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Background: Erectile dysfunction (ED) is a common issue among adult males. The Composite Dietary Antioxidant Index (CDAI) reflects anti-inflammatory levels and has been linked to various diseases, but its relationship with ED is unclear., Materials and Methods: This cross-sectional study utilised comprehensive data on clinical factors from the 2001-2004 National Health and Nutrition Examination Survey (NHANES). To investigate the link between variables and ED, we used multivariate regression analysis, univariate analysis, and subgroup analysis. The linear relationship between CDAI and ED was investigated by dose-response curve analysis. For sensitivity analysis, propensity score matching (PSM) was utilised to exclude the influence of potential confounders. Finally, we investigated the association between CDAI and ED using threshold effects analysis., Results: We included in our research a total of 2896 persons with data on CDAI from NHANES 2001-2004. Among these, 2,098 participants were thought to be free of ED, whereas 798 participants had ED. We found that compared to the ED group, men in the non-ED group had higher levels of CDAI (p < 0.0001 before PSM and p = 0.0145 after PSM). Additionally, after adjusting for covariates, it was found that an elevated CDAI was associated with a reduced incidence of ED [OR = 0.65(p = 0.001) before PSM and OR = 0.62(p = 0.002) after PSM]. Subgroup analysis indicated stronger associations in high-risk groups, and dose-response curves confirmed a linear negative correlation between CDAI and ED., Conclusions: This study revealed a negative linear relationship between CDAI and the incidence of ED. The CDAI can be used as an indicator for assessing ED risk and for ED prevention., Competing Interests: Declarations Competing interests The authors declare no competing interests. Ethics approval and consent to participate NHANES was approved by National Center for Health Statistics Research Ethic Review Board. All subjects signed the informed consent during the recruitment period., (© 2024. The Author(s).)

There are currently no studies exploring omicron infection and male sexual function and semen quality. Our aim was to estimate changes in sexual function and semen quality in men recovering from infection since the COVID-19 Omicron pandemic started in China in late 2022. We collected 1540 questionnaires and assessed male function before infection and acute phase after infection by using International Index of Erectile Function-5, Premature Ejaculation Diagnostic Tool, and Arizona Sexual Experience Scale. We also collected the before and after semen analysis results of 247 male patients. During the acute phase after infection, the proportion of erectile dysfunction was significantly higher than before infection, but ejaculatory function was not significantly altered; In addition, semen analysis showed significant difference in semen concentration, semen activity and PR a+b sperm forward movement after infection compared to pre-infection.: COVID-19 Omicron can affect erectile function as well as sexual experience in male patients in the acute phase. Decreased sexual function due to COVID-19 Omicron may be related to body temperature and anxiety during infection., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Xiao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Obesity, which has emerged as a major global public health challenge, is associated with myriad medical and multisystemic complications. Obesity impacts the male reproductive and sexual function in multiple ways as well. However, perhaps because of the focus on cardiovascular and metabolic health, the gonadal aspects of obesity medicine have not been given due attention. We propose the term OARS to describe obesity-associated reproductive and sexual syndrome in men living with obesity. OARS can be defined as a constellation of functional, hormonal, and structural abnormalities that affect the reproductive and sexual health of such men. The term OARS should attract attention to this neglected field and prompt efforts to prevent and address the needs of men living with obesity.

Introduction: Sexual dysfunction affects a couple's relationship and quality of life of the patient and the partner irrespective of age. In Lower urinary tract symptoms (LUTS) with benign prostatic hyperplasia (BPH), sexual dysfunction is highly prevalent. This study aims to evaluate prevalence of sexual dysfunction in patients having LUTS with BPH and effect of various treatment on it., Materials and Methods: The study is hospital based prospective cross-sectional study. Total 106 patients were included in this study. Fifty-six patients underwent medical treatment and 50 patients underwent transurethral resection of prostate (TURP) according to lower urinary tract symptom score along with grades of prostate. We measured prevalence of lower urinary tract symptoms, erectile dysfunction (ED), ejaculatory dysfunction (EJD).We compared the pre and post treatment ED, EJD scores in both medical and TURP group., Result: In our study, 11 (10.4%) patients had very mild ED, 12 (11.3%) had mild ED, 54 (50.9%) had moderate ED and 23 (21.7%) had severe ED. In our study, 11 (10.4%) patients had very mild EJD, 7 (6.6%) had mild EJD, 28 (26.4%) had moderate EJD and 2 (1.9%) had severe EJD. In medical group, ED pre-treatment versus ED post treatment was statistically significant ( p  = 0.0046), treatment of LUTS improves ED. EJD pre-treatment versus EJD post treatment was not statistically significant ( p  = 0.8368), treatment of LUTS associated with deterioration of EJD. In TURP group association of ED pre-treatment versus ED post treatment was statistically significant ( p  = 0.0319). Post TURP patients shows improvement in ED Association of EJD pre-treatment versus EJD post-treatment was statistically significant ( p  = 0.03000). Post TURP EJD deteriorate., Conclusion: We concluded that the severity of sexual dysfunction correlates with severity of LUTS. Ejaculatory function deteriorates after treatment of TURP compared to medical., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: To examine post-operative urinary and sexual functional outcomes for men with high-risk prostate cancer (HRPCa) who underwent radical prostatectomy (RP) within the Michigan Urological Surgery Improvement Collaborative (MUSIC)., Methods: We identified patients who underwent RP for HRPCa in MUSIC between 2014 and 2023. HRPCa was defined according to American Urological Association criteria. Patients completed Expanded Prostate Cancer Index Composite (EPIC-26) pre-RP and 3-, 6-, 12-, and 24-months postoperatively. Primary outcomes included social continence, defined as 0-1 pads used daily; and recovery of sexual function, defined as the ability to achieve erections firm enough for intercourse. Multivariable and bivariate analyses were performed to identify factors associated with recovery of social continence and sexual function., Results: Around 1323 patients were included in the post-RP urinary continence analysis and 422 men in the sexual function analysis. Fifty-eight percent and 86% of patients achieved social continence at 3- and 12-months post-RP, respectively. Continence recovery was associated with higher baseline EPIC-26 urinary continence scores (OR 1.10, per 5 points, 95% CI 1.06-1.15, P <.001), and negatively associated with increasing age (OR 0.78 per 5-year increase, 95% CI 0.71-0.85 P <.001). Fifteen percent of patients had recovery of sexual function at 12-month post-RP. On bivariate analysis, recovery of sexual function was associated with nerve-sparing at time of RP, lower pre-operative PSA, and not receiving post-RP ADT/RT., Conclusion: RP for HRPCa has acceptable rates of postoperative social continence. However, post-RP recovery of sexual function remains a challenge. This information has important implications for pre-operative counseling and post-operative follow-up for patients with HRPCa., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Erectile dysfunction (ED) is a condition that affects many males. Physical therapy (PT) is the one potential treatment for ED that may improve blood flow, muscle strength, and other factors that may contribute to the issue. Data on the prevalence and trends of research on PT for ED are lacking., Objective: This study aimed to evaluate the literature trends in PT for ED via bibliometric and visualized analysis., Methods: Data on publications were collected from Scopus covering the period between 1989 and 2022. To refine the data, bibliometric analyses were conducted using Microsoft Access, Microsoft Excel, an online visualization platform, and BiblioAnalytics. Power BI and Bibliomaster were used to generate figures and tables, while Biblioshiny and VOSviewer were used for visualization., Results: A total of 494 documents were identified. The year 2019 generated the largest number of publications, with a total of 54. These studies have received 12,917 citations related to PT for ED. The most common document type was the original article with 283 publications. The University of California, USA, was the most productive institution on this topic, with 21 publications and 2,035 citations. The USA led all countries with 114 publications on the topic. The Journal of Sexual Medicine secured the top ranking with an h-index of 18. The main topics studied were erectile dysfunction, shockwave therapy, and physiotherapy., Conclusion: The number of publications on PT for ED has demonstrated an upward trend over the last three decades., (© 2024 American Society of Andrology and European Academy of Andrology.)

