RESUMO
We analyzed the efficacy of penile low-intensity extracorporeal shockwave treatment for erectile dysfunction (ED) combined with cavernous artery disease (CAD). ED was evaluated by the International Index of Erectile Function, subdividing patients into mild and moderate/severe forms. CAD was assessed using penile color Doppler ultrasonography. Patients (n = 111) with a positive outcome after treatment, based upon the minimal clinically important difference of the International Index of ED, were followed up for 3 months and 6 months. We found a significant mean increase in the index of erectile function, with an overall improvement in hemodynamic parameters of the cavernous artery. In particular, 93.9% of the patients with mild ED without CAD responded to treatment and 72.7% resumed normal erectile function. Only 31.2% of the patients with moderate/severe ED and CAD responded to treatment, and none resumed normal erectile function. All patients with mild ED and no CAD maintained the effects of therapy after 3 months, while no patients with moderate/severe ED and CAD maintained the benefits of treatment after 3 months. Thus, patients with mild ED and no CAD have better and longer lasting responses to such treatment, with a higher probability of resuming normal erectile function than patients with moderate/severe ED and CAD.
RESUMO
Background: Sexual dysfunction has been traditionally attributed to psychogenic origins and managed bymental health professionals and urologists. However, advances in pathophysiology research point to avascular origin of the problem in the majority of patients, possibly due to atherosclerotic lesions in the genitalarteries that result in decreased blood flow. During management of Hypertension; even the highly skilledphysicians fail to raise the question of sexual dysfunction as they have never been accustomed to do it intheir routine practice.Aim: The study has two aims- (i) to evaluate sexual dysfunctions in male patients of Hypertension and (ii)comparison of sexual dysfunctions and other variables between case and control group.Methodology: Consecutive 200 Hypertensive patients were included in the study. Individuals withcomparable age served as a control group. Detailed socio-demographic variables, substance history andtreatment history for hypertension obtained using a semi-structured Performa. Subject’s sexual dysfunctionswere assessed by ASEX (Arizona Sexual Experience Scale), IIEF (International Index of ErectileDysfunction), PEDT ( Premature ejaculation diagnostic tools).Result: Of the 200 hypertensive patients, 74(37%) participants reported erectile dysfunction, 16(8%)participants reported premature ejaculation, while among 200 normotensive participants, only 8(4%)reported erectile dysfunction, 15(7.5%) reported premature ejaculation. Of the hypertensive participantsstudied, 23% had severe, 8% had moderate, 6% had mild erectile dysfunction. Frequency of erectiledysfunction increase with advancing age.Conclusion: The present study has revealed that erectile dysfunction was a major problem, with a higherprevalence among hypertensive men than normotensive men. Age was considered statistically significantpredictors of erectile dysfunction.Keywords: Sexual dysfunctions, International Index of Erectile dysfunction, Arizona sexual experiencescale, Premature ejaculation diagnostic tools, hypertension