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Characteristics of patients with erectile dysfunction in a family physician-led erectile dysfunction clinic: Retrospective case series

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      Abstract

      Objectives:

      1. To examine the characteristics of patients with erectile dysfunction in a family physician led erectile dysfunction clinic;

      2. To review association of chronic disease spectrum and erectile dysfunction;

      3. To review initial treatment pattern and outcome.

      Design: Retrospective case series review.

      Subjects: All consecutive patients seen in a regional hospital family physician led erectile dysfunction clinic from April 2014 to March 2015.

      Main outcome measures:

      1. The severity of erectile dysfunction, based on International Index of Erectile Function (IIEF-5).

      2. The associated chronic comorbidities of patients.

      3. Treatment patterns and patient outcomes.

      Results: One hundred and eighty three patients presented with erectile dysfunction (ED) with mean age 58.7 (range 23 to 82) years old were seen during the study period. One hundred and twenty seven patients (69.4%) had comorbidity of chronic diseases, including 50.8% had hypertension, 38.8% had diabetes mellitus and 33.9% had hyperlipidaemia. Their mean body mass index was 25.2 kg/m2, the mean blood pressure was 137.3/79.5 mm Hg (1 mm Hg = 0.133 kPa). According to IIEF-5 score, 50.3%, 30.6% and 18.6% had severe, moderate and mild erectile dysfunction respectively. The average duration of ED before seeking medical help was 3.9 years. Phosphodiesterase 5 (PDE5) inhibitors were prescribed to 119 patients (65%), and 57.1% of them achieved good response. Twenty nine patients (15.8%) were referred to other specialty for further management, including 27.6% had contraindication for PDE5 inhibitor.

      Conclusion: High proportion of erectile dysfunction patients had comorbitiy of chronic diseases. 57.1% of those patients receiving PDE5 inhibitors showed good response.

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      Most cited references 22

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      The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction

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        Definitions/epidemiology/risk factors for sexual dysfunction.

        Accurate estimates of prevalence/incidence are important in understanding the true burden of male and female sexual dysfunction and in identifying risk factors for prevention efforts. This is the summary of the report by the International Consultation Committee for Sexual Medicine on Definitions/Epidemiology/Risk Factors for Sexual Dysfunction. The main aim of this article is to provide a general overview of the definitions of sexual dysfunction for men and women, the incidence and prevalence rates, and a description of the risk factors identified in large population-based studies. Literature regarding definitions, descriptive and analytical epidemiology of sexual dysfunction in men and women were selected using evidence-based criteria. For descriptive epidemiological studies, a Prins score of 10 or higher was utilized to identify population-based studies with adequately stringent criteria. This report represents the opinions of eight experts from five countries developed in a consensus process and encompassing a detailed literature review over a 2-year period. The study aims to provide state-of-the-art prevalence and incidence rates reported for each dysfunction and stratified by age and gender. Expert opinion was based on the grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. A wealth of information is presented on erectile dysfunction, its development through time, and its correlates. The field is still in need of more epidemiological studies on the other men's sexual dysfunction and on all women's sexual dysfunctions. A review of the currently available evidence from epidemiological studies is provided.
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          The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis.

          Erectile dysfunction (ED) shares similar modifiable risks factors with coronary artery disease (CAD). Lifestyle modification that targets CAD risk factors may also lead to improvement in ED. We conducted a systematic review and meta-analysis of randomized controlled trials evaluating the effect of lifestyle interventions and pharmacotherapy for cardiovascular (CV) risk factors on the severity of ED. A comprehensive search of multiple electronic databases through August 2010 was conducted using predefined criteria. We included randomized controlled clinical trials with follow-up of at least 6 weeks of lifestyle modification intervention or pharmacotherapy for CV risk factor reduction. Studies were selected by 2 independent reviewers. The main outcome measure of the study is the weighted mean differences in the International Index of Erectile Dysfunction (IIEF-5) score with 95% confidence intervals (CIs) using a random effects model. A total of 740 participants from 6 clinical trials in 4 countries were identified. Lifestyle modifications and pharmacotherapy for CV risk factors were associated with statistically significant improvement in sexual function (IIEF-5 score): weighted mean difference, 2.66 (95% CI, 1.86-3.47). If the trials with statin intervention (n = 143) are excluded, the remaining 4 trials of lifestyle modification interventions (n = 597) demonstrate statistically significant improvement in sexual function: weighted mean difference, 2.40 (95% CI, 1.19-3.61). The results of our study further strengthen the evidence that lifestyle modification and pharmacotherapy for CV risk factors are effective in improving sexual function in men with ED.
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            Author and article information

            Affiliations
            1Family Medicine and General Outpatient Department, Kwong Wah Hospital, Mongkok, Hong Kong, China
            Author notes
            CORRESPONDING AUTHOR: Lap Kin Chiang, MBChB (CUHK), MSc (CUHK), MFM (Monash) Family Medicine and General Outpatient Department, Kwong Wah Hospital, 1/F, TTT Outpatient Building, Kwong Wah Hospital, 25 Waterloo Road, Mongkok, Hong Kong, China Tel.: +852-93075869 E-mail: chialk@123456ha.org.hk; lapkinchiang@123456gmail.com; lapkinchiang@123456yahoo.com.hk
            Journal
            FMCH
            Family Medicine and Community Health
            FMCH
            Compuscript (Ireland)
            2009-8774
            2305-6983
            May 2017
            May 2017
            : 5
            : 1
            : 85-91
            FMCH.2017.0114
            10.15212/FMCH.2017.0114
            Copyright © 2017 Family Medicine and Community Health

            This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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