Erectile Dysfunction Is Common among Men with Acromegaly and Is Associated with Morbidities Related to the Disease

TY - JOUR

T1 - Erectile Dysfunction Is Common among Men with Acromegaly and Is Associated with Morbidities Related to the Disease

AU - Lotti, Francesco

AU - Rochira, Vincenzo

AU - Pivonello, Rosario

AU - Santi, Daniele

AU - Galdiero, Mariano

AU - Maseroli, Elisa

AU - Balestrieri, Antonio

AU - Faustini-Fustini, Marco

AU - Peri, Alessandro

AU - Sforza, Alessandra

AU - Colao, Annamaria

AU - Maggi, Mario

AU - Corona, Giovanni

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Introduction: The prevalence of erectile dysfunction (ED) and its correlates in men with acromegaly has never been investigated. Aim: The aim of this study was to evaluate sexual function in men with acromegaly. Methods: Multicenter-based, retrospective analysis of a nonselected series of 57 acromegalic subjects (mean age: 52.7±14.2 years) was performed. Acromegalic subjects reporting ED (n=24) were compared with matched ED patients without acromegaly or pituitary disease (controls), selected from a cohort of more than 4,000 subjects enrolled in the Florence Sexual Medicine and Andrology Unit. Main Outcome Measures: Patients were interviewed using Structured Interview on Erectile Dysfunction (SIEDY) structured interview, a 13-item tool for the assessment of ED-related morbidities. Several clinical and biochemical parameters were taken. Penile color Doppler ultrasound (PCDU) was performed in a subgroup of 37 acromegalic subjects. Results: ED was reported by 42.1% of acromegalic subjects. After adjusting for age and testosterone, acromegalic subjects with ED had a higher prevalence of hypertension and more often reported an impairment of sleep-related erections and a longer smoking habit. Accordingly, acromegaly-associated ED was characterized by a higher organic component and worse PCDU parameters. No relationship between ED and testosterone levels or other acromegaly-related parameters was found. However, acromegalic subjects with severe ED reported a longer disease duration. In a case-control analysis, comparing acromegalic subjects with ED-matched controls free from acromegaly (1:5 ratio), acromegalic men had a worse ED problem and a higher organic component of ED, as derived from SIEDY score. In line with these data, acromegalic patients with ED had a higher prevalence of major adverse cardiovascular events history at enrollment and lower PCDU parameters. Conclusions: Subjects with complicated acromegaly are at an increased risk of developing ED, especially those with cardiovascular morbidities. Our data suggest including a sexual function evaluation in routine acromegaly follow-up.

AB - Introduction: The prevalence of erectile dysfunction (ED) and its correlates in men with acromegaly has never been investigated. Aim: The aim of this study was to evaluate sexual function in men with acromegaly. Methods: Multicenter-based, retrospective analysis of a nonselected series of 57 acromegalic subjects (mean age: 52.7±14.2 years) was performed. Acromegalic subjects reporting ED (n=24) were compared with matched ED patients without acromegaly or pituitary disease (controls), selected from a cohort of more than 4,000 subjects enrolled in the Florence Sexual Medicine and Andrology Unit. Main Outcome Measures: Patients were interviewed using Structured Interview on Erectile Dysfunction (SIEDY) structured interview, a 13-item tool for the assessment of ED-related morbidities. Several clinical and biochemical parameters were taken. Penile color Doppler ultrasound (PCDU) was performed in a subgroup of 37 acromegalic subjects. Results: ED was reported by 42.1% of acromegalic subjects. After adjusting for age and testosterone, acromegalic subjects with ED had a higher prevalence of hypertension and more often reported an impairment of sleep-related erections and a longer smoking habit. Accordingly, acromegaly-associated ED was characterized by a higher organic component and worse PCDU parameters. No relationship between ED and testosterone levels or other acromegaly-related parameters was found. However, acromegalic subjects with severe ED reported a longer disease duration. In a case-control analysis, comparing acromegalic subjects with ED-matched controls free from acromegaly (1:5 ratio), acromegalic men had a worse ED problem and a higher organic component of ED, as derived from SIEDY score. In line with these data, acromegalic patients with ED had a higher prevalence of major adverse cardiovascular events history at enrollment and lower PCDU parameters. Conclusions: Subjects with complicated acromegaly are at an increased risk of developing ED, especially those with cardiovascular morbidities. Our data suggest including a sexual function evaluation in routine acromegaly follow-up.

KW - Cardio-Metabolic Morbidities

KW - Erectile Dysfunction

KW - Major Adverse Cardiovascular Events

KW - Men with Acromegaly

KW - Penile Color Doppler Ultrasound

KW - Sexual Function

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U2 - 10.1111/jsm.12859

DO - 10.1111/jsm.12859

M3 - Article

VL - 12

SP - 1184

EP - 1193

JO - Journal of Sexual Medicine

JF - Journal of Sexual Medicine

SN - 1743-6095

IS - 5

ER -