önder Akdeniz
- Esentepe Hospital, Otorhinolaryngology Clinic, Bursa, Turkey
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Implication of Cigarette Smoking and Cessation on Sexual Function in Men and Women. CURRENT SEXUAL HEALTH REPORTS 2014. [DOI: 10.1007/s11930-014-0028-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Harte CB. Concurrent relations among cigarette smoking status, resting heart rate variability, and erectile response. J Sex Med 2014; 11:1230-9. [PMID: 24576257 DOI: 10.1111/jsm.12486] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Heart rate variability (HRV) is a marker of sympathovagal balance; it has been implicated in erectile function and is also altered by tobacco use. Furthermore, smoking and erectile health are strongly related, given that smokers are at increased risk for erectile dysfunction. Few studies have explored the interrelationships between smoking, HRV, and erectile function concurrently. AIM The aim of this study was to examine potential mechanisms underlying tobacco's effects on penile hemodynamics by exploring the mediating role of HRV. METHODS The sample comprised 119 men (smokers = 64; nonsmokers = 55) (mean age 28.90 years; standard deviation (SD) 11.68; range 18-58) selected from the control conditions of three previously published experiments. Participants were free from a history of cardiovascular disease, myocardial infarct, and/or cardiac/cardiovascular medication use. During a laboratory visit, self-report, anthropometric, cardiovascular, and electrocardiographic data were assessed, as well as sexual arousal responses elicited from viewing an erotic film. MAIN OUTCOME MEASURES Objective sexual arousal indices (circumferential change via penile plethysmography), self-reported erectile function (per the erectile function domain score of the International Index of Erectile Function [IIEF-EF]), and time- (SD of beat-to-beat intervals) and frequency-domain parameters of HRV (ratio of low-frequency [LF] power to high-frequency [HF] power [LF/HF ratio]) were assessed. RESULTS Being a current long-term cigarette smoker was associated with dysregulated sympathovagal balance (higher LF/HF ratios, indicative of sympathetic nervous system dominance), which in turn showed inverse relations with magnitude of erectile tumescence. HRV did not mediate relations between tobacco use and either IIEF-EF scores or resting penile circumference. CONCLUSIONS Findings suggest that dysfunctional cardiac autonomic tone may be an underlying mechanism by which tobacco exerts its deleterious effects on erectile health. Further research is necessary to determine whether this relationship is mechanistic in nature, or whether it is better explained by other health factors.
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Affiliation(s)
- Christopher B Harte
- Research Service, VA Boston Healthcare System, Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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Association between cigarette smoking and erectile tumescence: the mediating role of heart rate variability. Int J Impot Res 2013; 25:155-9. [PMID: 23303335 PMCID: PMC3624065 DOI: 10.1038/ijir.2012.43] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 10/11/2012] [Accepted: 11/26/2012] [Indexed: 01/08/2023]
Abstract
Cigarette smoking deleteriously affects erectile function, and conversely, quitting smoking improves erectile hemodynamics. Underlying mechanisms by which smoking (or reduction of smoking frequency) may affect erectile physiology are not well understood. This study examined the mediating role of heart rate variability (HRV; a marker of sympathovagal balance) among a sample of male chronic smokers from the United States. Sixty-two healthy men (Mage=38.27 years; s.d.=10.62) were assessed at baseline (while smoking regularly), at mid-treatment (while using a nicotine patch) and at follow-up, 4 weeks after patch discontinuation. Cigarette use, frequency-domain parameters of HRV (low frequency (LF), high frequency (HF), LF/HF ratio) and physiological sexual arousal responses (via penile plethysmography) were assessed at each visit. Results were consistent with mediation, in that greater reductions in cigarette use from baseline to follow-up were associated with longitudinal increases in LF, which in turn showed positive relationships with across-time changes in erectile tumescence. Neither HF nor LF/HF ratio mediated the relationship between smoking and erection. In conclusion, HRV mediated the inverse relationship between reductions in smoking and enhancements in erectile tumescence. Results underscore the possibility that cigarette use may deleteriously affect erectile function peripherally, in part, by disrupting cardiac autonomic function.
