Is type 2 diabetes mellitus a cause of severe erectile dysfunction in patients with metabolic syndrome?

OBJECTIVES: To determine the effect of type 2 diabetes mellitus (T2DM) as a major risk factor for severe erectile dysfunction (ED) in patients with metabolic syndrome (MS). METHODS: The study included 93 patients aged 30-70 years who had MS and ED. MS patients were divided into 2 groups: 37 patients with neither T2DM nor abnormal fasting glucose level (group 1) and 56 patients with T2DM (group 2). The severity of ED was determined according to the first 5-question version of the International Index of Erectile Function (IIEF-5). The MS was defined according to the 2005 International Diabetes Federation consensus definition. Logistic regression analysis, t test, and chi(2) tests were used to investigate the impact of T2DM on ED severity. RESULTS: The mean age of the patients was 55.5 years (P = .313). Eleven patients in group 1 (29.7%) and 42 patients in group 2 (75%) had severe ED (IIEF-5 score

A classification based on peak systolic velocity and end diastolic velocity predicts sildenafil citrate success.

OBJECTIVE: To attempt to predict the success rate of sildenafil citrate in erectile dysfunction patients using penile Doppler ultrasonography (PDU) measurements of peak arterial velocity and end diastolic velocity. MATERIAL AND METHODS: A total of 212 patients (age range 27-76 years) with vascular pathologies were included in the study. Following a PDU test, the patients were divided into arterial insufficiency, veno-occlusive dysfunction and mixed vascular pathology groups. Subsequently, patients were given sildenafil citrate 50 mg and re-evaluated 1 month later to determine its efficacy. If it was ineffective, the dose was increased to 100 mg and patients were reassessed. Arterial insufficiency and veno-occlusive dysfunction patients were classified into mild, moderate and severe groups depending on peak systolic and end diastolic velocities. RESULTS: The overall response rate in patients with arterial insufficiency was 74.5%, regardless of the degree of arterial insufficiency or the dose of sildenafil. The severe arterial insufficiency group had a much better response to 100 mg compared to 50 mg doses of sildenafil. Although the 50 mg sildenafil dose was effective in patients with minimal veno-occlusive dysfunction, 100 mg was better than 50 mg to achieve adequate erection in the mild and severe veno-occlusive dysfunction groups. CONCLUSIONS: Sildenafil was ineffective in patients with severe arterial and venous insufficiency. PDU and a simple classification of PDU velocity measurements can provide some important clues to the prognosis of treatment and avoid overtreatment and unnecessary office visits.