Effects of depression status on penile hemodynamics in men with erectile dysfunction
Huang, Y1; Liu, W1; Zhang, T1; Liu, Y1; Chen, B1; Lu, M1
1: Renji Hospital, School of Medicine, Shanghai Jiao Tong University, China
Introduction. Depression is an important psychological factor that is associated with erectile dysfunction (ED). However, to date, few studies have been conducted on the organic pathologic changes caused by depression.
Aim. This study aims to investigate the effects of depression on penile hemodynamics in Chinese men with ED.
Methods. Male subjects aged 20-50 years with ED complaint were screened by a detailed questionnaire that allowed analyses of their sexual experience and history. Men with acute and/or chronic disease (including diagnosed hypertension and diabetes) and those receiving long-term pharmacotherapy were excluded. Evaluation of ED was conducted by the International Index of Erectile Function-5 (IIEF-5). Detection of penile hemodynamic was based on oral PDE-5 inhibitor usage combined with audiovisual sexual stimulation. A self-rating depression scale (SDS) was used to evaluate the depression status; and the depression score index (DSI) was calculated as total SDS scores divided by 80. Depression status and non-depression status were defined as DSI ≥0.5 and DSI <0.5, respectively. Biochemical indicators related to metabolism (including fasting blood glucose, insulin, cholesterol and triglyceride) and sex hormones were detected. Comparison analyses on the data between depression and non-depression groups were conducted.
Results. A total of 569 patients with ED were screened, and categorized as depression group (n=238; mean age: 28.99±5.92 years) or non-depression group (n=331; mean age: 30.69±5.21 years). No significant difference in baseline characteristics or hemodynamic parameters was found between the test and control groups. PDE5i-induced erection test revealed a significantly higher incidence of erection failure and inadequate erection in the depression group compared with the non-depression group (28.6% (n=68) vs. 23.6% (n=78), P=0.035). In subjects with adequate erection (n=423), the depression group had a significantly higher peak systolic velocity (PSV) than the non-depression group (Left PSV: 42.12±16.31 cm/s vs. 39.15±14.65 cm/s，P=0.028；Right PSV: 43.68±17.12cm/s vs. 40.69±15.01cm/s，P=0.034). The incidence of severe deep venous reflux (venous reflux rate ≥20cm/s) was also found to be significantly higher in the depression group compared with those who did not have depression (23.6% vs. 19.2%, P=0.042).
Conclusions. Depression status increases the incidence of severe venous reflux rate and reduces the chance of success with PDE5i-induced erection. Depression status is also associated with a higher peak systolic velocity in PDE5i-induced erection.
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