Prevalence and risk factors of erectile dysfunction in cirrhotic patients: An observational study

Mohamed Fakhry; Hamdy Mahfouz; Khalid Abdelazeem; Mohamed AbdelSabour; Nour Shaheen; Ahmed Fathy; Amro M Hassan; Hazem Dief; Mohamed El-Nady; Mustafa A Haridy; Omran Mohamed; Safwat Salama; Emad Abdelrazzak; Walid Saber; Tarek Mohamed; Maha Mohamed; Wael Esmat; Eman Fathy; Muhamed Abdelrahim; Rasha Maree

doi:10.1080/2090598X.2023.2238933

Prevalence and risk factors of erectile dysfunction in cirrhotic patients: An observational study

Arab J Urol. 2023 Jul 24;22(1):6-12. doi: 10.1080/2090598X.2023.2238933. eCollection 2024.

Authors

Mohamed Fakhry¹, Hamdy Mahfouz¹, Khalid Abdelazeem¹, Mohamed AbdelSabour², Nour Shaheen³, Ahmed Fathy¹, Amro M Hassan¹, Hazem Dief⁴, Mohamed El-Nady⁵, Mustafa A Haridy¹, Omran Mohamed¹, Safwat Salama¹, Emad Abdelrazzak¹, Walid Saber⁶, Tarek Mohamed⁷, Maha Mohamed⁸, Wael Esmat⁹, Eman Fathy¹⁰, Muhamed Abdelrahim¹¹, Rasha Maree¹¹

Affiliations

¹ Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
² Dermatology, Andrology and Venereal Diseases Department, Faculty of Medicine Al-Azhar University, Assiut, Egypt.
³ Faculty of Medicine, Alexandria University, Alexandria, Egypt.
⁴ Urology Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
⁵ Internal Medicine, Kasr El-Einy School of Medicine, Cairo University, Cairo, Egypt.
⁶ Internal Medicine, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
⁷ Radiodiagnosis Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
⁸ Department of Tropical Medicine and Gastroenterology, Sohag University, Assiut, Egypt.
⁹ Clinical Pathology Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
¹⁰ Department of Dermatology, Venerology and Andrology, Faculty of Medicine, Assiut University, Assiut, Egypt.
¹¹ Department of Tropical Medicine and Gastroenterology, Assiut University, Assiut, Egypt.

Abstract

Background: Erectile dysfunction (ED) is a prevalent complication observed in male patients with liver cirrhosis; however, there is limited understanding of the etiological determinants responsible for its occurrence. The objective of this investigation is to explore potential contributory factors that underlie the development of ED in male patients with liver cirrhosis.

Method: A cross-sectional study was conducted on 200 male patients with liver cirrhosis, who were divided into three groups according to the Child score. ED was studied using the International Index of Erectile Function (IIEF-5) Questionnaire and penile Doppler.

Results: The prevalence of ED among the cirrhotic patients was 80%, and it was more frequent in patients with advanced liver disease (Child C). Penile venous leakage was observed in 20% of cirrhotic patients, which increased to 28.6% in those with advanced liver cirrhosis. Multivariate logistic regression analysis showed that age, low albumin levels, elevated INR, high hemoglobin levels, and Child C were predictors of ED in cirrhotic patients.

Conclusion: Several clinical variables have been identified as potential contributors to the development of erectile dysfunction (ED) in patients with cirrhosis. These variables include advanced age, decreased levels of albumin, elevated INR, increased hemoglobin levels, and Child C classification. Early identification and treatment of these factors could potentially improve the quality of life for cirrhotic patients with ED. Notably, patients with ED in this population were observed to have elevated levels of INR, serum bilirubin, and hemoglobin, as well as reduced levels of serum albumin.

Keywords: Erectile dysfunction; HCV; liver cirrhosis.