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Glina S, Sharlip ID, Hellstrom WJ. Modifying Risk Factors to Prevent and Treat Erectile Dysfunction. J Sex Med 2013; 10:115-9. [DOI: 10.1111/j.1743-6109.2012.02816.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
OBJECTIVE To provide the first empirical investigation of the association between smoking cessation and indices of physiological and subjective sexual health in men. SUBJECTS AND METHODS Male smokers, irrespective of erectile dysfunction status, who were motivated to stop smoking ('quitters'), were enrolled in an 8-week smoking cessation programme involving a nicotine transdermal patch treatment and adjunctive counselling. Participants were assessed at baseline (while smoking regularly), at mid-treatment (while using a high-dose nicotine transdermal patch), and at a 4-week post-cessation follow-up. Physiological (circumferential change via penile plethysmography) and subjective sexual arousal indices (continuous self-report), as well as self-reported sexual functioning were assessed at each visit. RESULTS Intent-to-treat analyses indicated that, at follow-up, successful quitters (n= 20), compared with those who relapsed (n= 45), showed enhanced erectile tumescence responses, and faster onset to reach maximum subjective sexual arousal. Although successful quitters displayed across-session enhancements in sexual function, they did not show a differential improvement compared with unsuccessful quitters. CONCLUSIONS Smoking cessation significantly enhances both physiological and self-reported indices of sexual health in long-term male smokers, irrespective of baseline erectile impairment. It is hoped that these results may serve as a novel means to motivate men to stop smoking.
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Liu-Seifert H, Kinon BJ, Tennant CJ, Sniadecki J, Volavka J. Sexual dysfunction in patients with schizophrenia treated with conventional antipsychotics or risperidone. Neuropsychiatr Dis Treat 2009; 5:47-54. [PMID: 19557099 PMCID: PMC2695222 DOI: 10.2147/ndt.s4766] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To better understand sexual dysfunction in patients with schizophrenia and its associations with prolactin and reproductive hormones. METHODS This was a secondary analysis of an open-label, one-day study (N = 402). The primary objective of the study was to assess the prevalence of hyperprolactinemia in patients with schizophrenia who had been treated with conventional antipsychotics or risperidone. Other atypical antipsychotics available at the time of the study were not included due to a more favorable prolactin profile. RESULTS The majority of patients (59% of females and 60% of males) reported impairment of sexual function. In postmenopausal females, risk of impaired sexual interest was increased by 31% for every 10 ng/ml increase in prolactin (p = 0.035). In males, lower testosterone was associated with higher prolactin (p < 0.001) and with orgasmic (p = 0.004) and ejaculatory dysfunction (p = 0.028). CONCLUSION These findings suggest that hyperprolactinemia may be associated with sexual dysfunction. They also provide more information on the relationships between prolactin, reproductive hormones, and sexual dysfunction. Sexual dysfunction is an understudied yet important consideration in the treatment of schizophrenia. More attention is warranted in this area as it may provide opportunities for improved quality of life and adherence to treatment for patients.
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Affiliation(s)
- Hong Liu-Seifert
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.
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Harte CB, Meston CM. The inhibitory effects of nicotine on physiological sexual arousal in nonsmoking women: results from a randomized, double-blind, placebo-controlled, cross-over trial. J Sex Med 2008; 5:1184-1197. [PMID: 18331269 PMCID: PMC2859209 DOI: 10.1111/j.1743-6109.2008.00778.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Extensive research suggests that long-term cigarette smoking is an independent risk factor for the introduction of sexual dysfunction in men. However, results of limited data investigating this relationship in women are mixed. No studies have examined the acute effects of tobacco or nicotine on physiological sexual response in women. Controlled experimental studies examining acute effects of isolated nicotine intake on female physiological sexual responses are necessary in order to help elucidate tobacco's potential role in the development and/or maintenance of sexual impairment in women. AIM To examine whether isolated nicotine intake acutely affects sexual arousal responses in nonsmoking women. METHODS Twenty-five sexually functional women (mean age = 20 years) each with less than 100 direct exposures to nicotine completed two counterbalanced conditions in which they were randomized to received either nicotine gum (6 mg) or placebo gum, both administered double-blind and matched for appearance, taste, and consistency, approximately 40 minutes prior to viewing an erotic film. MAIN OUTCOME MEASURES Physiological (changes in vaginal pulse amplitude via vaginal photoplethysmography) and subjective (continuous self-report) sexual responses to erotic stimuli were examined, as well as changes in mood. RESULTS Nicotine significantly reduced genital responses to the erotic films (P = 0.05), corresponding to a 30% attenuation in physiological sexual arousal. This occurred in 11 of 18 women with valid physiological assessments. Nicotine had no significant effect on continuous self-report ratings of sexual arousal (P = 0.45), or on mood (all Ps > 0.05). CONCLUSIONS Acute nicotine intake significantly attenuates physiological sexual arousal in healthy nonsmoking women. Our findings provide support to the hypothesis that nicotine may be the primary pharmacological agent responsible for genital hemodynamic disruption, thereby facilitating a cascade of biochemical and vascular events which may impair normal sexual arousal responses.
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Affiliation(s)
| | - Cindy M Meston
- University of Texas at Austin-Department of Psychology, Austin, TX, USA.
