Poster, Podium & Video Sessions
Presentation Authors: Jaime A. Cavallo*, Jared S. Winoker, Kyle A. Blum, New York, NY, Wendy L. Poage, E. David Crawford, Aurora, CO, Steven A. Kaplan, Nelson N. Stone, New York, NY
Introduction: Many lifestyle factors and comorbidities that may contribute to the development of erectile dysfunction (ED) are potentially modifiable. Therefore, the ability to predict ED severity based on associated comorbidities would be of value in counseling patients about early lifestyle modifications to prevent future dysfunction. We sought to identify patient risk factors that predict worse patient-reported Sexual Health Inventory for Men (SHIM) scores.
Methods: We retrospectively reviewed 25,388 men who participated in a nationwide men's health screening program in 2003, 2011, and 2012. All men completed a questionnaire, which included exercise frequency, fat content of diet, urinary symptoms, sexual function, medical comorbidities, and body mass index (BMI). Testosterone (T) was available in 10,130. SHIM scores were stratified by severity: none (21-25), mild (17-21), moderate (8-16), or severe (1-7). Associations between SHIM and patient factors were assessed by Chi-squared test and ANOVA. Statistically significant variables from univariate analyses (p<.05) were included in a multivariable linear regression model for patient-reported SHIM score.
Results: Median age was 61.2 years (IQR 54-68) with racial distribution of 75.6% Caucasian, 17.1% African American, 5.2% Hispanic, and 2.0% Asian. On linear regression, age (HR .28 95% CI .31-.24; p<.0001), BMI (HR .08 95% CI .13-.04, p=.001), prostatic enlargement (HR 1.87 95% CI 2.58-1.16; p<.0001), heart disease (HR 1.34 95% CI 2.26-.428; p=.004), diabetes (HR 1.99 95% CI 2.78-1.20, p=.0001), and total AUA symptom score (HR .12 95% CI .16-.07, p<.0001) were associated with a lower SHIM score. Factors that did not reach statistical significance were race (p=.36), history of heart attack (p=.09), exercise level (p=.07), fat content of diet (p=.74), and testosterone level (p=.27).
Conclusions: There are several health issues and lifestyle behaviors that predict the development and worsening of ED. Increased awareness of such modifiable factors may be useful in counseling patients to improve overall health and prevent potentially irreversible damage on erectile function. Likewise, worse SHIM scores should alert the physician to investigate comorbidities that may be inadequately managed.
Source Of Funding: none