AUA 2017: Risk Factors For Erectile Dysfunction In A Population Based Cohort

Boston, MA ( Erectile dysfunction (ED) has been associated with multiple disease states and medications. However, few studies have evaluated these risk factors in a population-based model. Dr. Bailey presented a study seeking to evaluate risk factors for ED using a population-based database.

The Olmstead County Study of Urinary Symptoms and Health Status among Men represents a prospective, ongoing study of men aged 40 and older and living in Olmsted County, Minnesota. The database includes detailed information on demographics, laboratory testing, medications, and comorbid conditions as well as assessments of erectile function using the Brief Male Sexual Inventory (BMSI) beginning in 2002. Exclusion criteria included men without a sexual partner or those with prior pelvic surgery. Univariate and multivariate analyses were performed on various medical conditions and medication use to assess correlation with the BMSI scores. Additional models were used to compare the impact of different severity levels of disease (indirectly measured by the number of medications used for that condition).

A total of 937 men were included in the study with a mean age of 61 years (SD 8.7). Mean BMSI score was 7.4 (3.6). Univariate analysis demonstrated age, hypertension, hyperlipidemia, diabetes, chronic kidney disease, myocardial infarction (MI), stroke, coronary artery disease (CAD), and benign prostatic hyperplasia (BPH) to all be associated with lower BMSI scores (p<0.05). When controlling for all significant univariate risk factors, only age (parameter estimate [PE] -0.2/year over age 40), cardiovascular disease (MI, stroke, CAD; PE -0.7), diabetes (PE -0.7), insulin (PE -2.0), and beta-blocker use (PE -0.6) maintained significance (p<0.05). In terms of equivalence for factors contributing to erectile dysfunction, these data suggests that beta-blocker use is equivalent to 3 years of aging, cardiovascular disease and diabetes are equivalent to 3.5 years of aging, and insulin use to 10 years of aging.

In conclusion, multiple risk factors are associated with ED. These data can help guide patient counseling regarding modifiable risk factors in an attempt of delaying ED as long as possible.

Presented By: George Bailey, Rochester, MN

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA