Erectile dysfunction as the first sign of systemic vascular diseases and of organovascular arterial ischemic diseases.
Guidelines and Challenge of the Angiology section of Slovak Medical Chamber (AS SMC, 2015)


Authors: Peter Gavorník 1,2,3;  Andrej Dukát 1,3;  Ľudovít Gašpar 1,2,3;  Denisa Medová 1,2;  Xénia Faktorová 1,2;  Eva Gavorníková 3,4
Authors‘ workplace: II. interná klinika LF UK a UN Bratislava, Slovenská republika, prednosta doc. MUDr. Ľudovít Gašpar, PhD. 1;  Prvé angiologické pracovisko (PAP), vedúci lekár doc. MUDr. Peter Gavorník, PhD., mim. prof. 2;  Angiologická sekcia Slovenskej lekárskej komory (AS SLK), Slovenská republika, predseda doc. MUDr. Peter Gavorník, PhD., mim. prof. 3;  Ambulancia všeobecného lekára pre dospelých, Poliklinika Ružinov, Bratislava, Slovenská republika 4
Published in: Vnitř Lék 2015; 61(7-8): 660-669
Category: Guidelines

Overview

Erectile dysfunction is a highly prevalent and progressive condition affecting the quality of life of man and his sexual partner. Evidence is accumulating in favour of erectile dysfunction as a sign of a genitovascular disease (GVD) in the majority of patients. Erectile dysfunction may be considered as the clinical manifestation of a organovascular disease affecting penis (male genitovascular disease – MGVD) as well as angina pectoris is the typical manifestation of a vascular disease affecting coronary arteries of a heart (cardiovascular disease – CVD). Several studies confirm the assumption that erectile dysfunction symptoms were found to come prior to cardiovascular disease symptoms in 60–95 % of CVD patients with mean interval of 2–3 years and likewise of all organovascular diseases (OVD). Four potent selective PDE5Is have been approved by the EMA for the treatment of erectile dysfunction. Physicians should systematically look for erectile dysfunction in any male with vascular risk factors.

Key words:
angiology/vascular medicine – diagnosis – erectile dysfunction – genitovascular arterial disease (GVAD) – management – organovascular diseases


Sources

1. Hatzimouratidis K, Eardley I, Giuliano F et al. Guidelines on Male Sexual Dysfunction: Erectile dysfunction and premature ejaculation. European Association of Urology (EAU). Eur Urol 2015; pii: S0302–2838(15)00516–3. Dostupné z WWW: <http://uroweb.org/guideline/male-sexual-dysfunction>. Update 2015.

2. Wein AJ, Kavoussi LR, Novick AC (eds). Campbell-Walsh Urology. 10th ed. Saunders Elsevier: Philadelphia 2011. ISBN 978–1416069119

3. Gavorník P. Angiológia 2 pre všeobecných praktických lekárov – Arteriológia. 1st ed. Vydavateľstvo Dr. Josef Raabe: Bratislava 2014. ISBN 978–80–8140–168–8.

4. Olin JW, Gornik HL, Bacharach JM et al. American Heart Association Council on Peripheral Vascular Disease, Council on Clinical Cardiology, Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, Council on Cardiovascular Disease in the Young, Council on Cardiovascular Radiology and Intervention, Council on Epidemiology and Prevention, Council on Functional Genomics and Translational Biology, Council for High Blood Pressure Research, Council on the Kidney in Cardiovascular Disease, and Stroke Council. Fibromuscular Dysplasia: State of the Science and Critical Unanswered Questions: A Scientific Statement From the American Heart Association. Circulation 2014; 129(9): 1048–1078.

5. Anderson JL, Halperin JL, Albert NM et al. Management of Patients With Peripheral Artery Disease (Compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in Collaboration With the Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society for Vascular Medicine, and Society for Vascular Surgery. Circulation 2013; 127(13): 1425–1443.

6. Arcidiacono MV, Traveset A, Rubinat E et al. Microangiopathy of large artery wall: neglected complication of diabetes mellitus. Atherosclerosis 2013; 228(1): 142–147.

7. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31(7): 1181–1357. DOI: <http: doi:10.1097/01.hjh.0000431740.32696.cc>.

8. Tendera M, Aboyans V, Bartelink ML et al. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries. The Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur Heart J 2011; 32(22): 2851–2906.

9. Gavorník P. Projekt Cievy. Cielené vysvetľovanie cievnych chorôb a cievnych porúch. Vnitř Lék 2009; 55(10): 996–997.

10. Antignani PL, Benedetti-Valentini F, Aluigi L et al. Diagnosis of vascular diseases. Ultrasound investigations – Guidelines. Int Angiol 2012; 31(5 Suppl 1): 1–77.

