A Simplified Approach to Assessing Penile Endothelial Function in Young Individuals at Risk of Erectile Dysfunction

Abstract

Erectile dysfunction (ED) reflects a risk for systemic cardiovascular diseases by virtue of a common etiology of vascular endothelial dysfunction, which is increasingly reported to affect young adults. On the basis of physiological phenomenon of reactive hyperemia (RH), systemic and penile endothelial functions in healthy young adults were compared with the use of digital data on arterial waveforms before and after RH induction. Between July 2009 and March 2011, 32 young adult volunteers with normal erectile functions were recruited. Questionnaires on medical histories and sexual functions and blood samples for testosterone and biochemical analyses were obtained. Dilatation index (DI) and penile arterial waveform amplitude (PAWA) ratios for assessing systemic and penile endothelial function were acquired with an air pressure sensing system on the arm and a penile arterial waveform analyzing system on the penis, respectively. A total cholesterol/high-density lipoprotein (TC/ HDL) ratio greater than 4.1 was used to define high risk for ED.Remarkable positive correlation was noted between DI and PAWA ratio (r 5 .640, P , .001). DI showed significant positive associations with serum testosterone (P 5 .012) and serum HDL level, whereas it showed negative correlations with total triglyceride and glycosylated hemoglobulin levels, body weight, waist circumference, body mass index, and diastolic blood pressure. Similarly, the PAWA ratio showed significant positive correlations with serum testosterone (P , .001) and HDL levels, but negative associations with body weight, waist circumference, and body mass index. Both DI and PAWA ratio successfully identified participants at high risk for ED (eg, TC/HDL ratio . 4.1; P , .05). Our results demonstrated that penile endothelial function can be assessed by evaluating systemic endothelial function in young healthy adults for early identification of risk for ED.Key words: Reactive hyperemia, air pressure sensing system, penile arterial waveform analyzing system.

Measuring and Evaluating Function, Impairment, and Change with Intervention

“…100 Many of the assessment techniques described in this chapter come into play in the next chapters that assess the presence and severity of cardiovascular disorders that impinge on erectile function. However, it should be noted that the vast number of clinical trials that emerged in the past ten years that depend on measures of endothelial viability and blood flow parameters underscore the message of this monograph: ED is, for the most part, now generally accepted into the fraternity of cardiovascular disorders, and it is to be assessed, diagnosed, and treated as such.…”