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Is Diabetic Erectile Dysfunction More Difficult to Treat?

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Oral Pharmacotherapy for Male Sexual Dysfunction

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Approximately 35 to 75% of men with diabetes mellitus (DM) have erectile dysfunction (ED). ED occurs about 5 to 10 yr earlier in men with diabetes than in age-matched controls (1). In a cross-sectional survey of 541 men with diabetes at a community-based clinic, the prevalence of ED increased progressively with age, from 6% in men aged 20 to 24 yr to 52% in those aged 55 to 59 yr (2). After the age of 60, 55 to 95% of men with diabetes are affected by ED, compared with approx 50% in an unselected population in the Massachusetts Aging Male Survey (3,4). In another cohort of patients who had type 1 diabetes for at least 10 yr, ED was reported in 1.1% of men aged 21 to 30 yr, 55% of men aged 50 to 60 yr, and 75% of men older than 60 yr (5).

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References

  1. Romeo JH, Seftel AD, Madhun ZT, et al. (2000) Sexual function in men with diabetes type 2: association with glycemic control. J Urol 163:788–791.

    Article  PubMed  CAS  Google Scholar 

  2. McCulloch DK, Campbell IW, Wu FC, et al. (1980) The prevalence of diabetic impotence. Diabetologia 18:279–283.

    Article  PubMed  CAS  Google Scholar 

  3. Feldman HA, Goldstein I, Hatzichristou DG, et al. (1994) Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 151:54–61.

    PubMed  CAS  Google Scholar 

  4. Kaiser FE. (1999) Erectile dysfunction in the aging man. Med Clin North Am 83:1267–1278.

    Article  PubMed  CAS  Google Scholar 

  5. Klein R, Klein BE, Lee KE, et al. (1996) Prevalence of self-reported erectile dysfunction in people with long-term IDDM. Diabetes Care 19:135–141.

    Article  PubMed  CAS  Google Scholar 

  6. Richardson D, Vinik A. (2002) Etiology and treatment of erectile failure in diabetes mellitus. Curr Diab Rep 2:501–509.

    Article  PubMed  Google Scholar 

  7. Fink HA, Mac DR, Rutks IR, et al. (2002) Sildenafil for male erectile dysfunction: a systematic review and meta-analysis. Arch Intern Med 162:1349–1360.

    Article  PubMed  CAS  Google Scholar 

  8. Guay AT, Perez JB, Velasquez E, et al. (2000) Clinical experience with intraurethral alprostadil (MUSE) in the treatment of men with erectile dysfunction. A retrospective study. Medicated urethral system for erection. Eur Urol 38:671–676.

    Article  PubMed  CAS  Google Scholar 

  9. Calles-Escandon J, Cipolla M. (2001) Diabetes and endothelial dysfunction: a clinical perspective. Endocr Rev 22:36–52.

    Article  PubMed  CAS  Google Scholar 

  10. De Angelis L, Marfella MA, Siniscalchi M, et al. (2001) Erectile and endothelial dysfunction in type II diabetes: a possible link. Diabetologia 44:1155–1160.

    Article  PubMed  Google Scholar 

  11. Levine LA, Kloner RA. (2000) Importance of asking questions about erectile dysfunction. Am J Cardiol 86:1210.

    Article  PubMed  CAS  Google Scholar 

  12. Theuma P, Fonseca VA. (2003) Novel cardiovascular risk factors and macrovascular and microvascular complications of diabetes. Curr Drug Targets 4:477–486.

    Article  PubMed  CAS  Google Scholar 

  13. Lin KY, Ito A, Asagami T, et al. (2002) Impaired nitric oxide synthase pathway in diabetes mellitus: role of asymmetric dimethylarginine and dimethylarginine dimethylaminohydrolase. Circulation 106:987–992.

    Article  PubMed  CAS  Google Scholar 

  14. Cartledge JJ, Eardley I, Morrison JF. (2000) Impairment of corpus cavernosal smooth muscle relaxation by glycosylated human haemoglobin. BJU Int 85:735–741.

    Article  PubMed  CAS  Google Scholar 

  15. Sasaki T, Yasuda H, Maeda K, et al. (1998) Hyperalgesia and decreased neuronal nitric oxide synthase in diabetic rats. Neuroreport 9:243–247.

    PubMed  CAS  Google Scholar 

  16. Veves A, Akbari CM, Primavera J, et al. (1998) Endothelial dysfunction and the expression of endothelial nitric oxide synthetase in diabetic neuropathy, vascular disease, and foot ulceration. Diabetes 47:457–463.

    Article  PubMed  CAS  Google Scholar 

  17. Carson CC, Burnett AL, Levine LA, et al. (2002) The efficacy of sildenafil citrate (Viagra) in clinical populations: an update. Urology 60:12–27.

    Article  PubMed  Google Scholar 

  18. Brock GB, McMahon CG, Chen KK, et al. (2002) Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses. J Urol 168:1332–1336.

    Article  PubMed  CAS  Google Scholar 

  19. Porst H, Rosen R, Padma-Nathan H, et al. (2001) The efficacy and tolerability of vardenafil, a new, oral, selective phosphodiesterase type 5 inhibitor, in patients with erectile dysfunction: the first at-home clinical trial. Int J Impot Res 13:192–199.

