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Is penile atherosclerosis the link between erectile dysfunction and cardiovascular risk? An autopsy study

Abstract

Erectile dysfunction (ED) is increasingly linked to coronary heart disease risk. Aim of this study was to test the hypothesis whether this association is due to penile atherosclerosis. We evaluated the prevalence and severity of penile atherosclerosis in relation to coronary and peripheral atherosclerosis. Between January and June 2010, a consecutive series of 31 men underwent an autopsy at the Department of Pathology at the Medical University Vienna. Atherosclerosis at the following localizations were histologically classified: right coronary artery, left coronary artery, left circumflex artery, internal iliac artery, dorsal penile artery and deep penile artery (bilateral). Coronary and peripheral atherosclerosis was present in 87.1 and 77.4% of cases. Atherosclerosis of penile arteries was detectable in only 4 men (12.9%). The only factor linked to penile atherosclerosis was diabetes (P=0.03). All other parameters as assessed according to medical history, general finding from autopsy or histological results regarding arterial lesions in general were not correlated to penile arterial lesions. In contrast to the high prevalence of atherosclerosis in general, penile arterial lesions are rarely present.

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References

  1. Lue TF . Erectile dysfunction. New Engl J Med 2000; 342: 1802–1813.

    CAS  Article  Google Scholar 

  2. Feldman HA, Goldstein I, Hatzichristou D, Krane RJ, McKinlay JB . Impotence and its medical and psychological correlates: results of the Massachussets Male Aging study. J Urol 1994; 151: 54–61.

    CAS  Article  Google Scholar 

  3. Seftel AD, Sun P, Swindle R . The prevalence of hypertension, hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction. J Urol 2004; 171: 2341–2345.

    Article  Google Scholar 

  4. Solomon H, Man JW, Jackson G . Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart 2003; 89: 251–253.

    CAS  Article  Google Scholar 

  5. Feldman HA, Johannes CB, Derby CA, Kleinman KP, Mohr BA, Araujo AB et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med 2000; 30: 328–338.

    CAS  Article  Google Scholar 

  6. Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA . Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005; 294: 2996–3002.

    CAS  Article  Google Scholar 

  7. Schouten BW, Bohnen AM, Bosch JL, Bernsen RM, Deckers JW, Dohle GR et al. Erectile dysfunction prospectively associated with cardiovascular disease in the Dutch general population: results from the Krimpen study. Int J Impot Res 2008; 20: 92–99.

    CAS  Article  Google Scholar 

  8. Böhm M, Baumhäkel M, Teo K, Sleight P, Probstfield J, Gao P et al. ONTARGET/TRANSCEND Erectile Dysfunction Substudy Investigators. Erectile dysfunction predicts cardiovascular events in high-risk patients receiving telmisartan, ramipril, or both: The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial/Telmisartan Randomized AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (ONTARGET/TRANSCEND) Trials. Circulation 2010; 120: 1439–1446.

    Article  Google Scholar 

  9. Ma RC, So WY, Yang X, Yu LW, Kong AP, Ko GT et al. Erectile dysfunction predicts coronary heart disease in type 2 diabetes. J Am Coll Cardiol 2008; 51: 2045–2050.

    Article  Google Scholar 

  10. Montorsi P, Montorsi F, Schulman CC . Is erectile dysfunction the ‘tip of the Iceberg’ of a systemic vascular disorder? Eur Urol 2003; 44: 352–354.

    Article  Google Scholar 

  11. Ponholzer A, Temml C, Mock K, Marszalek M, Obermayr R, Madersbacher S . Prevalence and risk Factors for Erectile Dysfunction in 2.869 men using a validated questionnaire. Eur Urol 2005; 47: 80–85.

    Article  Google Scholar 

  12. Stary HC, Chandler AB, Dinsmore RE, Fuster V, Glagov S, Insull Jr W et al. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation 1995; 1: 92, : 1355-74.

    Google Scholar 

  13. Jackson G, Boon N, Eardley I, Kirby M, Dean J, Hackett G et al. ED and CHD prediction: evidence-based guidance and consensus. Int J Clin Pract 2010; 64: 848–857.

    CAS  Article  Google Scholar 

  14. Bookstein JJ, Valji K, Parsons L, Kessler W . Pharmacoarteriography in the evaluation of impotence. J Urol 1987; 137: 333–337.

    CAS  Article  Google Scholar 

  15. Rosen MP, Greenfield AJ, Walker TG, Grant P, Guben JK, Dubrow J et al. Arteriogenic impotence: findings in 195 impotent men examined with selective internal pudendal angiography. Young Investigators award.. Radiology 1990; 174: 1043–1048.

    CAS  Article  Google Scholar 

  16. Rogers JH, Karimi H, Kao J, Link D, Javidan J, Yamasaki DS et al. Internal pudendal Artery Stenoses and ED: Correlation with angiographic coronary artery disease. Cath Cardiovasc Interv 2010; 76: 882–887.

    Article  Google Scholar 

  17. Gacci M, Eardley I, Guliano F, Hatzichristou D, Kaplan SA, Maggi M et al. Critical Analysis of the relationship between sexual dysfunctions and LUTS due to BPH. Eur Urol 2011; 60: 809–825.

    Article  Google Scholar 

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Correspondence to A Ponholzer.

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Ponholzer, A., Stopfer, J., Bayer, G. et al. Is penile atherosclerosis the link between erectile dysfunction and cardiovascular risk? An autopsy study. Int J Impot Res 24, 137–140 (2012). https://doi.org/10.1038/ijir.2012.3

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  • DOI: https://doi.org/10.1038/ijir.2012.3

Keywords

  • artery
  • impotence
  • obstruction
  • pelvic atherosclerosis

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