Öz
Materials and Methods: Twenty-seven patients who underwent penile Doppler US were recruited to this prospective study. Penile blood flow following intracavernosal papaverine injection using Doppler US was evaluated in the ultrasound unit. The peak systolic velocity and end-diastolic velocity were recorded and the diagnosis according to Doppler US was determined. Erection score according to Erection Hardness Grading Scale was evaluated, which ranked the scores from 1 to 4. A scoring for erectile function was performed with the International Index of Erectile Function (IIEF-5), and the Sexual Health Inventory for Men (SHIM) was defined. Doppler US findings were compared with SHIM scales.
Results: There were a total of 27 patients with a mean age of 55.74±9.02 (39-70) years. Among these patients, 21 (78%) had abnormal penile Doppler US findings. According to Doppler US findings, patients were classified as normal (n=6), borderline for arterial insufficiency (n=2), arterial insufficiency (n=5), and venous insufficiency (n=14). No complications were detected in any of the patients due to penile Doppler US evaluation. Erection was not completely enough except in 2 patients. The lowest erection hardness and the lowest IIEF-5 scores were detected in the patients with arterial problems.
Conclusion: The rate of vascular problems in diabetic men with erectile dysfunction is high and venous insufficiency was found to be more often in our study.
Anahtar Kelimeler
Diabetes mellitus erectile dysfunction IIEF-5 questionnaire penile Doppler US
Kaynakça
- Williams SK, Melman A. Novel therapeutic targets for erectile dysfunction. Maturitas 2012;71(1):20-7.
- Cohen SD. The challenge of erectile dysfunction management in the young man. Curr Urol Rep 2015;16(12):84.
- Lewis RW. Epidemiology of erectile dysfunction. Urol Clin North Am 2001;28(2):209-16.
- Binmoammar TA, Hassounah S, Alsaad S, Rawaf S, Majeed A. The impact of poor glycaemic control on the prevalence of erectile dysfunction in men with type 2 diabetes mellitus: A systematic review. JRSM Open 2016;7(3):1-10.
- Penson DF, Latini DM, Lubeck DP, Wallace KL, Henning JM, Lue TF. Do impotent men with diabetes have more severe erectile dysfunction and worse quality of life than the general population of impotent patients? Results from the Exploratory Comprehensive Evaluation of Erectile Dysfunction (ExCEED) database. Diabetes Care 2003;26(4):1093-9.
- Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med 1998;338(20):1397-404.
- Mäkimattila S, Yki-Järvinen H. Endothelial dysfunction in human diabetes. Curr Diab Rep 2002;2(1):26-36.
- Chitaley K. Type 1 and type 2 diabetic-erectile dysfunction: Same diagnosis (ICD-9), different disease? J Sex Med 2009;6(Suppl 3):262-8. 9. Kirilmaz U, Guzel O, Aslan Y, Balci M, Tuncel A, Atan A. The effect of lifestyle modification and glycemic control on the efficiency of sildenafil citrate in patients with erectile dysfunction due to type-2 diabetes mellitus. Aging Male 2015;18(4):244-8.
- Gupta N, Herati A, Gilbert BR. Penile Doppler ultrasound predicting cardiovascular disease in men with erectile dysfunction. Curr Urol Rep 2015;16(3):16.
- Lue TF, Hricak H, Marich KW, Tanagho EA. Vasculogenic impotence evaluated by high-resolution ultrasonography and pulsed Doppler spectrum analysis. Radiology 1985;155(3):777-81.
- Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology 1997;49(6):822-30.
- Rosen RC, Cappalleri JC, Smith MD, Lipsky J, Pena BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999;11(6):319-26.
- Dargis L, Trudel G, Cadieux J, Villeneuve L, Préville M, Boyer R. Validation of the International Index of Erectile Function (IIEF) and presentation of norms in older men. Sexologies 2013;22(1):e20-e26.
- Rosen RC, Cappalleri JC, Gendrano N 3rd. The international index of erectile function (IIEF): A state-of-the-science review. Int J Impot Res 2002;14(4):226-44.
- Fitzgerald SW, Erickson SJ, Foley WD, Lipchik EO, Lawson TL. Color Doppler sonography in the evaluation of erectile dysfunction. Radiographics 1992;12(1):3-17.
- Pereira JA, Bilhim T, Rio Tinto H, Fernandes L, Martins Pisco J, Goyri-O’Neill J. Radiologic anatomy of arteriogenic erectile dysfunction: A systematized approach. Acta Med Port 2013;26(3):219-25.
