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Prevalence of erectile dysfunction in male stroke patients, and associated co-morbidities and risk factors

International Urology and Nephrology volume 40, pages 701–708 (2008)Cite this article

Abstract

Background

Sexual problems have been a common finding in chronically ill and physically disabled patients such as those with cerebrovascular accidents. Previous studies have supported the association between stroke and erectile dysfunction (ED).

Objectives

The aim of this study was to investigate the prevalence of ED and its severity in male stroke patients in Qatar and to assess the co-morbidities and risk factors associated with ED.

Design

This was a cross-sectional study.

Setting

The study was conducted from January to December 2006 at the Hamad General Hospital, Hamad Medical Corporation (HMC).

Subjects

Eight hundred Qatari and non-Qatari patients 35–75 years of age were invited to participate in this study; 605 patients gave their consent, which was a response rate of 75.6%.

Methods

Face-to-face interviews were based on a questionnaire that included socio-demographic factors. The classification of the type of stroke was made according to the criteria of stroke by the World Health Organization (WHO). All patients completed a second questionnaire addressing their general medical history, type of treatment and co-morbidity with other diseases or risk factors. Sexual function was evaluated with the International Index of Erectile Function (IIEF).

Results

The mean age of subjects was 56.1 ± 9.8 years. Approximately 48.3% of the studied population reported some degree of erectile dysfunction. Of the stroke patients with ED, 36% had severe ED, 32.9% had moderate ED and 31.2% had mild ED. More than half of the stroke patients (59.6%) with ED were in the age group 60–75 years. The prevalence of ED increased with increasing age. The co-morbidities and risk factors were significantly more prominent in ED patients than in those without ED for hypercholesterolemia (P < 0.001), diabetes (P = 0.002), and hypertension (P = 0.031). Medication taken for these diseases also had a significant association with ED.

Conclusions

Our study findings revealed a greater prevalence of ED in stroke patients in the population of Qatar. The most important co-morbid factors for ED in stroke patients were diabetes, hypertension and hypercholesterolemia, and the risk factors were smoking and obesity.

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References

  1. Ebrahim S (2001) Conference report, World Stroke Congress. Int J Epidemiol 30:189

    Google Scholar 

  2. Korpelainen JT, Nieminen P, Myllyla VV (1999) Sexual functioning among stroke patients and their spouses. Stroke 30:715–719

    PubMed  CAS  Google Scholar 

  3. Korpelainen JT, Kauhanen ML, Kemola H et al (1998) Sexual dysfunction in stroke patients. Acta Neurol Scand 98:400–405

    PubMed  CAS  Google Scholar 

  4. Monga TN, Ostermann HJ (1998) Sexuality and sexual adjustment in stroke patients. Phys Med Disabil Rehabil State Art Rev 20:317–329

    CAS  Google Scholar 

  5. Monga TN, Lawson JS, Inglis J (1986) Sexual dysfunction in stroke patients. Arch Phys Med Rehabil 67:19–22

    PubMed  CAS  Google Scholar 

  6. Giaquinto S, Buzzelli S, Di Francesco L et al (2003) Evaluation of sexual changes after stroke. J Clin Psychiatry 64:302–307

    PubMed  Article  Google Scholar 

  7. Kimura M, Murata Y, Shimoda K et al (2001) Sexual dysfunction following stroke. Compr Psychiatry 42:217–222

    PubMed  Article  CAS  Google Scholar 

  8. Araujo AB, Mohr BA, McKinlay JB (2004) Changes in sexual function in middle-aged and older men: longitudinal data from the Massachusetts Male Aging Study. J Am Geriatr Soc 52:1502–1509

    PubMed  Article  Google Scholar 

  9. Ayta IA, Mckinlay JB, Krane RJ (1999) The likely worldwide increase in erectile dysfunction between 1995 and 2005 and some possible policy consequences. BJU Int 84:50–56

    PubMed  Article  CAS  Google Scholar 

  10. Bener A, Al-Ansari A, Afifi M et al (2007) Erectile dysfunction among hypertensive men in a rapidly developing country. Indian J Urol 23:109–113

    Article  PubMed  Google Scholar 

  11. Mittawae B, El-Nashaar AR, Fouda A et al (2006) Incidence of erectile dysfunction in 800 hypertensive patients: a multicenter Egyptian national study. Urology 67:575–578

    PubMed  Article  Google Scholar 

  12. Kushiro T, Takahashi A, Saito F et al (2005) Erectile dysfunction and its influence on quality of life in patients with essential hypertension. Am J Hypertens 18:427–430

    PubMed  Article  Google Scholar 

  13. Rosen RC, Riley A, Wagner G et al (1997) The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 49:822–830

    PubMed  Article  CAS  Google Scholar 

  14. Rosen RC, Cappelleri JC, Smith MD et al (1999) Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 11:319–326

    PubMed  Article  CAS  Google Scholar 

  15. Cappelleri JC, Rosen RC, Smith MD (1999) Diagnostic evaluation of the erectile function domain of the International Index of Erectile Function. Urology 54:346–351