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Harte CB, Meston CM. Acute effects of nicotine on physiological and subjective sexual arousal in nonsmoking men: a randomized, double-blind, placebo-controlled trial. J Sex Med 2008; 5:110-21. [PMID: 17971108 PMCID: PMC2864030 DOI: 10.1111/j.1743-6109.2007.00637.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Chronic nicotine treatment has deleterious effects on vascular functioning and catecholamine modulation, which may compromise erectile functioning. Evidence that long-term cigarette smoking is an independent risk factor for introducing impotence is robust. However, limited studies have focused on the acute effects of smoking on physiological sexual response, and none have investigated the deleterious effects of isolated nicotine on human sexual arousal. Consequently, pathophysiological underpinnings of tobacco-induced-and particularly, nicotine-induced-erectile dysfunction are not well understood. AIM To provide the first empirical examination of the acute effects of isolated nicotine on sexual arousal in nonsmoking men. METHODS Twenty-eight sexually functional heterosexual men (mean age 21 years), each with less than 100 direct exposures to nicotine, participated in a double-blind, randomized, placebo-controlled, crossover trial. Participants received either Nicorette polacrilex gum (SmithKline Beecham Consumer Healthcare, Pittsburgh, PA, USA) (6 mg; approximately equivalent to smoking one high-yield cigarette) or placebo gum, matched for appearance, taste, and consistency, approximately 40 minutes prior to viewing an erotic film. MAIN OUTCOME MEASURES Physiological (circumferential change via penile plethysmography) and subjective (continuous self-report) sexual responses to erotic stimuli were examined, as well as changes in mood. RESULTS Nicotine significantly reduced erectile responses to the erotic films (P = 0.02), corresponding to a 23% reduction in physiological sexual arousal. This occurred in 16 of 20 men with valid physiological recordings. Nicotine had no significant effect on continuous subjective ratings of sexual arousal (P = 0.70) or on mood (all Ps > 0.05). CONCLUSIONS Isolated nicotine can significantly attenuate physiological sexual arousal in healthy nonsmoking men. These findings have implications for elucidating physiological mechanisms responsible for the effects of nicotine on sexual dysfunction, and for assisting public health policy in considering the deleterious effects of nicotine on sexual health.
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Prasad KV, Al Ansari A, Al Kadhi S, El Malik EF. Evaluation of the Demographics, Prevalence of Risk Factors and Treatment Strategies of Erectile Dysfunction in Qatar. Qatar Med J 2007. [DOI: 10.5339/qmj.2007.1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Records of patients attending the Andrology Clinic, Hamad Medical Corporation, Qatar; over a period often years were analyzed to determine the demographic features, contributory risk factors, and best methods of treatment for erectile dysfunction (ED). Of1,245patients with ages ranging from 19-78 years (mean 49 years) 45% were Qataris. Most complained of weak erections, a few reported ejaculatory dysfunction. Diabetes mellitus was the most frequent risk factor (53%) followed by hypertension (28%), smoking (27%) and coronary artery disease (14%). Oral Sildenafil given to 310 patients gave overall satisfaction to 75 (49%) of the 152 patients in whom satisfaction could be assessed; intracorporal injection given to 413 patients resulted in overall satisfaction to 107 (68%) of 157 in whom satisfaction could be assessed; penile prosthesis implantation in 64 patients remained an effective therapeutic modality with 31 (84%) of the 37 patients in whom satisfaction could be assessed being satisfied with the results.
Conclusion: Erectile dysfunction is as common in Qatar as it is in the rest of the world. The higher incidence of diabetes mellitus in the ED. population in the region forms the major risk factor and might reflect the need for the implementation of preventive strategies.
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Affiliation(s)
- K. V. Prasad
- Ureology Section, Department of Surgery Hamad Medical Corporation, Doha, Qatar
| | - A. Al Ansari
- Ureology Section, Department of Surgery Hamad Medical Corporation, Doha, Qatar
| | - S. Al Kadhi
- Ureology Section, Department of Surgery Hamad Medical Corporation, Doha, Qatar
| | - E. F. El Malik
- Ureology Section, Department of Surgery Hamad Medical Corporation, Doha, Qatar
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Bardell T, Brown PM. Smoking inside Canadian acute care hospitals. Can Respir J 2006; 13:266-8. [PMID: 16896428 PMCID: PMC2683305 DOI: 10.1155/2006/139359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess smoking policies at Canadian acute care hospitals. METHOD A questionnaire was designed, piloted and faxed to all acute care hospitals in Canada. The questionnaire was designed to address the following: what is the current policy regarding patient smoking? Are staff and/or visitors allowed to smoke inside the hospital? Is there a separate policy for psychiatric patients? Are smoking cessation products available at the hospital pharmacy? Is the policy governed by regional or municipal legislation? RESULTS A total of 852 hospitals were included in the study. Of these, 476 responded to the questionnaire, for an overall response rate of 56%. Twenty-seven per cent of respondents allowed patient smoking inside the hospital. While staff smoking was not allowed inside most hospitals (93%), 32% of hospitals in Quebec allowed staff to smoke inside the building. Thirty per cent of hospitals had a separate policy for psychiatric patients, and 27% of hospitals had provisions for visitor smoking. Sixty-seven per cent of hospitals were able to offer patients smoking cessation products while they were in hospital. CONCLUSIONS Many Canadian hospitals continue to allow smoking inside their facilities. There is considerable variation in hospital smoking policies across the country.