Abstract: The aim of this study was to explore the incidence of new-onset erectile dysfunction (ED) in diabetes mellitus (DM) patients with sodium-glucose cotransporter 2 inhibitors (SGLT2I) use compared with a control group of non-SGLT2I use by propensity score matching approach. Cox proportional hazards regression models were used to examine the effect of SGLT2I and risk factors on the risk of developing ED, presented as a hazard ratio with a 95% confidence interval. One lakhs fifty nine thousand seven hundred seventy three patients with DM using SGLT2I and 159,773 propensity score matching patients with DM who had never used SGLT2I were included. SGLT2I users had a higher risk of ED than the non-SGLT2I users (adjusted hazard ratio = 1.55, 95% confidence interval = 1.40-1.72). The likelihood of developing ED was higher in patients with SGLT2I use was found., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: This study aimed to assess the relationship between multiple indicators of inflammation and erectile dysfunction through an analysis of data from the National Health and Nutrition Examination Survey (NHANES). This represents the first large-scale, cross-sectional investigation that explores this association by jointly analyzing various inflammatory markers., Methods: We performed a cross-sectional analysis with NHANES data from 2001 to 2004. Erectile dysfunction (ED) was evaluated through a self-reported questionnaire and testosterone levels, while inflammatory markers were derived from standard blood test parameters. Our approach included multivariate logistic regression, subgroup analyses, generalized additive modeling (GAM), and smoothed curve fitting to evaluate the link between inflammatory markers (NLR, MLR, SII, SIRI, AISI) and ED. Additionally, we utilized receiver operating characteristic (ROC) curves to determine the diagnostic utility of these markers, comparing their area under the curve (AUC) values., Results: A total of 3610 participants were included in this study, and the population-weighted ED patients were 18.91%. In the adjusted model, multiple logistic regression analysis showed a positive association between five inflammatory indicators (Ln-NLR, Ln-MLR, Ln-SII, Ln-SIRI, and Ln-AISI) and ED. Smoothed curve fitting showed a nonlinear positive correlation between the five inflammatory indicators and ED. Furthermore, subgroup analyses showed that this correlation was stronger in people older than 50 year. ROC curve analysis showed the highest diagnostic performance for the study outcome with MLR (AUC = 0.616, 95% CI: 0.5952-0.637), which was significantly better than SIRI, NLR, AISI, and SII., Conclusion: MLR is potentially more effective than other biomarkers (NLR, SIRI, AISI, SII) in predicting ED. Men with elevated MLR levels should be particularly aware of their increased risk of developing ED., (© 2024. The Author(s).)

Background: Erectile dysfunction is no longer a whisper in the shadows; it's a rising tide threatening the sexual health of millions of men in different regions. In the cases of diabetes, the condition worsens and has a potent cocktail of physical and psychological distress, chipping away at men's confidence, self-esteem, and mental health. This worrying trend shows no signs of slowing down, with projections claiming a staggering 322 million men globally could be affected in the near future. This urgent issue demands immediate attention and action. Thus, this umbrella review intended to estimate the current burden of erectile dysfunction and associated risk factors among diabetic patients in the global context., Methods: Following PRISMA guidelines, we searched for relevant studies in PubMed, Embase, Scopus, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar. These studies reported the prevalence of erectile dysfunction and associated risk factors in diabetic patients. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews 2 tool. To estimate the pooled prevalence of erectile dysfunction, we employed a weighted inverse variance random-effects model. We further conducted subgroup analyses, assessed heterogeneity and publication bias, and performed sensitivity analyses to strengthen the robustness of our findings. Prediction intervals were also calculated to estimate the range within which future observations will likely fall. In all statistical analyses, the statistical significance was declared at P- value < 0.05., Results: In this umbrella review, a total of 108 030 male diabetic patients were included to estimate the global prevalence of erectile dysfunction. The pooled global prevalence of erectile dysfunction in diabetic patients was 65.8% (95CI: 58.3 - 73.3%), while In Africa it was 62.9% (95CI: 46.1-79.7). Age (> 40 years) (AOR = 1.95, 95CI: 1.03-3.24), DM duration (> 10years) (AOR = 1.90,95CI: 1.16-2.65), peripheral vascular disease (AOR = 2.74, 95CI: 1.42-4.06) and BMI (> 30 kg/m2) (AOR = 1.07,95CI: 1.01-1.20) were identified as associated risk factors of erectile dysfunction in diabetic patient., Conclusion: The high global prevalence of erectile dysfunction (ED) in diabetic patients is alarming, with an estimated two-thirds experiencing the condition. These findings underscore the significant burden of ED faced by diabetic men and emphasize the urgent need for global attention to the issue. This includes promoting early screening for erectile dysfunction in this population and ensuring access to appropriate treatment and support., (© 2024. The Author(s).)

Background: Coffee is a widely consumed beverage with potential benefits for various chronic diseases. Its effect on reducing erectile dysfunction (ED) risk is unclear. This Mendelian randomization (MR) study investigates the impact of coffee/caffeine consumption on ED., Methods: Two sets of coffee consumption-associated genetic variants at the genome-wide significance level were obtained from recent studies of coffee consumption. Taking into account other sources of caffeine, genetic variants associated with caffeine consumption from tea were also obtained. The inverse variance weighted (IVW) method was utilized as the primary analysis. Sensitivity analysis methods and meta-analysis methods were performed to confirm the robustness of the results, while the genetic variants associated with confounders, e.g., diabetes and hypertension, were excluded., Results: Genetically predicted coffee/caffeine consumption was unlikely to be associated with the risk of ED in the Bovijn datasets, with similar directional associations observed in the FinnGen datasets. The combined odds ratio for ED was 1.011 (95% CI 0.841-1.216, p =0.906) for coffee consumption from the genome-wide meta-analysis, 1.049 (95% CI 0.487-2.260, p =0.903) for coffee consumption from the genome-wide association study, and 1.061 (95% CI 0.682-1.651, p =0.793) for caffeine from tea., Conclusion: Using genetic data, this study found no association between coffee/caffeine consumption and the risk of ED., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Xiang, Hu, Peng, Luo, Chen and Zhang.)

Objectives: To compare 1-year functional and 5-year oncological outcomes of men undergoing robot-assisted laparoscopic prostatectomy (RALP) with neurovascular structure-adjacent frozen-section examination (NeuroSAFE) with those in men undergoing RALP without NeuroSAFE (standard of care [SOC])., Subjects and Methods: Men undergoing RALP in our centre between 1 January 2009 and 30 June 2018 were enrolled from a prospectively maintained database. Patients were excluded if they had undergone preoperative therapy or postoperative adjuvant therapy or were enrolled in clinical trials. Patients were grouped based on use of NeuroSAFE. Follow-up was censored at 5 years. The primary outcome was difference in time to biochemical recurrence (BCR) on multivariable analysis, defined as prostate-specific antigen (PSA) >0.2 ng/L on two consecutive measurements. Secondary outcomes were difference in 1-year erectile dysfunction and incontinence., Results: In the enrolment period, 1199 consecutive men underwent RALP, of whom 1140 were eligible, including 317 with NeuroSAFE and 823 with SOC. The median PSA follow-up was 60 months in both groups. Rates of 5-year BCR were similar on Kaplan-Meier survival curve analysis (11% vs 11%; P = 0.9), as was time to BCR on multivariable Cox proportional hazards modelling (hazard ratio 1.2; P = 0.6). Compared with the SOC group at 1 year, the NeuroSAFE group had similar unadjusted rates of incontinence (5.1% vs 7.7%) and lower unadjusted impotence (57% vs 80%). On multivariable analysis, NeuroSAFE patients had equivalent risk of incontinence (odds ratio [OR] 0.59, 95% CI 0.17-1.6; P = 0.4) but significantly reduced risk of erectile dysfunction (OR 0.37, 95% CI 0.22-0.60; P < 0.001)., Conclusions: For men undergoing RALP, compared with SOC, NeuroSAFE patients had equivalent time to BCR and risk of 1-year incontinence, and significantly lower risk of 1-year erectile dysfunction., (© 2024 The Author(s). BJU International published by John Wiley & Sons Ltd on behalf of BJU International.)

