Evaluation and Treatment of Erectile Dysfunction in Men With Diabetes Mellitus

Dey, Jayant; Shepherd, M.

doi:10.4065/77.3.276

Cited by 56 publications

(35 citation statements)

References 31 publications

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“…In particular, diabetic men with ED appear to have more severe dysfunction (as measured by the Erectile Function and Intercourse Satisfaction domains of the IIEF) at presentation than nondiabetic men with ED. Although diabetes-related ED is thought to be multifactorial in etiology and to include an endocrinologic component (11,12), no differences were noted in the Sexual Desire domain of the IIEF. Because diabetic men with ED appear to have greater dysfunction than nondiabetic men, it is not surprising that they also present with worse diseasespecific HRQOL, as measured by the Emotional Life domain of the PIED scales.…”

Section: Conclusion -Results From Thementioning

confidence: 94%

Do Impotent Men With Diabetes Have More Severe Erectile Dysfunction and Worse Quality of Life Than the General Population of Impotent Patients?

et al. 2003

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OBJECTIVE -Little is known regarding how diabetic men with erectile dysfunction (ED) differ from the general population of impotent men. The primary objective of this study was to compare disease-specific health-related quality of life (HRQOL) and severity of ED in impotent men with and without diabetes. RESEARCH DESIGN AND METHODS -Validated functional and HRQOL questionnaires (including the InternationalIndex of Erectile Function, the Sexual Self-Efficacy Scale, and the Psychological Impact of Erectile Dysfunction scales) were administered to patients in an ED disease registry. Men with ED and a history of diabetes (n ϭ 20) were compared with men with ED and no history of diabetes (n ϭ 90) at baseline and at the 12-month follow-up.RESULTS -Diabetic impotent men reported worse erectile function and intercourse satisfaction at baseline, and ED had a greater impact on their emotional life. Diabetic men with ED had significantly different trends over time in the Erectile Function (P Ͻ 0.001), Intercourse Satisfaction (P Ͻ 0.013), Sexual Desire (P Ͻ 0.016), Overall Satisfaction (P Ͻ 0.023), and the Sexual Experience-Psychological Impact domains (P Ͻ 0.002). In addition, there was a trend toward a difference over time in the Emotional Life-Psychological Impact domain (P Ͻ 0.067).CONCLUSIONS -Impotent men with diabetes present with worse ED than nondiabetic men with ED, resulting in worse disease-specific HRQOL in the diabetic men. Although diabetic patients initially respond well to ED treatment, responses do not appear to be durable over time. Therefore, clinicians must provide longer-term follow-up when treating ED in diabetic patients. Diabetes Care 26:1093-1099, 2003E rectile dysfunction (ED) is a common complication of diabetes, with prevalence ranging between 27 and 75% (1-3). Despite the high prevalence of this condition in patients with diabetes, little is known regarding how diabetic subjects with ED differ from the general population of impotent men. Comparison of randomized clinical trials assessing the efficacy of sildenafil show that diabetic men with ED differ from the general population of impotent men in their response to oral therapy (4,5). However, it is not known whether diabetic men present with worse sexual dysfunction than impotent patients from the general population or whether ED has a different impact on quality of life in diabetic men when compared with nondiabetic patients.In fact, little is known regarding the impact ED has on quality of life in diabetic subjects. To date, there has been a single study that specifically examined healthrelated quality of life (HRQOL) in impotent men with diabetes. De Berardis et al. (6) used the Short Form 36 (SF-36) to study general HRQOL in 1,460 men with diabetes. Of these patients, 34% reported frequent erectile problems. Impotent diabetic subjects were more likely to report depressive symptoms, have lower scores in the mental domains of the SF-36, and report a less satisfactory sex life. Although this cross-sectional study demonstrates that ED has a d...

