The effect of vascular risk factors on penile vascular status in men with erectile dysfunction

Purpose: The cause of erectile dysfunction is mostly organic in nature and is most commonly associated with a vasculogenic etiology. This study evaluates the relationship between penile hemodynamic parameters and vascular risk factors in men with erectile dysfunction. Materials and Methods: A total of 1,216 patients with erectile dysfunction were evaluated regarding the relationship between vascular risk factors and penile vascular parameters. The patients were stratified according to the type and number of risk factors present. Each patient underwent a penile duplex Doppler ultrasound study after injections of intracavernous prostaglandin El with accompanying visual sexual stimulation to evaluate penile blood flow parameters. Specific criteria were used to categorize patients according to varying definitions of vascular status. The odds ratio for selected vascular risk factors was calculated. The rates of arterial insufficiency, venoocclusive dysfunction, mixed vascular disease and nonvascular etiologies were also evaluated. These results were statistically compared to those from patients with erectile dysfunction without vascular risk factors. Results: The poorest blood flow parameters were observed in patients with erectile dysfunction with coronary artery disease and diabetes. Arterial insufficiency was most prevalent in patients with coronary artery disease, followed by diabetes. Paradoxically, it was least likely to occur in the smoking group. Venoocclusive dysfunction was observed most often in hypertensive patients with erectile dysfunction. The odds ratio for having abnormal penile blood flow parameters correlated with the number of vascular risk factors present. Conclusions: This study demonstrates that vascular risk factors are associated with abnormalities in the hemodynamics of blood vessels. Moreover, the number of vascular risk factors correlates with an increased likelihood of having abnormal penile vascular parameters.