The World Health Organization recognizes sexual health as not merely the absence of disease, but a state of physical, mental, and social well-being in relation to one's sexuality. Achieving sexual satisfaction is pivotal for many individuals, as it significantly contributes to their quality of life. Among various sexual disorders, erectile dysfunction (ED) is notably prevalent, affecting an estimated 10-20 million men in the United States alone. This condition impacts not just the person experiencing it but also significantly influences their intimate connections with partners. Although the causes of ED are multifactorial, recent research highlights a compelling association between sleep disorders, such as sleep deprivation, obstructive sleep apnea (OSA), and insomnia, and the incidence of ED. Furthermore, engaging in night work has been observed to exacerbate the risk of developing ED. One common sleep disorder, sleep related bruxism (SRB), despite its prevalence, has not generally been associated with ED. However, there is some interesting evidence hinting at a potential relationship, including a few studies reporting a high prevalence of ED in individuals with SRB. This review delves into the epidemiological, etiological, and mechanistic links between ED and SRB, aiming to uncover potential intersections between these two conditions. These insights could pave the way for innovative research avenues, possibly exploring treatments like vasodilation medication, that might concurrently address both ED and SRB., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: Erectile dysfunction (ED) is a common sexual problem among men with chronic kidney disease (CKD). The severity of sexual dysfunction tends to worsen with kidney damage. This study aims to evaluate the erectile function and sexual quality of life of adult male CKD patients undergoing hemodialysis (HD) in a hospital located in the Brazilian Amazon., Methods: A cross-sectional quantitative study was performed within the HD Sector of the Nephrology Unit including men with CKD aged ≥ 18 years, undergoing ≥ 3 weekly HD sessions for ≥ 3 months who had been sexually active for ≥ 6 months. We used the Male Sexual Quotient (MSQ) to measure sexual satisfaction and the International Index of Erectile Function (IIEF5) to establish erectile function. Statistical analysis was performed with SPSS 21.0 using appropriate tests, such as Mann-Whitney and Kruskal-Wallis (P < 0.05)., Results: Ninety-eight patients (51.68 ± 15.28 years) were evaluated. They were primarily married/or living with a partner (60.20%), with HD time between 1 to 5 years (55.10%), and an average KTV of 1.17. ED prevalence was 66.30%, and it was associated with a higher age group (p = 0.01), lower family income (p = 0.02), diabetes (p = 0.01), lower mean corpuscular hemoglobin (p = 0.04), higher total calcium (p = 0.04), and lower albumin (p = 0.03). Around 75% classified their sex life as regular to excellent., Conclusion: Despite the high ED prevalence, most men with CKD in HD reported experiencing regular to excellent sex life. The study underscores the importance of establishing effective screening and conducting routine evaluations regarding sexual issues in these men.

Background: Erectile dysfunction (ED) is a common condition with various contributing factors, including lifestyle and dietary habits. Caffeine, a widely consumed stimulant, has been linked to multiple physiological effects on vascular function and hormonal balance that might influence sexual function. This meta-analysis aims to evaluate the association between caffeine intake and the risk of ED by analyzing data from cohort studies., Methods: A systematic search was conducted across PubMed, Web of Science, Scopus, and Embase databases, and a manual search was conducted on Google Scholar for studies on the relationship between caffeine intake and ED in adult men. The search included observational studies published up to April 1, 2024. Four cohort studies were included, and their data were extracted and analyzed by STATA version 18., Results: Four included cohort studies comprised 51,665 cohort members. The study population included adult males, on average, aged 18 to 80. The results indicate that there was no significant relationship between coffee consumption and the risk of ED (relative risk [RR] = 0.94, 95% CI: 0.86-1.03; p = 0.999)., Conclusions: The current evidence suggests no significant relationship between caffeine intake and ED, but limited studies limit conclusions. Future research should focus on larger sample sizes, standardized outcome assessments, and different dosages and forms of caffeine consumption., (© 2024. The Author(s).)

Erectile dysfunction (ED) is closely related to oxidative stress, and antioxidant is a treatment and prevention method for erectile dysfunction. The Compound Dietary Antioxidant Index (CDAI) represents the overall dietary antioxidant intake of the human body. However, the link between CDAI and ED is unclear. The objective of this research was to examine the linkage between CDAI and ED. The research utilized information collected from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2001 to 2004. To assess the association between CDAI and ED, the analysis employed weighted multivariate logistic regression along with weighted restricted cubic splines (RCS). Additionally, subgroup interaction analysis was conducted to confirm the findings. In this investigation, 3184 adults from the U.S., all above the age of 20, were part of the study cohort, with 863 of them identified as having ED. Adjustments for potential confounding variables revealed that the odds ratio (95% confidence interval) of CDAI associating with ED was 0.95 (0.92-0.99; P = 0.01). Besides, compared to the lowest tertile, the highest tertile of CDAI was associated with a lower risk of ED (0.63 [0.46-0.88]; P = 0.01). The application of weighted restricted cubic splines (RCS) analysis delineated a nonlinear inverse relationship between CDAI levels and the probability of ED. Subgroup analysis further demonstrated that the association between CDAI and ED remained consistent across subgroups. This cross-sectional analysis revealed a significant correlation, indicating that elevated levels of CDAI are closely linked with a lower likelihood of ED., (© 2024. The Author(s).)

Introduction: Erectile dysfunction (ED) is a well-studied entity in diabetes mellitus (DM). As with DM, prediabetes also appears to be associated with changes in microvascular-related comorbidities. These include retinopathy, neuropathy, nephropathy, and ED. ED is a condition characterized by an inability to maintain penile erection for adequate sexual activity, either consistently or recurrently. Endothelial damage due to any cause corresponding to hyperglycemia signifies the relationship between prediabetes and ED. While the evaluation of ED in diabetics has been extensively studied worldwide, there is a paucity of knowledge about ED among prediabetics., Materials and Methods: The study type was observational and was conducted at a tertiary center in India. Adult males aged 18-50 years with prediabetes were included in the study over a duration of 18 months. Evaluation for ED was performed using the International Index of Erectile Function 5 (IIEF-5)., Results: A total of 139 participants were enrolled in the present study. The severity of ED was categorized as follows: 32.4% of participants had mild ED, 11.5% had mild-to-moderate ED, and 6.5% had moderate ED. A positive association was found between prediabetes-related parameters and ED., Conclusion: There is a significant prevalence of ED in prediabetic males compared to the general population, as found in our study. Overall, 50.3% of participants were found to have ED. We recommend exploring this subject with more structured and larger studies., (© Journal of the Association of Physicians of India 2024.)

Objectives: This study aimed to investigate the prevalence of sexual disorders in stage 2 - 5 chronic kidney disease (CKD) during predialysis and its relationship with laboratory parameters., Methods and Results: This cross-sectional study included 110 predialysis patients and 110 healthy controls admitted to clinics. The International Index of Erectile Function (IIEF) and Female Sexual Function Index (FSFI) were used. Sexual dysfunction was detected in 76% of female patients and 31.4% of the control group, and the FSFI total and subscale scores of the patients were significantly lower than those of the control group. The frequency of erectile dysfunction in male patients and controls was 56.7% and 33.3%, respectively. The erectile function, sexual satisfaction, and overall satisfaction scores on the IIEF scale were significantly lower than those in the control group. Low glomerular filtration rate, high calcium levels, increased C-reactive protein, anemia, and metabolic acidosis in male and female patients, and testosterone deficiency in male patients were associated with sexual dysfunction. In multiple regression analysis, eGFR was the only independent variable associated with sexual dysfunction. Luteinizing hormone (LH) and prolactin levels increased as the disease progressed in men and women with sexual dysfunction, while testosterone levels decreased in male patients. Low testosterone levels were related to erectile dysfunction. The increase in parathormone and prolactin levels was related to loss of libido in the male and female patient groups., Conclusion: Metabolic acidosis and low eGFR appear to be the most important risk factors contributing to sexual disorders in patients with CKD.

Purpose of Review: The goal of this paper is to provide a summary of the recent research, evaluation, work-up, and treatment recommendations regarding erectile dysfunction in adolescents and young adults to better equip pediatric urologists to manage patients with this condition., Recent Findings: The latest research regarding erectile dysfunction in this population includes organic and psychogenic etiologies, correlations between the COVID-19 pandemic, and online pornography consumption. In our large pediatric urology practice, we found an 31x increase of adolescent males presenting with erectile dysfunction since 2014. The majority of cases are attributed to a psychogenic etiology such as anxiety or depression. It is likely that with stress from anxiety and depression, cortisol levels rise, increasing vascular resistance and leading erectile dysfunction in this population. Most patients want to be reassured of normal testosterone levels, offered cognitive behavioral therapy, and be rehabilitated with tadalafil starting at 5 mg p.o. daily until tapered., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Urological consultations for erectile dysfunction (ED) are increasing worldwide. Penile prosthesis (PP) implantations are performed when other treatments are unsuccessful. However, there is no data regarding PP implantations in France beyond the year 2016., Objectives: This study aimed to describe the changes in the number and type of PP implants used for the treatment of ED in France from 2016 to 2021 and the hospitalization rates following implantation using French national data from the Program for the Medicalization of Information Systems (PMSI)., Materials and Methods: We analyzed data on PP implantations in all France hospitals. PPs were coded into three types according to the Common Classification of Medical Procedures (CCAM). The number of patients admitted to hospital with complications twelve months after implantation was also recorded., Results: During the study period, 3675 men received 3868 PPs in France. A gradual increase in the total number of implanted PPs was observed, with an overall increase of 33.8%. In 2020, there was a sharp decline in the number of implanted PPs, primarily owing to the COVID-19 pandemic. The most commonly used implant was PPs with an extracavernous compartment, comprising 85% of all PPs. Twelve months after implantation, only 1-2% of the patients were rehospitalized., Conclusion: PP implantation surgeries are highly reproducible and have a low incidence of complications, in terms of rehospitalization after one year of placement (1.8%). Moreover, there was an increase in the demand for penile prosthesis implantations in France between 2016 and 2021., Level of Evidence: 4: Descriptive epidemiological study., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