- Aslan Y, Tuncel A, Aydin O, Balci M, Karabulut E, Atan A. The association between Erection Hardness Grading Scale and International Index of Erectile Function in men with erectile dysfunction treated with sildenafil citrate. Urol Int 2011;86(4):434-8.
- Defeudis G, Gianfrilli D, Di Emidio C, et al. Erectile dysfunction and its management in patients with diabetes mellitus. Rev Endocr Metab Disord 2015;16(3):213-31.
- Rosen RC, Fisher WA, Eardley I, Niederberger C, Nadel A, Sand M. The multinational Men's Attitudes to Life Events and Sexuality (MALES) study: I. Prevalence of erectile dysfunction and related health concerns in the general population. Curr Med Res Opin 2004;20(5):607-17.
- McCulloch DK, Campbell IW, Wu FC, Prescott RJ, Clarke BF. The prevalence of diabetic impotence. Diabetologia 1980;18(4):279-83.
- Chrysant SG. Antihypertensive therapy causes erectile dysfunction. Curr Opin Cardiol 2015;30(4):383-90.
- Kilic M, Serefoglu EC, Ozdemir AT, Balbay MD. The actual incidence of papaverine‐induced priapism in patients with erectile dysfunction following penile colour Doppler ultrasonography. Andrologia 2010;42(1):1-4.
- Secil M, Arslan D, Goktay AY, Esen AA, Dicle O, Pirnar T. The prediction of papaverine induced priapism by color Doppler sonography. J Urol 2001;165(2):416-8.
- Metawea B, El-Nashar AR, Gad-Allah A, Abdul-Wahab M, Shamloul R. Intracavernous papaverine/phentolamine-induced priapism can be accurately predicted with color Doppler ultrasonography. Urology 2005;66(4):858-60.
Öz
Gereç ve Yöntem: Penil Doppler US incelemesi yapılan 27 hasta prospektif yürütülen bu çalışmaya dahil edildi. Hastalara US ünitesinde, penil kavernöz cisme papaverin enjeksiyonunu takiben Doppler US yapılarak penil kan akımı değerlendirildi. Pik sistolik akım hızı, diyastol sonu hız kaydedilerek Doppler US tanısı belirlendi. Ereksiyon düzeyi, ereksiyon sertlik derecelendirme skalasına göre 4 puan üzerinden değerlendirildi. Erektil fonksiyon için IIEF-5 (erektil fonksiyon uluslararası indeksi) anketi ile skorlama yapıldı ve SHIM (erkekler için seksüel sağlık envanteri) seviyesi belirlendi. Elde edilen Doppler US tanıları ile SHIM seviyeleri karşılaştırıldı. Bulgular: Çalışma dahilinde 27 hasta mevcuttu. Hastaların yaş ortalaması 55.74±9.02 (aralık 39-70) idi. Hastaların 21’inde (%78) anormal penil Doppler US bulguları elde edildi. Hastalar Doppler US bulgularına göre normal (n=6), arteriyel yetmezlik için sınırda (n=2), arteriyel yetmezlik (n=5) ve venöz yetmezlik (n=14) olarak sınıflandırıldı. Penil Doppler incelemesine bağlı olarak hiçbir hastada komplikasyon gelişmedi. Ereksiyon sertliği iki hasta hariç diğerlerinde tam düzeyde değildi. En düşük ereksiyon sertlikleri ve IIEF-5 skorları arteriyel problem durumunda gözlendi. Sonuç: Erektil disfonksiyon şikayeti bulunan diabetes mellitus tanılı hastalarda vasküler problem oranı yüksektir ve çalışmamızda özellikle venöz yetmezlik daha sık olarak gözlenmiştir.
Anahtar Kelimeler
Diabetes mellitus erektil disfonksiyon IIEF-5 anketi penil Doppler US
Kaynakça
- Williams SK, Melman A. Novel therapeutic targets for erectile dysfunction. Maturitas 2012;71(1):20-7.
- Cohen SD. The challenge of erectile dysfunction management in the young man. Curr Urol Rep 2015;16(12):84.
- Lewis RW. Epidemiology of erectile dysfunction. Urol Clin North Am 2001;28(2):209-16.
- Binmoammar TA, Hassounah S, Alsaad S, Rawaf S, Majeed A. The impact of poor glycaemic control on the prevalence of erectile dysfunction in men with type 2 diabetes mellitus: A systematic review. JRSM Open 2016;7(3):1-10.
