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Article of the week: The global prevalence of erectile dysfunction: a review




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Every week, the Editor-in-Chief selects an Article of the Week from the current issue of BJUI. The abstract is reproduced below and you can click on the button to read the full article, which is freely available to all readers for at least 30 days from the time of this post.

In addition to the article itself, there is a video prepared by the authors. Please use the comment tools at the bottom of each post to join the conversation. 

If you only have time to read one article this week, it should be this one.

The global prevalence of erectile dysfunction: a review

Anna Kessler*, Sam Sollie*, Ben Challacombe, Karen Briggs and Mieke Van Hemelrijck*

*School of Cancer and Pharmaceutical Sciences, King’s College London, Translational Oncology and Urology Research (TOUR) and Urology Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

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Abstract

Objective

To evaluate the global prevalence of erectile dysfunction (ED); as well as its association with physiological and pathological ageing by examining the relationship between ED and cardiovascular disease (CVD), benign prostatic hyperplasia (BPH), and dementia. We also aimed to characterize discrepancies caused by the use of different ED screening tools.

Methods

The Excerpta Medica dataBASE (EMBASE) and Medical Literature Analysis and Retrieval System Online (MEDLINE) were searched to find population‐based studies investigating the prevalence of ED and the association between ED and CVD, BPH and dementia in the general population.

                    Global prevalence of ED

Results

The global prevalence of ED was 3–76.5%. ED was associated with increasing age. Use of the International Index of Erectile Function (IIEF) and Massachusetts Male Aging Study (MMAS)‐derived questionnaire identified a high prevalence of ED in young men. ED was positively associated with CVD. Men with ED have an increased risk of all‐cause mortality odds ratio (OR) 1.26 (95% confidence interval [CI] 1.01–1.57), as well as CVD mortality OR 1.43 (95% CI 1.00–2.05). Men with ED are 1.33–6.24‐times more likely to have BPH then men without ED, and 1.68‐times more likely to develop dementia than men without ED.

Conclusion

ED screening tools in population‐based studies are a major source of discrepancy. Non‐validated questionnaires may be less sensitive than the IIEF and MMAS‐derived questionnaires. ED constitutes a large burden on society given its high prevalence and impact on quality of life, and is also a risk factor for CVD, dementia and all‐cause mortality.

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