It is unknown if the risk of erectile dysfunction (ED) following Coronavirus-19 (COVID-19) infection is virus-specific. Our study assessed the risk of ED in COVID-19 patients as compared to patients with other common viral infections. The TriNetX COVID-19 Research Network was queried. We examined cohorts of men aged ≥18 years infected with: COVID-19, influenza, respiratory syncytial virus, enterovirus, acute viral hepatitis, mononucleosis, and herpes zoster. Men were included if they had at least one outpatient follow-up visit within 18 months and excluded if they had one of the other viruses of interest or a prior ED diagnosis or treatment, prostatectomy, pelvis radiation, or chronic hepatitis infection. Cohorts were propensity score matched and compared for differences in new ED diagnosis and/or prescription of phosphodiesterase-5 inhibitors (PDE5i). COVID-19 positive men were less likely to develop ED or have a PDE5i prescription than men with infected with herpes zoster [Relative Risk (RR): 0.37, 95% Confidence Interval (CI) 0.27-0.49] and more likely to develop ED or have a PDE5i prescription than men with no acute viral illness (RR: 1.33, 95% CI 1.25-1.42). In this national propensity-matched cohort study comparing post-infection ED risk and PDE5i prescriptions, we found that COVID-19 was no more likely to result in a diagnosis of ED or prescription of PDE5i when compared to all acute viral illnesses except herpes zoster, which was more likely to result in a diagnosis of ED or prescription of PDE5i when compared to COVID-19. These findings suggest an inflammatory etiology (perhaps due to cytokine release, endothelial dysfunction, or blunted hormone signaling) behind any acute infection can result in a heightened ED risk; however, further studies are required to investigate the connection between other viral infections and ED., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Purpose: Elevated blood lipids are considered a risk factor for atherosclerosis, which can lead to erectile dysfunction. This study aimed to explore the relationship between the atherogenic index of plasma (AIP), atherogenic coefficient (AC), Castelli's risk index-I (CRI-I), Castelli's risk index-II (CRI-II), and erectile dysfunction., Methods: Based on the National Health and Nutrition Examination Survey (NHANES) data from 2001-2004, multivariable-adjusted logistic regression models were used to evaluate the association between AIP, AC, CRI-I, and CRI-II with ED. Smooth curve fitting was employed to assess the linear association., Results: A total of 1806 male participants with complete data were enrolled in the study. In Model 1, those in the highest tertile of AIP had a 49% increased risk of ED compared to the lowest tertile (OR 1.49; 95% CI 1.15-1.91 p = 0.0021). After adjusting for the variables of age, race, education, body mass index, and poverty income ratio (PIR), significant positive correlations were found between ED and AIP, with each 1-unit increase in AIP associated with a 65% increase in the risk of developing ED (OR 1.65; 95% CI 1.03-2.64 p = 0.0361)., Conclusions: AIP is positively associated with the development of ED in US adults. More prospective cohort studies are needed to confirm the link between AIP and ED., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Whether erectile dysfunction (ED) leads to considerable stress for affected men remains unclear? In this study, we investigated whether organic ED (OED) is associated with increased risks of herpes zoster (HZ) and postherpetic neuralgia (PHN)., Methods: A representative subset of Taiwan's National Health Insurance Research Database was employed for this study. Enrollees with OED from the years 2000 to 2018 were selected. To ensure comparability between the case and control groups, we implemented 1:1 propensity score matching based on age, index year, comorbidities, and medications., Results: The case group included 20,808 patients with OED, while the control group consisted of 20,808 individuals without OED. The OED group exhibited a significantly elevated risk of HZ (adjusted hazard ratio [aHR] = 1.74) and PHN (aHR = 1.56) compared to the non-OED group., Conclusions: Men experiencing OED seem to face elevated risks of HZ and PHN compared to those without OED. ED may serve as a warning sign for individuals at HZ risk.

Background: Antidiabetic drugs are widely used in clinical practice as essential drugs for the treatment of diabetes. The effect of hypoglycemic drugs on erectile dysfunction has not been fully proven due to the presence of multiple confounding factors., Methods: Two-sample Mendelian randomization (TSMR) was used to examine the causal effect of antidiabetic drugs (including metformin, insulin and gliclazide) on erectile dysfunction. We used five robust analytic methods, of which the inverse variance weighting (IVW) method was the primary method, and also assessed factors such as sensitivity, pleiotropy, and heterogeneity. Effect statistics for exposures and outcomes were downloaded from publicly available data sets, including open Genome-Wide Association Studies (GWAS) and the UK Biobank (UKB)., Results: In some of the hypoglycemic drug use, there was a significant causal relationship between metformin use and erectile dysfunction [Beta: 4.9386; OR:1.396E+02 (95% CI:9.13-2135); p-value: 0.0004), suggesting that metformin increased the risk of erectile dysfunction development. Also, we saw that gliclazide use also increased the risk of erectile dysfunction [Beta: 11.7187; OR:0.0125 (95% CI:12.44-1.21E+09); P value: 0.0125). There was no significant causal relationship between insulin use and erectile dysfunction [Beta: 3.0730; OR:21.6071 (95% CI:0.24-1942.38); p-value: 0.1806).Leave-one-out, MR-Egger, and MR-PRESSO analyses produced consistent results., Conclusion: The use of metformin and gliclazide have the potential to increase the risk of erectile dysfunction. There is no causal relationship between the use of insulin and erectile dysfunction., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Feng, Jinhua, Shulin, Jiangping, Zhongxiang and Xiaohong.)

Objectives: Several systematic reviews and meta-analyses have reported positive relationships between erectile dysfunction (ED) and periodontal disease. However, no study has evaluated the relationships of occlusal support status and the number of remaining teeth with ED. The aim of the present study was to investigate the relationships between ED and the remaining teeth number, periodontal disease, and occlusal support status., Methods: This study included 400 community-dwelling men. Periodontal health status and occlusal support condition were evaluated using the Community Periodontal Index (CPI) and Eichner classification. Multivariable analyses were performed to evaluate the relationships between ED and the remaining teeth number, periodontal disease, and occlusal support status., Results: The median age was 53 years. Of the 400 men, 333 (83%) were classified into ED group. In univariable analyses, remaining teeth number, CPI score, and Eichner classification were significantly associated with ED. In multivariable analyses, the remaining teeth number (odds ratio [OR]: 0.907, p = 0.114) and CPI score (OR: 0.978, p = 0.864) were not significantly associated with ED, whereas the Eichner classification was independently and significantly associated with ED (OR: 3.490, p = 0.042)., Conclusions: Poor occlusal support status was significantly associated with ED in community-dwelling men, as opposed to remaining teeth number and periodontal health status., (© 2024 The Japanese Urological Association.)

We aimed to establish the prevalence of atypical masturbation in the general population and explore the association between atypical masturbation and male sexual dysfunction in heterosexual males. Atypical masturbation refers to stimulation significantly distinct from that encountered during partnered sexual activity. We posted questionnaires that contained the abridged International Index of Erectile Function (IIEF-6) and the premature ejaculation diagnostic tool on social media in China. We collected 2743 valid questionnaires from December 9, 2020, to April 18, 2021. We found that the prevalence of atypical masturbation in the general population was 10.97%. Men with atypical masturbation had lower IIEF-6 scores and higher rates of erectile dysfunction (ED) than men with typical masturbation. The prevalence of premature ejaculation and estimated intravaginal ejaculatory latency time were not significantly different among men with different patterns of masturbation. Our study demonstrated that atypical masturbation is associated with ED, and a clinician dealing with sexual issues should inquire more fully about masturbation patterns than has been done to date., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Erectile dysfunction (ED) is associated with inflammation. The systematic immune-inflammation index (SII), as a new inflammation marker, was applied to predict the risk of diseases. However, no research explores the relationship between SII and ED. Hence, the purpose of this study was to investigate the association between SII and ED., Methods: Related data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2001-2004. Based on self-report, all participants were classified into ED and non-ED group. Weighted multivariate regression analysis the relationship between categorical SII and ED in unadjusted and adjusted models. Restricted cubic spline (RCS) was used to examine the association of continuous SII and ED risk. Furthermore, the association between categorical SII and the risk of ED was evaluated among subgroups of age, body mass index, hypertension, diabetes and cardiovascular disease. Finally, weighted multivariate regression analysis and RCS were performed to assessed the connection between SII and the risk of severe ED., Results: Initially, data on 21,161 participants were obtained. After implementing the inclusion and exclusion criteria, 3436 participants were included in analyses. Weighted multivariate regression analysis demonstrated that Q4 group SII was associated with an increased risk of ED (OR = 1.03, 95% confidence intervals: 1.00-1.05, p = .03). RCS showed SII was nonlinearly associated with the risk of ED, and the inflection point of SII was at 485.530. In addition, subgroup analyses demonstrated that participants in the SII > 485.530 group had a higher ED risk than SII ≤ 485.530 group among subgroups of age ≥50, hypertension, and non-diabetes. Weighted multivariate regression analysis and RCS found no relationship of SII and the risk of severe ED., Conclusion: In US adults, SII > 485.530 was correlated with an increased risk of ED. While, no significant association between SII and severe ED risk. Additional studies are required to support our results., (© 2024 The Author(s). Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.)

