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Elizabeth A Platz - One of the best experts on this subject based on the ideXlab platform.
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a prospective study of lower urinary tract symptoms and Erectile Dysfunction
The Journal of Urology, 2008Co-Authors: Alison M Mondul, Eric B Rimm, Edward Giovannucci, Dale B Glasser, Elizabeth A PlatzAbstract:Purpose: Several studies have shown that men with lower urinary tract symptoms are more likely to experience Erectile Dysfunction. All except 1 of these studies were cross-sectional, limiting inferences about whether lower urinary tract symptoms precipitate Erectile Dysfunction.Materials and Methods: The association between lower urinary tract symptoms and incident Erectile Dysfunction was examined prospectively in the Health Professionals Follow-Up Study. Lower urinary tract symptoms were assessed biennially by the American Urological Association symptom index, which captures symptoms of frequency, urgency and force of urinary stream. Severe lower urinary tract symptoms was defined as a symptom score of 20 points or greater and no lower urinary tract symptoms was defined as a score of 7 points or less in men not treated for lower urinary tract symptoms. In 2000 the men were asked to rate Erectile function for several periods. Erectile Dysfunction was defined as poor or very poor function, or Erectile dys...
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prevalence and risk factors for Erectile Dysfunction in the us
The American Journal of Medicine, 2007Co-Authors: Elizabeth Selvin, Arthur L Burnett, Elizabeth A PlatzAbstract:Abstract Purpose To assess the prevalence of Erectile Dysfunction and to quantify associations between putative risk factors and Erectile Dysfunction in the US adult male population. Methods Cross-sectional analysis of data from 2126 adult male participants in the 2001-2002 National Health and Nutrition Examination Survey (NHANES). Erectile Dysfunction assessed by a single question during a self-paced, computer-assisted self-interview. These data are nationally representative of the noninstitutionalized adult male population in the US. Results The overall prevalence of Erectile Dysfunction in men aged ≥20 years was 18.4% (95% confidence interval [CI], 16.2-20.7), suggesting that Erectile Dysfunction affects 18 million men (95% CI, 16-20) in the US. The prevalence of Erectile Dysfunction was highly positively related to age but was also particularly high among men with one or more cardiovascular risk factors, men with hypertension, and men with a history of cardiovascular disease, even after age adjustment. Among men with diabetes, the crude prevalence of Erectile Dysfunction was 51.3% (95% CI, 41.9-60.7). In multivariable analyses, Erectile Dysfunction was significantly and independently associated with diabetes, lower attained education, and lack of physical activity. Conclusions The high prevalence of Erectile Dysfunction among men with diabetes and hypertension suggests that screening for Erectile Dysfunction in these patients may be warranted. Physical activity and other measures for the prevention of cardiovascular disease and diabetes may prevent decrease in Erectile function.
Brendon Stubbs - One of the best experts on this subject based on the ideXlab platform.
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high prevalence of Erectile Dysfunction in diabetes a systematic review and meta analysis of 145 studies
Diabetic Medicine, 2017Co-Authors: Youssef Kouidrat, Damiano Pizzol, Theodore D Cosco, Trevor Thompson, M Carnaghi, Alessandro Bertoldo, Marco Solmi, Brendon StubbsAbstract:Erectile Dysfunction may be common among men with diabetes, but its prevalence is still debated. We aimed to assess the relative prevalence of Erectile Dysfunction in diabetes searching major databases from inception to November 2016 for studies reporting Erectile Dysfunction in men with Type 1 and Type 2 diabetes mellitus. We conducted a meta-analysis of the prevalence [and 95% confidence intervals (95% CIs)] of Erectile Dysfunction in diabetes compared with healthy controls, calculating the relative odds ratios (ORs) and 95% CIs. A random effect model was applied. From 3747 initial hits, 145 studies were included representing 88 577 men (age: 55.8 ` 7.9 years). The prevalence of Erectile Dysfunction in diabetes overall was 52.5% (95% CI, 48.8 to 56.2) after adjusting for publication bias, and 37.5%, 66.3% and 57.7% in Type 1, Type 2 and both types of diabetes, respectively (P for interaction < 0.0001). The prevalence of Erectile Dysfunction was highest in studies using the Sexual Health Inventory for Men (82.2%, 17 studies, P for interaction < 0.0001). Studies with a higher percentage of people with hypertension moderated our results (beta = 0.03; 95% CI, 0.008 to 0.040; P = 0.003; R2 = 0.00). Compared to healthy controls (n = 5385) men with diabetes (n = 863) were at increased odds of having Erectile Dysfunction (OR 3.62; 95% CI, 2.53 to 5.16; P < 0.0001; I2 = 67%, k = 8). Erectile Dysfunction is common in diabetes, affecting more than half of men with the condition and with a prevalence odds of approximately 3.5 times more than controls. Our findings suggest that screening and appropriate intervention for men with Erectile Dysfunction is warranted.
