Incidence of extragenital vascular disease in patients with erectile dysfunction of arterial origin

Abstract

This research was carried out to evaluate the prevalence of carotid and/or lower limb artery abnormalities in patients with arterial erectile dysfunction (ED). To this end, patients with ED (Andrology Unit) or suspected peripheral atherosclerosis (Angiology Unit) underwent an independent and parallel echo-Duplex examination. The Andrology Unit examined 167 patients with ED of different etiologies: 52 of them had penile artery insufficiency and consequently their carotids and lower limb arteries had to be evaluated by means of echo-Doppler. In all, 36 out of the 46 patients with nonarterial organic ED and 22 out of the 69 patients with nonorganic ED underwent the same evaluation and served as controls. The Angiology Unit enrolled 457 ED patients who initially underwent echo-Doppler for suspected carotid and/or arterial leg atherosclerosis and subsequently dynamic echo-Doppler. Isolated penile artery insufficiency was found in 23.1 and 25% of the patients evaluated in the Angiology and Andrology Units, respectively. The remaining patients were shown to have ED associated with an atheroma or marked intima-media thickness of the carotid vessels and/or of leg arteries. The frequency of penile arterial insufficiency and of carotid and/or lower limb artery abnormalities was significantly higher (Po0.01) compared to that found in patients with ED of nonarterial organic or psychogenic origin. Both Units found that the frequency of penile artery insufficiency and carotid or lower limb artery abnormalities was significantly higher than that of penile artery insufficiency alone or plus both carotid and lower limb artery abnormalities. This study showed that penile artery insufficiency is associated with carotid and/or lower limb artery ultrasound abnormalities in about 75% of the cases. Therefore, arterial ED may be regarded as a sign of a more generalized atherosclerosis.

Peak systolic velocity in patients with arterial erectile dysfunction and peripheral arterial disease

“…[6][7][8] Recent evidence has clearly shown that penile artery abnormalities in these patients are an ominous sign of the presence of a generalized arterial/arteriolar insufficiency or of atherosclerotic disease in other parts of the body. 3,18 The assumption of ED as a sign of atherosclerosis is also supported by a correlation between retinal vascular disease and low cavernous PSV. 19 Atherosclerotic lesions may progress over decades and their progression in various arterial districts seems to be associated with the presence of cardiovascular risk factors and/or host's response (chronic low-grade inflammation state) to the clinical management (dietetic and pharmacological strategies) of these factors.…”

Erectile dysfunction as a harbinger for increased cardiometabolic risk

“…One study found that penile artery insufficiency is associated with carotid and/or lower limb artery ultrasound abnormalities (atheroma or marked intima-media thickness) approximately 75% of the time. 29 Another study found that the severity of ED based on penile Doppler ultrasound correlates with associated ultrasound abnormalities in the carotid artery, lower limb arteries or both vascular beds. Men with ED and both carotid and lower limb abnormalities had the most severe penile artery disease based on ultrasound assessments of all three vascular beds.…”

Correlations between lower urinary tract symptoms, erectile dysfunction, and cardiovascular diseases: Are there differences between male populations from primary healthcare and urology clinics? A review of the current knowledge

“…Psychogenic and somatic erectile dysfunction are equally prevalent in men visiting their general practitioner for sexual dysfunction. In young men, erectile dysfunction is mostly caused by a psychological condition, compared to older men, in whom a somatic cause is more common (19,20).…”