We sought to assess if COVID-19 infection recovery is associated with increased rates of newly diagnosed erectile dysfunction. Using IBM MarketScan, a commercial claims database, men with prior COVID-19 infection were identified using ICD-10 diagnosis codes. Using this cohort along with an age-matched cohort of men without prior COVID-19 infection, we assessed the incidence of newly diagnosed erectile dysfunction. Covariates were assessed using a multivariable model to determine association of prior COVID-19 infection with newly diagnosed erectile dysfunction. 42,406 men experienced a COVID-19 infection between January 2020 and January 2021 of which 601 (1.42%) developed new onset erectile dysfunction within 6.5 months follow up. On multivariable analysis while controlling for diabetes, cardiovascular disease, smoking, obesity, hypogonadism, thromboembolism, and malignancy, prior COVID-19 infection was associated with increased risk of new onset erectile dysfunction (HR 1.27; 95% CI 1.1-1.5; P = 0.002). Prior to the widespread implementation of the COVID-19 vaccine, the incidence of newly diagnosed erectile dysfunction is higher in men with prior COVID-19 infection compared to age-matched controls. Prior COVID-19 infection was associated with a 27% increased likelihood of developing new-onset erectile dysfunction when compared to those without prior infection., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Prior research has demonstrated that erectile dysfunction (ED) is a significant risk factor for cardiovascular disease (CVD) and premature mortality. Few studies have examined the link between ED and hyperglycemia, and the predictive power of ED for mortality in individuals with hyperglycemia. A cohort of 1584 adults diagnosed with hyperglycemia, consisting of 583 individuals with diabetes and 1001 individuals with prediabetes, was selected from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2004. The study found a positive correlation between severe ED and hyperglycemia (OR, 2.03; 95% CI 1.53-2.68), while no significant relationship was observed between severe ED and CVD events (OR, 1.60; 95% CI 0.91-2.80). Additionally, no statistical association was found between diabetes or prediabetes status and ED. After multivariable adjustments, severe ED was found to be significantly associated with an increased risk of all-cause mortality (HR, 1.67; 95% CI 1.16-2.39), while no significant association was observed between severe ED and CVD mortality (HR, 1.92; 95% CI 0.92-3.98). Our study indicates a significant correlation between ED and hyperglycemia status. Hyperglycemia Individuals with ED generally exhibited an unfavorable prognosis for mortality due to all causes and CVD, particularly among those with low levels of physical activity., (© 2024. The Author(s).)

Background: Erectile dysfunction (ED) is a very common condition among adult men and its prevalence increases with age. The ankle-brachial blood pressure index (ABPI) is a noninvasive tool used to assess peripheral vascular disease (PAD) and vascular stiffness. However, the association between ABPI and ED is unclear. We aimed to explore the association between ABPI and ED in the US population., Methods: Our study used data from two separate National Health and Nutrition Examination Survey (NHANES) datasets (2001-2002 and 2003-2004). Survey-weighted logistic regression models were used to explore the association between ABPI as a continuous variable and quartiles with ED. We further assessed the association between ABPI and ED using restricted cubic regression while selecting ABPI thresholds using two-piecewise Cox regression models. In addition, we performed subgroup analyses stratified by BMI, race, marital status, diabetes, and hypertension., Main Outcome Measure: ABPI was calculated by dividing the mean systolic blood pressure at the ankle by the mean systolic blood pressure at the arm., Results: Finally, 2089 participants were enrolled in this study, including 750 (35.90%) ED patients and 1339 (64.10%) participants without ED. After adjusting for all confounding covariates, logistic regression analyses showed a significant association between ABPI and ED (OR=0.19; 95% CI, 0.06-0.56, P=0.01); with ABPI as a categorical variable, compared with the lowest quartile, the OR and 95% CI for the second quartile were 0.58 (0.34-0.97; P = 0.04).Besides, splines indicated that there was an L-shaped relationship between ABPI levels and the risk of ED. Piecewise Cox regression demonstrated the inflection point at 1.14, below which the OR for ED was 0.06 (0.02-0.20; P < 0.001), and above which the OR was 2.79 (0.17-4.53; P = 0.469)., Conclusion: In our study, lower ABPI was independently associated with ED risk. In addition, the lowest ABPI level associated with ED risk was 1.14, below this level, lower ABPI was associated with higher ED risk., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wu, Zhang and Zheng.)

Background and Intention: Erectile dysfunction (ED) is an underappreciated clinical condition in men. This study aims to compare the dynamic changes in the distribution of ED among male kidney transplant recipients (mKTRs) in four epochs: end-stage renal disease period (ESRDp), early post-transplant period (EPTP), pre-COVID-19, and post-COVID-19., Methods: General information was gathered through interviews, follow-ups, and medical records. The International Index of Erectile Function Questionnaire-5 was used to assess erectile function. The Mann-Whitney U test and chi-square test were used to analyze differences in ED strength. Univariate and logistic regression analyses were conducted to identify risk factors for ED., Results: The database contains 230 mKTRs. In the ESRDp, 17.0% had normal erectile function, 53.5% had mild ED, 18.3% had moderate ED, and 11.3% had severe ED. In the EPTP, the distribution was 38.2% normal, 42.6% mild, 10.8% moderate, and 8.2% severe. In the pre-COVID-19 period, it was 34.3%, 47.3%, 10.4%, and 7.8%, and in the post-COVID-19 period, it was 23.0%, 45.6%, 21.3%, and 10.0%. Overall, erectile function improved after kidney transplant (KT). However, post-COVID-19, the proportion of erectile function significantly decreased compared to EPTP and pre-COVID-19 periods. Risk factors for post-pandemic ED included degree, Generalized Anxiexy Disorder-7, kidney donor type, postoperative time, hypertension and hemoglobin concentration., Conclusion: KT improves erectile function in mKTRs within 5 years, but post-SARS-CoV-2 viral infection, ED worsens due to altered risk factors. These findings inform future research for comprehensive ED prevention and management strategies in this population., (© 2024. The Author(s).)

Erectile dysfunction (ED) is related to nutritional and inflammatory factors. The hemoglobin, albumin, lymphocyte, and platelet score (HALP), a new index reflecting the nutritional and inflammatory status, has been associated with a higher risk of diabetic retinopathy, particularly at lower values (≤ 42.9). However, studies focusing on the relationship between HALP and ED risk are scarce. Hence, this study aimed to investigate the association between HALP and ED. Data were extracted from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2004. Based on self-reported data, participants were classified into either the ED group or the non-ED group. Next, the HALP score was categorized into four quartiles (Q1-4). Weighted multivariate regression analysis was performed to assess the relationship between categorical HALP and ED risk. Additionally, restricted cubic spline (RCS) analysis was conducted to examine the association between continuous HALP scores and ED risk. Furthermore, subgroup analyses were conducted to examine the association between categorical HALP and the risk of ED based on age, as well as the status of hypertension, diabetes and cardiovascular disease. Finally, a mediation analysis was carried out to investigate the mediating effect of HALP and related parameters on the association between urinary cobalt levels and ED. Initially, the data of 21,161 participants were collected. After implementing the inclusion and exclusion criteria, 3406 participants were included in the final analyses. Weighted multivariate regression analysis demonstrated that the Q4 HALP group was associated with a lower risk of ED (OR 0.96, 95% confidence intervals 0.92-1.00, P = 0.037). Meanwhile, RCS analysis showed that HALP was nonlinearly associated with the risk of ED. In addition, subgroup analyses demonstrated that participants in the Q3/4 HALP group had a significantly lower ED risk than those in the Q1 group among patients aged ≥ 50 years, as well as those with hypertension and diabetes. Lastly, mediation analysis revealed that HALP and its associated parameters had a marginal average causal mediation effect on the relationship between urinary cobalt levels and ED risk (P > 0.05). In US adults, high HALP scores were correlated with a lower risk of ED. The relationship was more pronounced in participants aged ≥ 50 years with hypertension and diabetes. Furthermore, HALP and its parameters may not mediate the association between urinary cobalt levels and ED risk., (© 2024. The Author(s).)