Kevin T. Mcvary - One of the best experts on this subject based on the ideXlab platform.
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Erectile Dysfunction aua guideline
The Journal of Urology, 2018Co-Authors: Arthur L Burnett, Lawrence S. Hakim, Ajay Nehra, Kevin T. Mcvary, Rodney H Breau, Daniel J Culkin, Martha M Faraday, Joel J Heidelbaugh, Mohit Khera, Martin MinerAbstract:Purpose: The purpose of this guideline is to provide a clinical strategy for the diagnosis and treatment of Erectile Dysfunction.Materials and Methods: A systematic review of the literature using the Pubmed, Embase, and Cochrane databases (search dates 1/1/1965 to 7/29/17) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of Erectile Dysfunction. Evidence-based statements were based on body of evidence strength Grade A, B, or C and were designated as Strong, Moderate, and Conditional Recommendations with additional statements presented in the form of Clinical Principles or Expert Opinions.Results: The American Urological Association has developed an evidence-based guideline on the management of Erectile Dysfunction. This document is designed to be used in conjunction with the associated treatment algorithm.Conclusions: Using the shared decision-making process as a cornerstone for care, all patients should be informed of all treatment modalities that are not contr...
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Erectile Dysfunction and lower urinary tract symptoms
European urology focus, 2017Co-Authors: Cosimo De Nunzio, Claus G Roehrborn, Karlerik Andersson, Kevin T. McvaryAbstract:Abstract Context Lower urinary tract symptoms (LUTSs) and Erectile Dysfunction (ED) are substantial health concerns with a significant impact on the overall male quality of life. Objective To evaluate the available evidence of the association between LUTSs and ED in patients with benign prostatic hyperplasia (BPH), and discuss possible clinical implications for the management of LUTS/BPH. Evidence acquisition A systematic review of the existing literature published between 1997 and June 2017 and available in the Medline, Scopus, and Web of Science databases was conducted using both the Medical Subject Heading (MeSH) and free-text protocols. The MeSH search was conducted by combining the following terms: "lower urinary tract symptoms," "LUTS," "benign prostatic hyperplasia," "BPH," "Erectile Dysfunction," "sexual Dysfunction," "BPE," and "benign prostatic enlargement." The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Evidence synthesis Several community-based studies in different geographical areas have provided strong evidence of an age-independent association between LUTSs and ED. Several biological mechanisms have been proposed to explain this association, but further research is required to better understand the molecular pathways involved. It is necessary to evaluate the possible impact of the metabolic syndrome treatment on LUTS/ED management. Considering the possible relationship between LUTSs and ED, their impact on the quality of life, and the possible adverse effects associated with LUTS medical treatment, clinicians should always evaluate ED in patients with LUTSs and take the opportunity to evaluate patients reporting ED for LUTSs. Conclusions Data from the peer-reviewed literature suggest the existence of an association between LUTS/BPH and ED, although their casual relationship has not been established yet. Emerging data also suggest that pathophysiological mechanisms involved in the metabolic syndrome are key factors in both disorders. Considering the association, it is also recommended that men presenting with LUTSs or ED should be evaluated for both disorders. A better understanding of the molecular pathways behind this association may also help identify new possible targets and develop novel therapeutic approaches to manage LUTSs and ED. Patient summary In this manuscript, we report on all the available evidence linking Erectile Dysfunction and lower urinary tract symptoms. Our findings suggest the existence of a strong relationship between these two conditions. On the basis of these findings, we recommend that clinicians always explore both conditions in male patients presenting with either of symptoms.
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papaverine topical gel for treatment of Erectile Dysfunction
The Journal of Urology, 1995Co-Authors: Ragab Elrashidy, Kevin T. McvaryAbstract:ABSTRACTIntracavernous injection of vasoactive substances has been shown to be an effective means of treatment of organic Erectile Dysfunction. However, up to 50% of men eventually discontinue treatment often because of lack of spontaneity and needle phobia. This study was done as a phase I, placebo controlled, nonblinded investigation of the safety and efficacy of a topical papaverine gel in the treatment of Erectile Dysfunction. Of 20 men with organic impotence 17 completed the trial and 13 of these patients had spinal cord injuries. After application of a 15% and 20% papaverine base gel to the scrotum, perineum and penis, cavernous artery diameter was significantly increased (36%, p <0.001) as assessed by color flow Doppler ultrasound. Peak systolic flow velocity increased 26%. Only 3 of 14 patients achieved an increase in cavernous artery diameter of 75% or more and 2 of 14 had a peak systolic flow velocity of 25 cm. per second or more after application of a topical base gel. Similar findings were pre...