    Article  PubMed  CAS  Google Scholar 

  20. Desouza C, Parulkar A, Lumpkin D, et al. (2002) Acute and prolonged effects of sildenafil on brachial artery flow-mediated dilatation in type 2 diabetes. Diabetes Care 25:1336–1339.

    Article  PubMed  CAS  Google Scholar 

  21. Katz SD, Balidemaj K, Homma S, et al. (2000) Acute type 5 phosphodiesterase inhibition with sildenafil enhances flow-mediated vasodilation in patients with chronic heart failure. J Am Coll Cardiol 36:845–851.

    Article  PubMed  CAS  Google Scholar 

  22. Halcox JP, Nour KR, Zalos G, et al. (2002) The effect of sildenafil on human vascular function, platelet activation, and myocardial ischemia. J Am Coll Cardiol 40:1232–1240.

    Article  PubMed  CAS  Google Scholar 

  23. Carosa E, Martini P, Brandetti F, et al. (2004) Type V phosphodiesterase inhibitor treatments for erectile dysfunction increase testosterone levels. Clin Endocrinol (Oxf). 61:382–386.

    Article  CAS  Google Scholar 

  24. Padma-Nathan H, Hellstrom WJ, Kaiser FE, et al. (1997) Treatment of men with erectile dysfunction with transurethral alprostadil. Medicated Urethral System for Erection (MUSE) Study Group. N Engl J Med 336:1–7.

    Article  PubMed  CAS  Google Scholar 

  25. Price DE, Cooksey G, Jehu D, et al. (1991) The management of impotence in diabetic men by vacuum tumescence therapy. Diabet Med 8:964–967.

    Article  PubMed  CAS  Google Scholar 

  26. Carson CC, Mulcahy JJ, Govier FE. (2000) Efficacy, safety and patient satisfaction outcomes of the AMS 700CX inflatable penile prosthesis: results of a long-term multicenter study. AMS 700CX Study Group. J Urol 164:376–380.

    Article  PubMed  CAS  Google Scholar 

  27. Benet AE, Sharaby JS, Melman A. (1994) Male erectile dysfunction assessment and treatment options. Compr Ther 20:669–6673.

    PubMed  CAS  Google Scholar 

  28. Guay AT, Spark RF, Jacobson J, et al. (2002) Yohimbine treatment of organic erectile dysfunction in a dose-escalation trial. Int J Impot Res 14:25–31.

    Article  PubMed  CAS  Google Scholar 

  29. Ernst E, Pittler MH. (1998) Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials. J Urol 159:433–436.

    Article  PubMed  CAS  Google Scholar 

  30. Spark RF, White RA, Connolly PB. (1980) Impotence is not always psychogenic. Newer insights into hypothalamic-pituitary-gonadal dysfunction. JAMA 243:750–755.

    Article  PubMed  CAS  Google Scholar 

  31. Tan RS, Pu SJ. (2002) Impact of obesity on hypogonadism in the andropause. Int J Androl 25:195–201.

    Article  PubMed  CAS  Google Scholar 

  32. Leifke E, Gorenoi V, Wichers C. et al. (2000) Age-related changes of serum sex hormones, insulin-like growth factor-1 and sex-hormone binding globulin levels in men: cross-sectional data from a healthy male cohort. Clin Endocrinol (Oxf) 53:689–695.

    Article  CAS  Google Scholar 

  33. Fukui M, Kitagawa Y, Nakamura N, et al. (2003) Association between serum testosterone concentration and carotid atherosclerosis in men with type 2 diabetes. Diabetes Care 26:1869–1873.

    Article  PubMed  CAS  Google Scholar 

  34. Guay AT, Bansal S, Heatley GJ. (1995) Effect of raising endogenous testosterone levels in impotent men with secondary hypogonadism: double blind placebo-controlled trial with clomiphene citrate. J Clin Endocrinol Metab 80:3546–3552.

    Article  PubMed  CAS  Google Scholar 

  35. Wei M, Macera CA, Davis DR, et al. (1994) Total cholesterol and high density lipoprotein cholesterol as important predictors of erectile dysfunction. Am J Epidemiol 140:930–937.

    PubMed  CAS  Google Scholar 

  36. Saltzman EA, Guay AT, Jacobson J. (2004) Improvement in erectile function in men with organic erectile dysfunction by correction of elevated cholesterol levels: a clinical observation. J Urol 172:255–258.

    Article  PubMed  Google Scholar 

  37. Moyad MA, Hathaway S, Ni HS. (1999) Traditional Chinese medicine, acupuncture, and other alternative medicines for prostate cancer: an introduction and the need for more research. Semin Urol Oncol 17:103–110.

    PubMed  CAS  Google Scholar 

  38. Colberg SR, Stansberry KB, McNitt PM, et al. (2002) Chronic exercise is associated with enhanced cutaneous blood flow in type 2 diabetes. J Diabetes Complications 16:139–145.