Objective: This study assessed the association between erectile dysfunction (ED) and arthritis., Methods: Weighted logistic regression and subgroup analyses were used to investigate the association between arthritis incidence and ED among participants in the 2001-2004 National Health and Nutrition Examination Survey database., Results: Among the participants, 27.8% and 18.5% had a self-reported history of ED and arthritis, respectively. ED was associated with arthritis (odds ratio [OR]=4.00; 95% confidence interval [CI]: 3.20-4.99; p<0.001], which remained significant after adjustment (OR=1.42, 95% CI: 1.00-1.96; p<0.001). Stratified by type of arthritis, after full adjustment, osteoarthritis remained significant (OR=1.11; 95% CI: 1.03-1.20; p=0.017), and rheumatoid arthritis (OR=1.03, 95% CI: 0.93-1.13; p= 0.5) and other arthritis (OR=1.04, 95% CI: 0.98-1.11; p=0.2) were not significantly correlated with ED. Multiple inference analyses confirmed the robustness of the results., Conclusion: Our study showed that arthritis was strongly associated with ED. There is an urgent need to raise awareness and conduct additional research on the reasons behind this association in order to implement more scientific and rational treatment programs for patients with ED and arthritis., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Liu, Lei, Li and Liu.)

Background: Insulin resistance (IR) is involved in the development of erectile dysfunction (ED). The purpose of this study was to assess the correlation between the metabolic score for IR (METS-IR) index and risk of erectile dysfunction in US adults., Methods: This study selected individuals from the National Health and Nutrition Examination Survey (NHANES). Logistic regression analysis, subgroup analysis, and dose-response curve analysis were carried out to assess the relationship between the METS-IR index and ED prevalence., Results: This study ultimately included 1759 participants aged ≥ 20 years, of whom 512 self-reported a history of ED. After adjusting for all confounders, each unit increase in METS-IR index was associated with a 3% increase in erectile dysfunction prevalence (OR = 1.03, 95% CI: 1.01-1.04). In almost all subgroups, an increased METS-IR index was associated with a higher prevalence of ED. The dose-response curve displayed a positive non-linear connection between METS-IR value and the prevalence of ED., Conclusion: The study found a positive association between the METS-IR index and ED. METS-IR is useful as a simplified IR evaluation index for early identification of people with high risk of ED., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Sexual dysfunction (erectile dysfunction in males, sexual dissatisfaction, sexual interest/arousal disorders, and dyspareunia in females) has not been the subject of indepth research in people with cystic fibrosis (CF). This study aimed to determine the prevalence of sexual dysfunction in adults with CF, factors associated with sexual dysfunction, and the impact of sexual dysfunction on quality of life., Method: We conducted a multicentre study in adults with cystic fibrosis followed in specialist centres in Western France. We assessed erectile dysfunction and its severity using the IIEF5 self-questionnaire (International Index of Erectile Function); the FSFI (Female Sexual Function Index) was used to assess sexual function in females, and we evaluated quality of life in both sexes using the CFQ-R14+ questionnaire., Results: In total, 77 males and 74 females completed the sexual function questionnaire (mean age 32+/- 10 and 25+/- 8,5 years respectively). Among them, 21 % of males and 30 % of females reported sexual dysfunction. CFQ-R14+ score was significantly lower in males with erectile dysfunction than those without (p < 0.001). Faecal incontinence was associated with more frequent sexual dysfunction in females and higher severity of erectile dysfunction in males., Conclusion: The prevalence of sexual disorders is relatively high in males and females with cystic fibrosis. Therefore, it seems important to train specialist teams to address the issue of sexuality without embarrassment, and to encourage them to seek out and treat faecal incontinence, which is associated with greater severity or frequency of these symptoms., Competing Interests: Declaration of competing interest None., (Copyright © 2024 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.)

Existing research on the precise link between dietary niacin intake and erectile dysfunction (ED) is scarce. Thus, this study aimed to investigate the potential association between dietary niacin intake and the risk of ED. Multivariate logistic regression and restricted cubic splines (RCSs) were used to examine the relationship between dietary niacin intake and ED. Subgroup interaction analysis was performed to assess the impact of different subgroups on the study outcomes. In addition, 1:1 propensity score matching (PSM) was employed to adjust for potential confounding factors, ensuring the reliability of the results. The analyzed data were collected from the 2001-2004 National Health and Nutrition Examination Survey (NHANES) in the USA. The study encompassed 3184 adults, among whom 863 participants were identified as having ED. Following adjustments for potential confounders, the findings revealed that higher niacin intake, specifically in the highest tertile, was associated with a decreased risk of ED compared to that in the lowest tertile, showing an odds ratio (OR) of 0.56 (95% confidence interval [CI]: 0.37-0.85). Analysis of dose-response curves illustrated a negative correlation between dietary niacin intake and the risk of ED. Subgroup and interaction analyses fortified the consistency of these results. Furthermore, PSM corroborated the validity of the findings. This study suggests an inverse association between dietary niacin intake and the risk of ED. However, establishing a cause-and-effect relationship remains elusive, and defining the safe threshold of niacin intake to prevent ED requires further investigation., (Copyright © 2024 Copyright: ©The Author(s)(2024).)

Background: -Recent evidence suggests that hyperuricemia may act as independent risk factors for erectile dysfunction (ED), in addition to the already established factors. The current evidence supporting this relationship remains insufficient., Methods and Results: -A total of 3,810 participants from the NHANES pool between 2001 and 2004 were included in our study, comprising 1,093 individuals with ED and 2,717 individuals without ED. Univariable and multivariable logistic regression analyses were conducted to examine the relationship between uric acid (UA) and the prevalence of ED. In the fully adjusted model, no significant association was observed between UA and ED (OR = 1.02, 95% CI: 0.84-1.24), and no significant differences were noted among the various UA levels (p = 0.5). In our sensitivity analyses, employing a stricter definition for ED, no significant results were found in the fully adjusted model (OR = 0.85, 95% CI: 0.60-1.19). Furthermore, no significant differences were observed among the various UA levels (p = 0.083)., Conclusions: -Our study did not establish a correlation between UA levels and ED. Nonetheless, further research with larger sample cohorts is required to verify these findings., (© 2024. The Author(s).)