Martin Miner - One of the best experts on this subject based on the ideXlab platform.
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Erectile Dysfunction aua guideline
The Journal of Urology, 2018Co-Authors: Arthur L Burnett, Lawrence S. Hakim, Ajay Nehra, Kevin T. Mcvary, Rodney H Breau, Daniel J Culkin, Martha M Faraday, Joel J Heidelbaugh, Mohit Khera, Martin MinerAbstract:Purpose: The purpose of this guideline is to provide a clinical strategy for the diagnosis and treatment of Erectile Dysfunction.Materials and Methods: A systematic review of the literature using the Pubmed, Embase, and Cochrane databases (search dates 1/1/1965 to 7/29/17) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of Erectile Dysfunction. Evidence-based statements were based on body of evidence strength Grade A, B, or C and were designated as Strong, Moderate, and Conditional Recommendations with additional statements presented in the form of Clinical Principles or Expert Opinions.Results: The American Urological Association has developed an evidence-based guideline on the management of Erectile Dysfunction. This document is designed to be used in conjunction with the associated treatment algorithm.Conclusions: Using the shared decision-making process as a cornerstone for care, all patients should be informed of all treatment modalities that are not contr...
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cardiovascular disease prevention in men with vascular Erectile Dysfunction the view of the preventive cardiologist
The American Journal of Medicine, 2016Co-Authors: Nishant P Shah, Martin Miner, Miguel Cainzosachirica, David I Feldman, Roger S Blumenthal, Khurram Nasir, Kevin L Billups, Michael J BlahaAbstract:Vascular Erectile Dysfunction is a powerful marker of increased cardiovascular risk. However, current guidelines lack specific recommendations on the role that the evaluation of vascular Erectile Dysfunction should play in cardiovascular risk assessment, as well on the risk stratification strategy that men with vascular Erectile Dysfunction should undergo. In the last 3 years, Erectile Dysfunction experts have made a call for more specific guidance and have proposed the selective use of several prognostic tests for further cardiovascular risk assessment in these patients. Among them, stress testing has been prioritized, whereas other tests are considered second-line tools. In this review, we provide additional perspective from the viewpoint of the preventive cardiologist. We discuss the limitations of current risk scores and the potential interplay between Erectile Dysfunction assessment and the use of personalized prognostic tools, such as the coronary artery calcium score, in the cardiovascular risk stratification and management of men with vascular Erectile Dysfunction. Finally, we present an algorithm for primary care physicians, urologists, and cardiologists to aid clinical decision-making.
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diagnosis and treatment of Erectile Dysfunction for reduction of cardiovascular risk
The Journal of Urology, 2013Co-Authors: Ajay Nehra, Culley C. Carson, G Jackson, Arthur L Burnett, Martin Miner, Kevin L Billups, Jacques Buvat, Glenn R Cunningham, Irwin GoldsteinAbstract:Purpose: We established Erectile Dysfunction as an often neglected but valuable marker of cardiovascular risk, particularly in younger men and men with diabetes. We also reviewed evidence that lifestyle change, combined with informed prescribing of pharmacotherapies used to mitigate cardiovascular risk, can improve overall vascular health and sexual functioning in men with Erectile Dysfunction.Materials and Methods: We performed a PubMed® search for articles and guidelines pertinent to relationships between Erectile Dysfunction and cardiovascular disease, cardiovascular and all cause mortality, and pharmacotherapies for dyslipidemia and hypertension. The clinical guidance presented incorporates the current literature and the expertise of the multispecialty investigator group.Results: Numerous cardiovascular risk assessment tools exist but risk stratification remains challenging, particularly in patients at low or intermediate short-term risk. Erectile Dysfunction has a predictive value for cardiovascular ...
Eric B Rimm - One of the best experts on this subject based on the ideXlab platform.