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Affiliation(s)
| | - Peter M Brown
- Correspondence: Dr Peter M Brown, Department of Surgery, Queen’s University, 76 Stuart Street, Kingston, Ontario K7L 2V6. Telephone 613-533-2660, e-mail
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Elhanbly S, Abdel-Gaber S, Fathy H, El-Bayoumi Y, Wald M, Niederberger CS. Erectile dysfunction in smokers: a penile dynamic and vascular study. ACTA ACUST UNITED AC 2005; 25:991-5. [PMID: 15477374 DOI: 10.1002/j.1939-4640.2004.tb03172.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In this study, we aimed to determine the hemodynamic mechanisms through which cigarette smoking, as an independent risk factor, induces erectile dysfunction (ED). We performed a standard ED evaluation that included history; a physical exam; and serum glucose, testosterone, and prolactin levels. We then excluded ED patients with abnormal androgen profiles and patients with ED risk factors other than smoking. A total of 109 ED patients entered the study, including 71 current smokers and 38 nonsmokers. All patients then underwent extensive evaluation, including nocturnal penile tumescence and rigidity (NPTR) monitoring with Rigiscan, followed by pharmacopenile duplex ultrasonography (PPDU) and redosing pharmacocavernosometry (RPC). Results of the above tests were compared in the smoker and nonsmoker groups. We also performed receiver operating characteristic (ROC) curve analysis to determine which diagnostic parameter is most affected by cigarette smoking. The 4 most significant variates served as input features for a logistic regression model, designed to predict smoking. The average age for smokers and nonsmokers was 44.3 and 51.2 years, respectively (P = .02). Eighty-six percent of smokers had abnormal NPTR testing compared with 55% of nonsmokers (P = .02). The average peak systolic velocity (PSV) was 26.8 and 31.2 cm/s for smokers and nonsmokers, respectively, and this difference was not found to be statistically significant (P = .19) in this study. On performing RPC, an abnormal maintenance flow (MF) of >5 mL/min was detected in 89% of smokers and in 47% of nonsmokers, and the difference was significant (P < .01). With the use of smoking as the outcome, the ROC area of different diagnostic parameters was as follows: 0.79 for penile base rigidity, 0.58 for PSV, and 0.77 for MF. A logistic regression model that used the 4 most significant variates as input features yielded a ROC of 0.857. The results of NPTR testing in our smoker and nonsmoker groups indicated that ED in smokers is mainly of organic etiology. On the basis of the PPDU findings and the higher incidence of abnormal MF in the smoker group and its relatively high ROC value, we concluded that dysfunction of penile veno-occlusive mechanisms plays a substantial role in the development of ED in smokers.
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Affiliation(s)
- Samir Elhanbly
- Department of Andrology, Mansoura University, Mansoura, Egypt
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de Mouzon J, Belaisch-Allart J. Conséquences sur la fertilité féminine et sur les procréations médicalement assistées. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/s0368-2315(05)82977-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Martínez Piédrola M, Castro Molina M, Sáez Crespo A. Disfunción eréctil: objetivos e intervenciones en la consulta de enfermería. ENFERMERIA CLINICA 2005. [DOI: 10.1016/s1130-8621(05)71077-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sundaram R, Shulman L, Fein AM. Trends in tobacco use. Med Clin North Am 2004; 88:1391-7, ix. [PMID: 15464103 DOI: 10.1016/j.mcna.2004.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The use of tobacco can be traced back to ancient times. Its popularity grew exponentially during the twentieth century, surging during wartime and with the advent of mass media. The tobacco industry in the United States has been under constant legal pressure during the past 40 years. Despite the well-known and continually increasing morbidity and mortality related to smoking, it continues to be a prominent feature in worldwide culture and health.
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Affiliation(s)
- Ravi Sundaram
- Division of Pulmonary and Critical Care Medicine, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030, USA
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