    PubMed  Article  CAS  Google Scholar 

  16. Ponholzer A, Temml C, Mock K (2005) Prevalence and risk factors for erectile dysfunction in 2869 men using a validated questionnaire. Eur Urol 47:80–85

    PubMed  Article  Google Scholar 

  17. Aho K, Harmsen P, Hatano S et al (1980) on behalf of the participants in the WHO collaborative study on the control of stroke in the community. Cerebrovascular disease in the community: results of a WHO Collaborative Study. Bull World Health Org 58:113–130

    Google Scholar 

  18. Apslund K, Bonita R, Kuulasmaa K et al (1995) for the WHO MONICA Project. Multinational comparisons of stroke epidemiology: evaluation of case ascertainment in the WHO MONICA Stroke Study. Stroke 25:355–360

    Google Scholar 

  19. Bener A, Kamran S, Elouzi EB et al (2006) Association between stroke and acute myocardial infarction and its related risk factors: hypertension and diabetes. Anadolu Kardiyol Derg 6:24–27

    PubMed  Google Scholar 

  20. World Health Organization (2003) International society of hypertension writing group: 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens 21:1983–1992

    Article  Google Scholar 

  21. Doumas M, Tsakiris A, Douma S (2006) Factors affecting the increased prevalence of erectile dysfunction in Greek hypertensive compared with normotensive subjects. J Androl 27:469–477

    PubMed  Article  Google Scholar 

  22. Doumas M, Tsakiris A, Douma S (2006) Beneficial effects of switching from beta-blockers to nebivolol on the erectile function of hypertensive patients. Asian J Androl 8:177–182

    PubMed  Article  CAS  Google Scholar 

  23. Lundberg P, Biriell C (1993) Impotence—the drug risk factor. Int J Impot Res 5:237–239

    Google Scholar 

  24. Bonita R, Steward A, Beaglehole R (1995) International trends in stroke mortality. Stroke 21:989–992

    Google Scholar 

  25. Bener A, Al Suwaidi J, Al-Jaber K et al (2004) The epidemiology of hypertension and its associated risk factors in the Qatari population. J Hum Hypertens 18:529–530

    PubMed  Article  CAS  Google Scholar 

  26. Carod J, Egido J, Gonzalex JL et al (1999) Post stroke sexual dysfunction and quality of life. Stroke 30:2238–2248

    PubMed  CAS  Google Scholar 

  27. Sasayama S, Ishii N, Ishikura F et al (2003) Epidemiology of erectile dysfunction and cardiovascular disease. Circ J 67:656–659

    PubMed  Article  Google Scholar 

  28. Mak R, De Backer G, Kornitzer M et al (2002) Prevalence and correlates of erectile dysfunction in a population based study in Belgium. Eur Urol 41:132–138

    PubMed  Article  Google Scholar 

  29. Weiss RJ (1991) Effects of antihypertensive agents on sexual function. Am Fam Physician 44:2075–2082

    PubMed  CAS  Google Scholar 

  30. Jensen J, Lendorf A, Stimpel H et al (1999) The prevalence and etiology of impotence in 101 male hypertensive outpatients. Am J Hypertens 23:271–275

    Article  Google Scholar 

  31. Mirone V, Lmbimbo C, Bortolotti A et al (2002) Cigarette smoking as risk factor for ED: results from an Italian epidemiological study. Eur Urol 41:294–297

    PubMed  Article  Google Scholar 

  32. Jung JH, Kwon OY, Hyun JS (2006) The changes of male sexual dysfunction after stroke: correlations of brain lesions and sexual functions. Korean J Androl 24:71–75

    Google Scholar 

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Acknowledgments

The project was supported and funded by the Diabetic Association and Qatar Foundation, which we thank for generous support and help while this project was being conducted. We also would like to thank the Hamad Medical Corporation for their approval of this study.

Author information

Affiliations

  1. Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Weill Cornell Medical College Qatar, P.O. Box 3050, Doha, Qatar

    Abdulbari Bener

  2. Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, Manchester, UK

    Abdulbari Bener

  3. Qatar Diabetic Associations and Qatar Foundation, Doha, Qatar

    Abdulla O. A. A. Al-Hamaq

  4. Department of Neurology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar

    Saadat Kamran

  5. Department of Urology, Hamad Medical Corporation, Doha, Qatar

    Abdullah Al-Ansari

Authors
  1. Abdulbari Bener
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  2. Abdulla O. A. A. Al-Hamaq
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  3. Saadat Kamran
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  4. Abdullah Al-Ansari
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Corresponding author

Correspondence to Abdulbari Bener.

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Bener, A., Al-Hamaq, A.O.A.A., Kamran, S. et al. Prevalence of erectile dysfunction in male stroke patients, and associated co-morbidities and risk factors. Int Urol Nephrol 40, 701–708 (2008). https://doi.org/10.1007/s11255-008-9334-y

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  • DOI: https://doi.org/10.1007/s11255-008-9334-y

Keywords

  • Diabetes
  • Epidemiology
  • Erectile dysfunction
  • Hypertension
  • IIEF
  • Qatari population
  • Risk factors
  • Stroke