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association of diet with Erectile Dysfunction among men in the health professionals follow up study
JAMA Network Open, 2020Co-Authors: Benjamin N Breyer, Eric B Rimm, Edward Giovannucci, Scott R Bauer, Meir J Stampfer, Stacey A KenfieldAbstract:Author(s): Bauer, Scott R; Breyer, Benjamin N; Stampfer, Meir J; Rimm, Eric B; Giovannucci, Edward L; Kenfield, Stacey A | Abstract: ImportanceErectile Dysfunction, especially in younger men, is an early sign of cardiovascular disease and may decrease quality of life. Men may be motivated to adopt a healthy dietary pattern if it lowers their risk of Erectile Dysfunction.ObjectiveTo assess the association between adherence to a diet quality index based on healthy dietary patterns and Erectile Dysfunction in men.Design, setting, and participantsThis population-based prospective cohort study included men from the Health Professionals Follow-up Study with follow-up from January 1, 1998, through January 1, 2014. Participants included US male health professionals aged 40 to 75 years at enrollment. Men with Erectile Dysfunction or a diagnosis of myocardial infarction, diabetes, stroke, or genitourinary cancer at baseline were excluded. Analyses were completed in February 2020.ExposuresA food frequency questionnaire was used to determine nutrient and food intake every 4 years.Main outcomes and measuresDiet quality was assessed by Mediterranean Diet score and the Alternative Healthy Eating Index 2010 score, with higher scores indicating healthier diet. Dietary index scores were cumulatively updated from 1986 until men developed Erectile Dysfunction, cardiovascular disease, died, or were lost to follow-up. Incident Erectile Dysfunction was assessed with questionnaires in 2000, 2004, 2008, and 2012. Hazard ratios (HRs) by prespecified categories or quintiles of dietary index scores were estimated using Cox proportional hazards regression analyses stratified by age.ResultsAmong 21 469 men included in analysis, mean (SD) age at baseline was 62 (8.4) years. During a mean (SD) follow-up of 10.8 (5.4) years and 232 522 person-years, there were 968 incident Erectile Dysfunction cases among men younger than 60 years, 3703 cases among men aged 60 to less than 70 years, and 4793 cases among men aged 70 years or older. Men younger than 60 years and in the highest category of the Mediterranean Diet score had the lowest relative risk of incident Erectile Dysfunction compared with men in the lowest category (HR, 0.78; 95% CI, 0.66-0.92). Higher Mediterranean diet scores were also inversely associated with incident Erectile Dysfunction among older men (age 60 to l70 years: HR, 0.82; 95% CI, 0.76-0.89; age ≥70 years: HR, 0.93; 95% CI, 0.86-1.00). Men scoring in the highest quintile of the Alternative Healthy Eating Index 2010 also had a lower risk of incident Erectile Dysfunction, particularly among men age younger than 60 years (quintile 5 vs quintile 1: HR, 0.78; 95% CI, 0.63-0.97).Conclusions and relevanceThis cohort study found that adherence to healthy dietary patterns was associated with a lower risk for Erectile Dysfunction, suggesting that a healthy dietary pattern may play a role in maintaining Erectile health.
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a prospective study of lower urinary tract symptoms and Erectile Dysfunction
The Journal of Urology, 2008Co-Authors: Alison M Mondul, Eric B Rimm, Edward Giovannucci, Dale B Glasser, Elizabeth A PlatzAbstract:Purpose: Several studies have shown that men with lower urinary tract symptoms are more likely to experience Erectile Dysfunction. All except 1 of these studies were cross-sectional, limiting inferences about whether lower urinary tract symptoms precipitate Erectile Dysfunction.Materials and Methods: The association between lower urinary tract symptoms and incident Erectile Dysfunction was examined prospectively in the Health Professionals Follow-Up Study. Lower urinary tract symptoms were assessed biennially by the American Urological Association symptom index, which captures symptoms of frequency, urgency and force of urinary stream. Severe lower urinary tract symptoms was defined as a symptom score of 20 points or greater and no lower urinary tract symptoms was defined as a score of 7 points or less in men not treated for lower urinary tract symptoms. In 2000 the men were asked to rate Erectile function for several periods. Erectile Dysfunction was defined as poor or very poor function, or Erectile dys...
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a prospective study of risk factors for Erectile Dysfunction
The Journal of Urology, 2006Co-Authors: Constance G Bacon, Edward Giovannucci, Dale B Glasser, Murray A Mittleman, Ichiro Kawachi, Eric B RimmAbstract:Purpose: We examined the impact of obesity, physical activity, alcohol use and smoking on the development of Erectile Dysfunction.Materials and Methods: Subjects included 22,086 United States men 40 to 75 years old in the Health Professionals Followup Study cohort who were asked to rate their Erectile function for multiple periods on a questionnaire mailed in 2000. Men who reported good or very good Erectile function and no major chronic disease before 1986 were included in the analyses.Results: Of men who were healthy and had good or very good Erectile function before 1986, 17.7% reported incident Erectile Dysfunction during the 14-year followup. Obesity (multivariate relative risk 1.9, 95% CI 1.6–2.2 compared to men of ideal weight in 1986) and smoking (RR 1.5, 95% CI 1.3–1.7) in 1986 were associated with an increased risk of Erectile Dysfunction, while physical activity (RR 0.7, 95% CI 0.7–0.8 comparing highest to lowest quintile of physical activity) was associated with a decreased risk of Erectile dy...