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Vasculogenic Erectile Dysfunction and Metabolic Syndrome


Orhan Koca, MD, Haydarpaşa Numune Eğitim ve Araştırma Hastanesi II. Üroloji Kl, Üsküdar, Istanbul 34718,Turkey. Tel: +90 216 414 45 02; Fax: +90 216 345 59 82; E-mail:


Introduction.  Erectile dysfunction (ED), defined as the inability to achieve and/or maintain a penile erection sufficient for sexual intercourse, is a health problem affecting more than one-half of men between the age of 40 and 70 years.

Aim.  The aim of the present study was to determine the potential factors affecting penile vascular flow and predictability of vascular flow in patients with ED.

Methods.  Totally 163 male patients between 29 and 82 years of age who were admitted to our outpatient clinic with complaints of ED were included. After a detailed medical history was obtained, all patients were asked to complete the International Index of Erectile Function (IIEF) questionnaire. Blood samples were obtained for measurements of serum cholesterol, triglycerides, and fasting blood glucose (FBG), and the body mass index (BMI) was calculated.

Main Outcome Measures.  Penile color Doppler ultrasonography (PDU) was performed to evaluate flow patterns, Mann–Whitney U-test and Spearman correlation analyses were used to assess the relationship of PDU findings with hypertension, obesity (BMI ≥ 25 kg/m2), FBG, and cholesterol levels measurements.

Results.  The mean age, IIEF score, and BMI of the study population was 51.3 ± 12.1 years, 11.9 ± 6.1 and 28.5 ± 4.0 kg/m2, respectively. When the vascular pathologies detected with PDU and the presence of risk factors were compared, no significant correlation was determined between arterial insufficiency and metabolic syndrome (MS), whereas there was a significant correlation between veno-occlusive dysfunction and MS.

Conclusion.  The prevalence of ED increases with advanced age and with the presence of a systemic disease. Basic evaluations may not always be sufficient for assessment of ED. In the presence of MS, the use of penile Doppler ultrasonography should be considered for the evaluation of penile vascular structures in ED patients. Koca O, Çalışkan S, Öztürk Mİ, Güneş M, Kılıçoğlu G, and Karaman MI. Vasculogenic erectile dysfunction and metabolic syndrome. J Sex Med 2010;7:3997–4002.