- Penson DF, Latini DM, Lubeck DP, Wallace KL, Henning JM, Lue TF. Do impotent men with diabetes have more severe erectile dysfunction and worse quality of life than the general population of impotent patients? Results from the Exploratory Comprehensive Evaluation of Erectile Dysfunction (ExCEED) database. Diabetes Care 2003;26(4):1093-9.
- Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med 1998;338(20):1397-404.
- Mäkimattila S, Yki-Järvinen H. Endothelial dysfunction in human diabetes. Curr Diab Rep 2002;2(1):26-36.
- Chitaley K. Type 1 and type 2 diabetic-erectile dysfunction: Same diagnosis (ICD-9), different disease? J Sex Med 2009;6(Suppl 3):262-8. 9. Kirilmaz U, Guzel O, Aslan Y, Balci M, Tuncel A, Atan A. The effect of lifestyle modification and glycemic control on the efficiency of sildenafil citrate in patients with erectile dysfunction due to type-2 diabetes mellitus. Aging Male 2015;18(4):244-8.
- Gupta N, Herati A, Gilbert BR. Penile Doppler ultrasound predicting cardiovascular disease in men with erectile dysfunction. Curr Urol Rep 2015;16(3):16.
- Lue TF, Hricak H, Marich KW, Tanagho EA. Vasculogenic impotence evaluated by high-resolution ultrasonography and pulsed Doppler spectrum analysis. Radiology 1985;155(3):777-81.
- Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology 1997;49(6):822-30.
- Rosen RC, Cappalleri JC, Smith MD, Lipsky J, Pena BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999;11(6):319-26.
- Dargis L, Trudel G, Cadieux J, Villeneuve L, Préville M, Boyer R. Validation of the International Index of Erectile Function (IIEF) and presentation of norms in older men. Sexologies 2013;22(1):e20-e26.
- Rosen RC, Cappalleri JC, Gendrano N 3rd. The international index of erectile function (IIEF): A state-of-the-science review. Int J Impot Res 2002;14(4):226-44.
- Fitzgerald SW, Erickson SJ, Foley WD, Lipchik EO, Lawson TL. Color Doppler sonography in the evaluation of erectile dysfunction. Radiographics 1992;12(1):3-17.
- Pereira JA, Bilhim T, Rio Tinto H, Fernandes L, Martins Pisco J, Goyri-O’Neill J. Radiologic anatomy of arteriogenic erectile dysfunction: A systematized approach. Acta Med Port 2013;26(3):219-25.
- Aslan Y, Tuncel A, Aydin O, Balci M, Karabulut E, Atan A. The association between Erection Hardness Grading Scale and International Index of Erectile Function in men with erectile dysfunction treated with sildenafil citrate. Urol Int 2011;86(4):434-8.
- Defeudis G, Gianfrilli D, Di Emidio C, et al. Erectile dysfunction and its management in patients with diabetes mellitus. Rev Endocr Metab Disord 2015;16(3):213-31.
- Rosen RC, Fisher WA, Eardley I, Niederberger C, Nadel A, Sand M. The multinational Men's Attitudes to Life Events and Sexuality (MALES) study: I. Prevalence of erectile dysfunction and related health concerns in the general population. Curr Med Res Opin 2004;20(5):607-17.
- McCulloch DK, Campbell IW, Wu FC, Prescott RJ, Clarke BF. The prevalence of diabetic impotence. Diabetologia 1980;18(4):279-83.
- Chrysant SG. Antihypertensive therapy causes erectile dysfunction. Curr Opin Cardiol 2015;30(4):383-90.
- Kilic M, Serefoglu EC, Ozdemir AT, Balbay MD. The actual incidence of papaverine‐induced priapism in patients with erectile dysfunction following penile colour Doppler ultrasonography. Andrologia 2010;42(1):1-4.
- Secil M, Arslan D, Goktay AY, Esen AA, Dicle O, Pirnar T. The prediction of papaverine induced priapism by color Doppler sonography. J Urol 2001;165(2):416-8.
- Metawea B, El-Nashar AR, Gad-Allah A, Abdul-Wahab M, Shamloul R. Intracavernous papaverine/phentolamine-induced priapism can be accurately predicted with color Doppler ultrasonography. Urology 2005;66(4):858-60.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Aralık 2017 |
| Gönderilme Tarihi | 24 Ekim 2016 |
| Yayımlandığı Sayı | Yıl 2017Cilt: 56 Sayı: 4 |
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