Purpose: Lipid parameters have been shown to have significant predictive value for cardiovascular disease, but few studies have evaluated their correlation with erectile dysfunction (ED) in young men., Methods: The case-control study encompassed 186 young ED patients (ages 20-40) and 186 healthy controls. Lipid parameters, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), TC/HDL ratio, TG/HDL ratio, and LDL-C/HDL-C ratio, were assessed in all participants. The International Index of Erectile Function (IIEF-5) scores were collected for all participants to evaluate erectile status. Multivariate logistic regression analysis was utilized to appraise the association of lipid-related parameters with ED. Single-nucleotide polymorphisms (SNPs) significantly correlated with lipid parameters (TC, TG, LDL-C, HDL-C) were selected from genome-wide association studies (GWAS) as instrumental variables (IV) (P < 5.0 × 10 -8 ). Summary data for ED was gathered from a GWAS with a sample size of (n = 17,353 cases/28,210 controls). The inverse variance weighted (IVW) method was employed as the primary mendelian randomization (MR) analysis method to assess causal effects. Causal estimates were represented as odds ratios (OR) with 95% confidence intervals (CI)., Results: Results from the case-control study revealed that, when compared with the control group, levels of LDL-C, TG, UA, LDL-C/HDL-C, TG/HDL-C, and TC/HDL-C in the ED group were significantly elevated (P < 0.01), while HDL-C was significantly decreased (P < 0.01) in the ED group. Multivariate logistic regression analysis indicated LDL-C/HDL-C as a risk factor for both the incidence and severity of ED (P < 0.001). Two-sample MR analysis demonstrated no significant causal correlation between lipid parameters-LDL-C (OR, 0.98, 95% CI, 0.88-1.08, P = 0.616), HDL-C (OR, 1.07, 95% CI: 0.96-1.19, P = 0.249), TC (OR, 1.07, 95% CI, 0.96-1.18, P = 0.208), TG (OR, 0.98, 95% CI, 0.80-1.13, P = 0.579) -and an increased risk of ED (all P > 0.05)., Conclusions: The case-control analysis ascertained a significant association between LDL-C, HDL-C, LDL-C/HDL-C, and ED and its severity. However, results from the MR study do not support a causal role of lipid parameters in ED., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Urinary and sexual dysfunction after radical prostatectomy remains a major cause of morbidity, despite widespread availability of pharmacological and rehabilitative treatments. Smoking is a modifiable risk factor known to correlate with erectile and urinary dysfunction and we hypothesise that smoking cessation may improve post-prostatectomy urinary and sexual function recovery. Our objective is to systematically evaluate literature describing the association of smoking status with urinary and sexual function in men following radical prostatectomy., Methods: In total, 310 unique records were identified through a systematic search of the MEDLINE, EMBASE, Scopus, Web of Science, CINAHL and CENTRAL databases up to February 2023. Nine studies reported smoking status and post radical prostatectomy urinary and sexual function outcomes in men with localized prostate cancer. Risk of bias was assessed and meta-analysis included six studies., Results: Smokers had inferior erectile function after prostatectomy compared to non-smokers (OR 0.73, [95% CI 0.56-0.95]) during follow-up, while urinary incontinence was not statistically different between groups (OR 1.20, [95% CI 0.75-1.91]). Smoking cessation improved the EPIC-26 sexual domain score with 6.6 points on average [p = 0.03] to a clinically significant maximum of 12.5 points at 18-24 months., Conclusions: Smoking is associated with impaired sexual function recovery after radical prostatectomy and quitting may improve sexual function >18 months. Current evidence shows no such association for urinary outcomes. Further studies are needed to corroborate findings., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Data on functional and psychological side effects following curative treatment for prostate cancer are lacking from large, contemporary, unselected, population-based cohorts., Objective: To assess urinary symptoms, bowel disturbances, erectile dysfunction (ED), and quality of life (QoL) 12 mo after robot-assisted radical prostatectomy (RARP) and radiotherapy (RT) using patient-reported outcome measures in the Swedish prostate cancer database., Design, Setting, and Participants: This was a nationwide, population-based, cohort study in Sweden of men who underwent primary RARP or RT between January 1, 2018 and December 31, 2020., Outcome Measurements and Statistical Analysis: Absolute proportions and odds ratios (ORs) were calculated using multivariable logistic regression, with adjustment for clinical characteristics., Results and Limitations: A total of 2557 men underwent RARP and 1741 received RT. Men who underwent RT were older (69 vs 65 yr) and had more comorbidities at baseline. After RARP, 13% of men experienced incontinence, compared to 6% after RT. The frequency of urinary bother was similar, at 18% after RARP and 18% after RT. Urgency to defecate was reported by 14% of men after RARP and 34% after RT. At 1 yr, 73% of men had ED after RARP, and 77% after RT. High QoL was reported by 85% of men after RARP and 78% of men after RT. On multivariable regression analysis, RT was associated with lower risks of urinary incontinence (OR 0.25, 95% confidence interval [CI] 0.19-0.33), urinary bother (OR 0.79, 95% CI 0.66-0.95), and ED (OR 0.54, 95% CI 0.46-0.65), but higher risk of bowel symptoms (OR 2.86, 95% CI 2.42-3.39). QoL was higher after RARP than after RT (OR 1.34, 95% CI 1.12-1.61)., Conclusions: Short-term specific side effects after curative treatment for prostate cancer significantly differed between RARP and RT in this large and unselected cohort. Nevertheless, the risk of urinary bother was lower after RT, while higher QoL was common after RARP., Patient Summary: In our study of patients treated for prostate cancer, urinary bother and overall quality of life are comparable at 1 year after surgical removal of the prostate in comparison to radiotherapy, despite substantial differences in other side effects., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The aim of this study was to assess the association between a new metabolic index, the cardiometabolic index (CMI) and erectile dysfunction (ED). The data for this study relied on the National Health and Nutrition Examination Survey (NHANES), a cross-sectional database, between 2001 and 2004. The CMI was calculated as the following formula: Triglyceride (TG) (mmol/L)/ High density lipid-cholesterol (HDL-C) (mmol/L) ×waist-height ratio (WHtR). The multivariate logistic regression analyses were conducted to assess the association between CMI and ED, supplemented by subgroup analysis and dose-response curves. Finally, a total of 1367 adult male participants were identified, and the mean CMI was 0.83 ± 0.02. Multivariate logistic regression analysis showed that in model 2 controlling for all potential confounders, CMI was significantly associated with ED (OR = 1.49, 95% CI: 1.09, 2.04) (p = 0.017). Subsequently, we convert the CMI from a continuous variable to a categorical variable (Tertiles). The results showed that male participants in CMI Tertile 3 group had a higher risk of ED than those in Tertile 1 group in model 2 (OR = 2.07, 95% CI: 1.12, 3.83, P = 0.024). The subgroup analysis of model 2 demonstrated that CMI was significantly associate with ED in participants aged ≥50 y (OR = 2.31, 95% CI: 1.35, 3.95, P = 0.005), body mass index (BMI) > 30 kg/m 2 (OR = 1.78, 95% CI: 1.10, 2.90, P = 0.023), with hypertension (OR = 1.89, 95% CI: 1.63, 3.45, P = 0.020), with diabetes mellitus (OR = 1.67, 95% CI: 1.13, 2.47, P = 0.015), with cardiovascular disease (CVD) (OR = 1.54, 95% CI: 1.12, 2.10, P = 0.011) and smoking (OR = 2.07, 95% CI: 1.26, 3.39, P = 0.007). This study demonstrates a strong association between CMI and ED and an increased risk of ED with higher CMI levels. More prospective studies with large samples and good designs are needed to validate our results in the future., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Various observational studies have examined the prevalence and determinants of erectile dysfunction (ED) in men with type 1 diabetes across different geographical areas. Nevertheless, a comprehensive systematic review and meta-analysis to consolidate the worldwide prevalence and risk factors remains lacking. Hence, the primary study objective was to perform an extensive systematic review and meta-analysis that specifically examined ED prevalence and determinants in men with type 1 diabetes. A thorough exploration was conducted by examining electronic databases, such as PubMed, Embase, and Web of Science. The general ED prevalence and a 95% confidence interval (CI) in men with type 1 diabetes were summarized. The relevant risk factors were analyzed by deriving a comprehensive odds ratio (OR) from merging the ORs using fixed- or random-effects models. The sources of heterogeneity were investigated using subgroup analyses and meta-regression. This systematic review and meta-analysis included 19 articles involving 3788 men with type 1 diabetes. The meta-analysis revealed that men with type 1 diabetes had a combined ED prevalence of 42.5% (95% CI: 34.3%-50.8%). This prevalence showed significant heterogeneity (I 2  = 96.2%, P < 0.01). Meta-regression revealed that age (P = 0.016) and type 1 diabetes duration (P = 0.004) were significant causes of heterogeneity. Furthermore, the ED risk in men with type 1 diabetes was significantly influenced by age, type 1 diabetes duration, body mass index, glycated hemoglobin (HbA1c), retinopathy, and smoking habits (all P < 0.05). In summary, this systematic review and meta-analysis revealed a significant prevalence of ED in men with type 1 diabetes, highlighting the importance of clinicians addressing concerns regarding ED in this specific group of individuals., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

This study aimed to review the current knowledge on sexual dysfunction in men and women with hyperthyroidism through a systematic review and meta-analysis. Available clinical trials from the MEDLINE database were searched using a prerecorded protocol (Protocol Prospero ID: CRD42022340587), and obtained data were analyzed and reported according to the PRISMA guidelines. Pooled effect estimates were computed using a random-effects model. Twenty eligible studies were identified, of which 15 were included in this meta-analysis. The prevalence of erectile dysfunction was significantly higher in participants with hyperthyroidism than that in controls [odds ratio = 9.16 (95% confidence interval [CI], 5.0-16.5)]. Treatment of hyperthyroidism alone improved erectile functions [effect size, ES = 0.36 (95% CI, -0.01-72)] and mean intra-vaginal ejaculation latency time [ES = 0.63 (95% CI, 0.27-98)] among men with erectile dysfunction and/or premature ejaculation. The prevalence of premature ejaculation also decreased with treatment of hyperthyroidism [odds ratio = 0.11 (95% CI, 0.04-28). Women with hyperthyroidism demonstrated higher odds in female sexual dysfunction than controls [odds ratio = 4.34 (95% CI, 2.63-7.18)]. Female sexual function index scores in women with hyperthyroidism were also significantly lower than those in the controls with moderate effect sizes. An evident and reversible disruption of sexual functions under hyperthyroidism conditions was observed in both sexes., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Several reports showed that sexual function was affected during and after the COVID-19 pandemic., Aims: The objective of the study was to demonstrate whether a realistic association exists between the COVID-19 pandemic and erectile dysfunction (ED) among a sampled Egyptian population in Damietta governorate., Methods: This cross-sectional study consisted of 330 adult males diagnosed with COVID-19 infection. They were categorized in three age groups (18-29, 30-39, and 40-50 years, respectively). COVID-19-confirmed cases were assessed by the Arabic version of the International Index of Erectile Function questionnaire (IIEF) scores., Results: The prevalence of ED according to the IIEF was 55.1%. The ED was categorized into mild ED which represents 25.8% of the patients, mild to moderate which represents 22.4% of the patients, moderate which represents 7% of the patients, and severe which represents 0% of the patients. We found a significant negative correlation between the age of the patients and the IIEF score. Also, we found an association between the severity of COVID-19 infection and the IIEF score., Conclusion: An association of new-onset ED in men who suffered COVID-19 infection was established. This may be due to virus-induced endothelial cell dysfunction; however, an underlying mechanism and causation have not yet been clearly elucidated. While it appears that COVID-19 infection may be a risk factor for ED, additional research is needed to establish causality., (© 2024. The Author(s).)