    Article  PubMed  Google Scholar 

  39. Jiaan DB, Seftel AD, Fogarty J, et al. (1995) Age-related increase in an advanced glycation end product in penile tissue. World J Urol 13:369–375.

    Article  PubMed  CAS  Google Scholar 

  40. Plante GE. (2002) Vascular response to stress in health and disease. Metabolism 51:25–30.

    Article  PubMed  CAS  Google Scholar 

  41. Seftel AD, Vaziri ND, Ni Z, et al. (1997) Advanced glycation end products in human penis: elevation in diabetic tissue, site of deposition, and possible effect through iNOS or eNOS. Urology 50:1016–1026.

    Article  PubMed  CAS  Google Scholar 

  42. Xie Y, Garban H, Ng C, et al. (1997) Effect of long-term passive smoking on erectile function and penile nitric oxide synthase in the rat. J Urol 157:1121–1126.

    Article  PubMed  CAS  Google Scholar 

  43. Bivalacqua TJ, Usta MF, Champion HC, et al. (2003) Gene transfer of endothelial nitric oxide synthase partially restores nitric oxide synthesis and erectile function in streptozotocin diabetic rats. J Urol 169:1911–1917.

    Article  PubMed  CAS  Google Scholar 

  44. Jevtich MJ, Edson M, Jarman WD, et al. (1982) Vascular factor in erectile failure among diabetics. Urology 19:163–168.

    Article  PubMed  CAS  Google Scholar 

  45. Burchardt T, Burchardt M, Karden J, et al. (2000) Reduction of endothelial and smooth muscle density in the corpora cavernosa of the streptozotocin induced diabetic rat. J Urol 164:1807–1811.

    Article  PubMed  CAS  Google Scholar 

  46. Bemelmans BL, Meuleman EJ, Doesburg WH, et al. (1994) Erectile dysfunction in diabetic men: the neurological factor revisited. J Urol 151:884–889.

    PubMed  CAS  Google Scholar 

  47. Vernet D, Cai L, Garban H, et al. (1995) Reduction of penile nitric oxide synthase in diabetic BB/WORdp (type I) and BBZ/WORdp (type II) rats with erectile dysfunction. Endocrinology 136:5709–5717.

    Article  PubMed  CAS  Google Scholar 

  48. Stuckey BG, Jadzinsky MN, Murphy LJ, et al. (2003) Sildenafil citrate for treatment of erectile dysfunction in men with type 1 diabetes: results of a randomized controlled trial. Diabetes Care 26:279–284.

    Article  PubMed  CAS  Google Scholar 

  49. Boulton AJ, Selam JL, Sweeney M, et al. (2001) Sildenafil citrate for the treatment of erectile dysfunction in men with type II diabetes mellitus. Diabetologia 44:1296–1301.

    Article  PubMed  CAS  Google Scholar 

  50. Saenz de Tejada I, Anglin G, Knight JR, et al. (2002) Effects of tadalafil on erectile dysfunction in men with diabetes. Diabetes Care 25:2159–2164.

    Article  PubMed  Google Scholar 

  51. Goldstein I, Young JM, Fischer J, et al. (2003) Vardenafil, a new phosphodiesterase type 5 inhibitor, in the treatment of erectile dysfunction in men with diabetes: a multicenter double-blind placebo-controlled fixed-dose study. Diabetes Care 26:777–783.

    Article  PubMed  CAS  Google Scholar 

  52. Padma-Nathan H, Steers WD, Wicker PA. (1998) Efficacy and safety of oral sildenafil in the treatment of erectile dysfunction: a double-blind, placebo-controlled study of 329 patients. Sildenafil Study Group. Int J Clin Pract 52:375–379.

    PubMed  CAS  Google Scholar 

  53. Hellstrom WJ, Gittelman M, Karlin G, et al. (2002) Vardenafil for treatment of men with erectile dysfunction: efficacy and safety in a randomized, double-blind, placebo-controlled trial. J Androl 23:763–771.

    PubMed  CAS  Google Scholar 

  54. Valdevenito R, Melman A. (1994) Intracavernous self-injection pharmacotherapy program: analysis of results and complications. Int J Impot Res 6:81–91.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Section of Endocrinology, Department of Medicine, Tulane University School of Medicine, Veterans Affairs Medical Center, New Orleans, LA

    Pierre Theuma MD & Vivian A. Fonseca MD

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  1. Pierre Theuma MD
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  2. Vivian A. Fonseca MD
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Editors and Affiliations

  1. Department of Urology, Mayo Clinic College of Medicine, Jacksonville, FL

    Gregory A. Broderick MD

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© 2005 Humana Press Inc., Totowa, NJ

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Theuma, P., Fonseca, V.A. (2005). Is Diabetic Erectile Dysfunction More Difficult to Treat?. In: Broderick, G.A. (eds) Oral Pharmacotherapy for Male Sexual Dysfunction. Current Clinical Urology. Humana Press. https://doi.org/10.1385/1-59259-871-4:221

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  • DOI: https://doi.org/10.1385/1-59259-871-4:221

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-451-7

  • Online ISBN: 978-1-59259-871-7

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