Abstract
This research was carried out to evaluate the prevalence of carotid and/or lower limb artery abnormalities in patients with arterial erectile dysfunction (ED). To this end, patients with ED (Andrology Unit) or suspected peripheral atherosclerosis (Angiology Unit) underwent an independent and parallel echo-Duplex examination. The Andrology Unit examined 167 patients with ED of different etiologies: 52 of them had penile artery insufficiency and consequently their carotids and lower limb arteries had to be evaluated by means of echo-Doppler. In all, 36 out of the 46 patients with nonarterial organic ED and 22 out of the 69 patients with nonorganic ED underwent the same evaluation and served as controls. The Angiology Unit enrolled 457 ED patients who initially underwent echo-Doppler for suspected carotid and/or arterial leg atherosclerosis and subsequently dynamic echo-Doppler. Isolated penile artery insufficiency was found in 23.1 and 25% of the patients evaluated in the Angiology and Andrology Units, respectively. The remaining patients were shown to have ED associated with an atheroma or marked intima-media thickness of the carotid vessels and/or of leg arteries. The frequency of penile arterial insufficiency and of carotid and/or lower limb artery abnormalities was significantly higher (P<0.01) compared to that found in patients with ED of nonarterial organic or psychogenic origin. Both Units found that the frequency of penile artery insufficiency and carotid or lower limb artery abnormalities was significantly higher than that of penile artery insufficiency alone or plus both carotid and lower limb artery abnormalities. This study showed that penile artery insufficiency is associated with carotid and/or lower limb artery ultrasound abnormalities in about 75% of the cases. Therefore, arterial ED may be regarded as a sign of a more generalized atherosclerosis.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Rent or buy this article
Get just this article for as long as you need it
$39.95
Prices may be subject to local taxes which are calculated during checkout

References
NIH Consensus Development Panel on Impotence. NIH Consensus Conference. Impotence. J Am Med Assoc 1993; 270: 83–90.
Feldman HA et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.
Rosen RC et al. The multinational Men's Attidudes 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: 607–617.
Chew KK et al. Erectile dysfunction in general medicine practice: prevalence and clinical correlates. Int J Impot Res 2000; 12: 41–45.
Braun M et al. Epidemiology of erectile dysfunction: results of the ‘Cologne Male Survey’. Int J Impot Res 2000; 12: 305–311.
Marumo K, Murai M . Aging and erectile dysfunction: the role of aging and concomitant illness. Int J Urol 2001; 8: S50–S57.
Virag R, Bouilly P, Frydman D . Is impotence an arterial disorders? A study of arterial risk factors in 440 impotent men. Lancet 1985; 26: 181–184.
Morley JE et al. Relationship of penile brachial pressure index to myocardial infarction and cerebrovascular accidents in older men. Am J Med 1988; 84: 445–448.
Jensen J et al. The prevalence and etiology of impotence in 101 male hypertensive outpatients. Am J Hypertens 1999; 12: 271–275.
Jackson G . Erectile dysfunction and cardiovascular disease. Int J Clin Pract 1999; 53: 363–368.
Feldman HA et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts aging study. Prev Med 2000; 30: 328–338.
Cappelleri JC et al. Diagnostic evaluation of the erectile function domain of the international index of erectile dysfunction. Urology 1999; 54: 346–351.
Joint National Committee on prevention, detection, evaluation and treatment of high pressure. The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high pressure (JNC VI). Arch Intern Med 1997; 157: 2413.
Bluth EI, Wetzner SM, Stavros AT . Carotid duplex sonography: a multicenter recommendation for standardized imaging and Doppler criteria. Radiographics 1988; 8: 487.
Moneta GL, Yeager RS, Antonovic R . Accuracy of lower extremity arterial duplex mapping. J Vasc Surg 1992; 15: 275.
Salonen R, Salonen JT . Determinant of carotid intima-media thickness: a population-based ultrasonography study in eastern Finnish men. J Intern Med 1991; 229: 225–231.
Meuleman EJH et al. Assessment of penile blood flow by duplex ultrasonography in 44 men with normal erectile potency in different phases of erection. J Urol 1992; 147: 51–56.
Bortolotti A, Parazzini F, Colli E, Landoni M . The epidemiology of erectile dysfunction and its rik factors. Intern J Androl 1997; 20: 323–334.
Chung WS, Shim BS, Park YY . Hemodynamic insult by vascular risk factors and pharmacological erection in men with erectile dysfunction: Doppler sonography study. World J Urol 2000; 18: 427–430.
Ryu JK et al. Expression of cavernous transforming growth-factor beta1 and its Type II receptor in patients with erectile dysfunction. Intern J Androl 2004; 27: 42–49.
Montorsi F et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 2003; 44: 360–364; discussion 364–365.
Kloner RA, Speakman M . Erectile dysfunction and atherosclerosis. Curr Atheroscler Rep 2002; 4: 397–401.
Acknowledgements
We thank David Farrugia, Lecturer, Faculty of Economics, University of Catania, for the English text editing.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Vicari, E., Arcidiacono, G., Di Pino, L. et al. Incidence of extragenital vascular disease in patients with erectile dysfunction of arterial origin. Int J Impot Res 17, 277–282 (2005). https://doi.org/10.1038/sj.ijir.3901312
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijir.3901312
Keywords
- erectile dysfunction
- risk factors
- extragenital arterial Eco-Duplex changes
This article is cited by
-
Erectile dysfunction: a warning sign of silent vascular disease
International Urology and Nephrology (2009)
-
Erectile dysfunction as a harbinger for increased cardiometabolic risk
International Journal of Impotence Research (2008)
-
Metabolisches Syndrom und erektile Dysfunktion
Der Urologe (2007)
-
Peak systolic velocity in patients with arterial erectile dysfunction and peripheral arterial disease
International Journal of Impotence Research (2006)