Background: The relationship between erectile dysfunction (ED) and cardiovascular (CV) events has been postulated, with ED being characterized as a potential harbinger of CV disease. Location of residence is another important consideration, as the impact of rural residence has been associated with worse health outcomes., Aim: To investigate whether men from rural settings with ED are associated with a higher risk of major adverse CV events (MACEs)., Methods: A propensity-weighted retrospective cohort study was conducted with provincial health administrative databases. ED was defined as having at least 2 ED prescriptions filled within 1 year. MACE was defined as the first hospitalization for an episode of acute myocardial infarction, heart failure, or stroke that resulted in a hospital visit >24 hours. We classified study groups into ED urban, ED rural, no ED urban, and no ED rural. A multiple logistic regression model was used to determine the propensity score. Stabilized inverse propensity treatment weighting was then applied to the propensity score., Outcomes: A Cox proportional hazard model was used to examine our primary outcome of time to a MACE., Results: The median time to a MACE was 2731, 2635, 2441, and 2508 days for ED urban (n = 32 341), ED rural (n = 18 025), no ED rural (n = 146 358), and no ED urban (n = 233 897), respectively. The cohort with ED had a higher proportion of a MACE at 8.94% (n = 4503), as opposed to 4.58% (n = 17 416) for the group without ED. As compared with no ED urban, no ED rural was associated with higher risks of a MACE in stabilized time-varying comodels based on inverse probability treatment weighting (hazard ratio, 1.06-1.08). ED rural was associated with significantly higher risks of a MACE vs no ED rural, with the strength of the effect estimates increasing over time (hazard ratio, 1.10-1.74)., Clinical Implications: Findings highlight the need for physicians treating patients with ED to address CV risk factors for primary and secondary prevention of CV diseases., Strengths and Limitations: This is the most extensive retrospective study demonstrating that ED is an independent risk factor for MACE. Due to limitations in data, we were unable to assess certain comorbidities, including obesity and smoking., Conclusions: Our study confirms that ED is an independent risk factor for MACE. Rural men had a higher risk of MACE, with an even higher risk among those who reside rurally and are diagnosed with ED., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Although surgical treatment is curative for colorectal cancers, erectile dysfunction (ED) is one of the complications that affect the patient quality of life. The present study aimed to evaluate sexual dysfunction in patients who underwent anterior resection (AR) and low AR (LAR) surgery secondary to rectosigmoid pathologies in our clinic, to analyze the effective variables, and to compare the results., Methods: In the retrospectively designed study, male patients who underwent surgery for malignancy or other surgical pathologies in the General Surgery Clinic between January 2017 and December 2022 were examined. Female gender, patients under 18 years of age, and patients who refused to participate in the study were excluded., Results: The high age of the patient increased the risk of severe ED in the postoperative period. However, surgical technique, alcohol use, American Society of Anesthesiologists (ASA) score, and Clavien-Dindo class were not determinants in the presence of severe ED., Conclusion: ED is an emerging medical problem that affects patients who undergo colorectal surgery adversely both in social and psychological aspects. Discussions on the issue are still ongoing. Clinicians' concerns can be addressed in the future as the number of prospectively designed studies involving more homogeneous and larger populations increases., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Erectile dysfunction (ED) is a prevalent condition that is thought to be significantly impacted by oxidative stress. The oxidative balance score (OBS) has been built to characterize the state of antioxidant/pro-oxidant balance. There is less known regarding the relationship of OBS with ED., Methods: This study conducted cross-sectional analyses on 1860 males who participated in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2004. OBS was constructed by the 16 dietary components and 4 lifestyle factors. Self-reported ED was defined as men who indicated that they "never" or "sometimes" could achieve or keeping an erection adequate for satisfactory intercourse. Multivariate logistic regression models were applied to examine the association between OBS and the risk of ED., Results: Among 1860 participants, the median OBS was 20 (IQR 15-26), and OBS was lower in males with ED vs. those without ED (P = 0.001). The results of our analyses indicated a negative correlation between OBS and ED among male subjects. Specifically, each one-unit increase in the continuous OBS was relate to 3% reduction in the odds of ED after full adjustment. Moreover, when extreme OBS quartiles were compared, the adjusted odds ratio (95% confidence interval) for the 4th OBS category was 0.53 (0.32 to 0.88) after full adjustment (P for trend < 0.05). There was also statistical significance in the relationships between dietary/lifestyle OBS with ED, and the association between lifestyle OBS and ED may be even tighter. For each unit increase in lifestyle OBS, the odds of ED decreased by 11% after full adjustment., Conclusion: Higher OBS was associated with reduced risk of ED in U.S. males. These findings suggested that adopting an antioxidant-rich diet and engaging in antioxidant-promoting lifestyle behaviors may contribute to a lower incidence of ED. These results provided recommendations for a comprehensive dietary and lifestyle antioxidants for ED patients., (© 2024. The Author(s).)

Oxidative stress strongly influences the pathophysiology of erectile dysfunction (ED). In this study, we used the oxidative balance score (OBS), a composite index, to measure the effects of oxidative stress triggered by diet and lifestyle factors. Here, we conducted a cross-sectional study to determine the statistical relationship between OBS and ED among adult males in the U.S. The data from 3318 participants in the National Health and Nutrition Examination Survey (NHANES) 2001-2004 were analyzed. Weighted logistic regression was used to correct for confounding factors and acquire nationwide representative estimates. Generalized additive modeling was used to explore the nonlinear relationship. We also supplemented subgroup and sensitivity analysis to examine the robustness of the main results. Multivariate logistic regression indicated a consistent negative linear association between OBS and ED across all participants [OR (95% CI) = 0.96 (0.94, 0.98)]. After categorizing OBS into tertiles, participants in the highest tertile had 43% lower odds of having ED than those in the lowest tertile [OR (95% CI) = 0.57 (0.37, 0.87)]. The generalized additive model also visualized the linear trend of this association. Furthermore, this linear relationship remained relatively consistent, regardless of whether subgroup or sensitivity analyses were performed. Our findings suggest that adopting a lifestyle and diet pattern that promotes favorable OBS may effectively protect against the development of ED, regardless of the underlying causes., (© 2024. The Author(s).)

Background: Erectile dysfunction (ED) is a prevalent condition that affects middle-aged and older men, impacting their sexual health and overall wellbeing. We aimed to investigate the relationship between social support and ED among this specific population., Methods: Data were collected from the National Health and Nutrition Examination Survey. Social support was assessed through various dimensions, including emotional support, material support, and network support. Multivariate logistic regression was performed to examine the association between social support and ED, and a propensity-score-matched (PSM) analysis was further conducted., Results: Among 1938 middle-aged and older males in the United States, 49.9% had a history of ED. ED was more prevalent in older individuals and those with comorbidities such as hypertension, prostate disease, higher serum creatinine level, and mental problems. Males with lower social support scores had a higher weighted rate of ED ( P < 0.001). After adjusting for multiple variables in logistic regression analysis, a higher social support score was associated with a 19% lower likelihood of ED (weighted odds ratio [OR] 0.81, 95% confidence interval [CI] 0.66-0.98, P = 0.032). The association remained consistent after propensity score matching (OR 0.80, 95% CI 0.66-0.98, P = 0.028)., Conclusion: Social support appears to be associated with a reduced risk of ED in middle-aged and older men. Further research is needed to better understand this relationship and explore interventions that enhance social support, potentially leading to improved sexual health outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hu, Zhang, Zhang, Liu and Han.)