Erectile Dysfunction, Endothelium Dysfunction, and Microvascular Damage in Patients with Systemic Sclerosis
Article first published online: 27 FEB 2013
© 2013 International Society for Sexual Medicine
The Journal of Sexual Medicine
Volume 10, Issue 5, pages 1380–1388, May 2013
How to Cite
Erectile dysfunction, endothelium dysfunction, and microvascular damage in patients with systemic sclerosis. J Sex Med 2013;10:1380–1388., , , , , , , , , and .
- Issue published online: 25 APR 2013
- Article first published online: 27 FEB 2013
- Erectile Dysfunction;
- Raynaud's Phenomenon;
- Systemic Sclerosis;
- Connective Tissue Disorders;
- Sexual Dysfunction
Erectile dysfunction (ED) prevalence in men with systemic sclerosis (SSc) is high and can be considered a manifestation of endothelium damage.
This study aims to correlate ED with endothelial dysfunction and digital vascular damage in SSc patients.
Main Outcome Measures
The main outcome measures were erectile function, Doppler indices of cavernous arteries, flow-mediated dilation (FMD), capillaroscopic damage, skin perfusion, and digital pulsatility.
In 23 SSc patients, erectile function was investigated using the International Index of Erectile Function-5 (IIEF-5). Doppler indices of cavernous arteries, peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) were measured at the penoscrotal junction before and after pharmacostimulation with 20 mg prostaglandin E1. FMD and nailfold videocapillaroscopy (NVC) were used to evaluate endothelial dysfunction and capillaroscopic damage. Skin perfusion and digital sphygmic waves were measured by laser Doppler perfusion imaging (LDPI) and digital photoplethysmography (PPG), respectively.
IIEF-5 score was reduced in 83% of patients. PSV was reduced in 96%, while EDV was increased in 48% of patients. A positive correlation was observed between IIEF-5 score and FMD (r = 0.71, P < 0.0001) and between the former and PSV (r = 0.76, P < 0.0001). A negative correlation was observed between EDV and FMD (r = −0.509, P < 0.01). FMD and Doppler indices were reduced with capillaroscopic damage progression. A positive correlation exists between LDPI perfusion and IIEF-5 score (r = 0.743, P < 0.0001) and between the former and PSV (r = 0.714, P < 0.0001), while a negative correlation is observed between LDPI perfusion and EDV (r = −0.677, P < 0.0001). A positive correlation exists between PPG pulsatility and IIEF-5 score (r = 0.752, P < 0.0001) and between the former and PSV (r = 0.747, P < 0.0001), while negative correlation is observed between PPG pulsatility and EDV (r = −0.689, P < 0.0001).
In SSc patients, ED correlates with endothelial dysfunction and digital microvascular damage.