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Section: Conclusion -Results From Thementioning

confidence: 94%

Do Impotent Men With Diabetes Have More Severe Erectile Dysfunction and Worse Quality of Life Than the General Population of Impotent Patients?

et al. 2003

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“…17,18 Although lower efficacy was reported in diabetic patients compared to nondiabetic patients, sildenafil was found to increase erectile function in diabetic patients when compared to diabetic patients taking a placebo. 19 The meta-analysis by Fink et al 14 indicated that sildenafil was less efficacious in patients aged more than 65, compared to younger patients. Although the present study indicated that age was not a factor in efficacy, we acknowledge this may have been due to the small number of patients aged over 65.…”

Section: Discussionmentioning

confidence: 99%

Post-marketing surveillance study of the safety and efficacy of sildenafil prescribed in primary care to erectile dysfunction patients

et al. 2004

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In order to investigate the safety and efficacy of sildenafil prescribed in primary care, a post-marketing surveillance study was undertaken. A total of 651 men with erectile dysfunction (ED) were enrolled from 31 family physicians in Korea from December 1999 to July 2002. Patients were regularly followed up to ascertain the safety and efficacy of sildenafil. Of the 651 patients enrolled, 572 (87.9%) returned for safety evaluation and efficacy assessment. In all, 458 (80.1%) of 572 patients reported improved erectile function with sildenafil. Hypertension, diabetes and low-dose sildenafil were associated with poor efficacy. A total of 71 adverse events were reported among 56 patients (8.6%), with the most frequent being hot flushes (5.6%), followed by headache (2.6%), palpitation (1.0%), anxiety (0.5%) and elevated ALT (0.5%). Only six patients (1.0%) discontinued sildenafil as a direct result of adverse events. These results suggest that sildenafil prescribed by primary care physicians was well tolerated and improved erectile function in patients with ED.

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“…In fact, while diabetic neuropathy is an incalculable condition, the acute forms are usually painful and the erectile impotence of diabetic patients is usually the result of a chronic microvascular and neuropathic involvement [29][30]. The patient dismissed any causes due to encumbering life situations, voluptuary habits, alcohol abuse or variations in drug therapies.…”

Section: Discussionmentioning

confidence: 99%

Prolactinoma in a Diabetic Dialysis Patient with Erectile Dysfunction: A Difficult Differential Diagnosis

Piccoli

Bermont²,

Magnano³

et al. 2006

Rev Diabetic Stud

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■ AbstractDialysis patients often suffer from erectile dysfunction. The prevalence of this symptom in the context of dialysis is as high as 90%. Diabetes, diffuse vascular disease and pharmacological therapy are attendant causes of this condition, severely impairing the quality of life. Due to the high frequency of erectile dysfunction in uremic patients, minimalist diagnostic approaches are often used. Nevertheless, a careful differential diagnosis is also warranted in well dialyzed patients to identify causes and corrigible patterns. The case reported here exemplifies this critical issue. A 44 year old obese diabetic patient complained about the recent onset of erectile dysfunction. On examination, the penile echoDoppler was normal, and suggested a cause other than diabetic vascular disease. The high dialysis efficiency (daily hemodialysis, flexible schedules, EKRc from 15 to 25 ml/min) warranted the same diagnostic work-up as would adopted for non-uremic patients. Whilst the rising prolactine level (76.1 µg/l and 129 ng/ml) was still in the range commonly found in dialysis patients, a nuclear magnetic resonance examination was carried out and led to the identification of prolactinoma. Therapy with cabergoline was found effective and sexual potency was restored. Normalization of hormonal patterns followed within 2 months. This is the first case so far reported in a daily dialysis patient. It underlines the importance of a non-minimalist approach to the problem of sexual disorders in renal replacement therapy (RRT) patients, at least when dialysis efficiency is high and onset is rapid. It also suggests considering prolactinoma as an emerging diagnosis in the general population, which can be detected by the use of sensitive imaging techniques in the differential diagnosis of this condition.

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Evaluation and Treatment of Erectile Dysfunction in Men With Diabetes Mellitus

Cited by 56 publications

References 31 publications

Do Impotent Men With Diabetes Have More Severe Erectile Dysfunction and Worse Quality of Life Than the General Population of Impotent Patients?

Do Impotent Men With Diabetes Have More Severe Erectile Dysfunction and Worse Quality of Life Than the General Population of Impotent Patients?

Post-marketing surveillance study of the safety and efficacy of sildenafil prescribed in primary care to erectile dysfunction patients

Prolactinoma in a Diabetic Dialysis Patient with Erectile Dysfunction: A Difficult Differential Diagnosis

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