11. Bays H. Adiposopathy, “Sick Fat,” Ockham’s Razor, and Resolution of the Obesity Paradox. Curr Atheroscler Rep 2014; 16(5): 1–15.

12. López-Mejías R, Genre F, González-Juanatey C et al. Autoantibodies and biomarkers of endothelial cell activation in atherosclerosis. Vasa 2014; 43(2): 83–85.

13. Papadakis MA, McPhee SJ, Rabow MW (eds). Current Medical Diagnosis and Treatment 2014 (Lange Current Series). 53rd ed. McGraw-Hill Medical: San Francisco 2013. ISBN 978–0071806336.

14. Rydén L, Grant PJ, Anker SD et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. The Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J 2013; 34(39): 3035–3087. Erratum in: Eur Heart J 2014; 35(27): 1824.

15. Gavorník P. Končatinovocievne ischemické choroby. B 2.1/1 – 92. In: Gavorník P, Hrubiško M, Rozborilová E (eds). Diferenciálna diagnostika kardio-vaskulárnych, respiračných a hematologických ochorení. I. Dr. Josef Raabe: Bratislava 2010.

16. Guyatt GH, Akl EA, Crowther M et al. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed.: American College of Chest Physicians (ACCP) evidence-based clinical practice guidelines. Chest 2012; 141(2 Suppl): e737S-e801S. Dostupné z DOI: <http://dx.doi.org/10.1378/chest.11–2308>.

17. Ip JH, Fuster V, Badimon L et al. Syndromes of accelerated atherosclerosis: Role of vascular injury and smooth muscle cell proliferation. J Amer Coll Cardiol 1990; 15(7): 1667–1687.

18. Bergqvist D, Björck M, Lees T et al. Validation of the VASCUNET registry – pilot study. Vasa 2014; 43(2): 141–144.

19. George JN, Nester CM. Syndromes of Thrombotic Microangiopathy. N Engl J Med 2014; 371(7): 654–666.

20. James PA, Oparil S, Carter BL et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) Novelty and Significance . JAMA 2014; 311(5): 507–520.

21. Eckel RH, Jakikic JM, Ard JD et al. 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 129 (25 Suppl 2): S76-S99. Erratum in: Circulation 2014; 129 (25 Suppl 2): S100-S101. Circulation 2015; 131(4):e326.

22. Fernández MJN, Bermúdez CF, Munñoz DD et al. IgG4-related disease and isolated thoracic aortic aneurysm. Vasa Eur J Vasc Med 2014; 43(5): 385–389.

23. Stanley JC, Veith F, Wakefield TW (eds). Current Therapy in Vascular and Endovascular Surgery. 5th Edition. Philadelphia: Elsevier Inc 2014. ISBN 978–1-4557–0984–7.

24. Creager MA, Beckman JA, Loscalzo J (eds). Vascular Medicine. A companion to Braunwald´s Heart Disease. Second edition. Philadelphia: Elsevier Saunders 2013. ISBN-13: 978–1437729306. ISBN-10: 1437729304.

25. Grundy SM, Arai H, Barter P et al. An International Atherosclerosis Society Position Paper: Global recommendations for the management of dyslipidemia-Full report. Expert Dyslipidemia Panel of the International Atherosclerosis Society. J Clin Lipidol 2014; 8(1): 29–60.

26. Schwarcz AI, Quijano A, Olin JW et al. Internal medicine interns have a poor knowledge of peripheral arterial disease. Angiology 2012; 63(8): 597–602.

27. Gavorník P, Dukát A., Gašpar Ľ. Súčasnosť a budúcnosť farmako-artériotromboprofylaxie v klinickej praxi. Dokument (Odporúčania) Sekcie angiológov Slovenskej lekárskej komory (SA SLK, 2013). Vnitř Lék 2013; 59(12): 1081–1087.

28. Gavorník P, Dukát A, Gašpar Ľ. Manažment stabilnej anginy pectoris a iných foriem chronickej kardiovaskulárnej artériovej choroby. Vnitř Lék 2012; 58(7–8): 29–36.

29. Demer LL, Tintut Y Inflammatory, Metabolic, and Genetic Mechanisms of Vascular Calcification. Arterioscler Thromb Vasc Biol 2014; 34(4): 715–723.

30. Brown NK, Zhou Z, Zhang J et al. Perivascular Adipose Tissue in Vascular Function and Disease. A Review of Current Research and Animal Models. Arterioscler Thromb Vasc Biol 2014; 34(8): 1621–1630.

31. Kramer MHH, Bauer W, Dicker D et al. on behalf of the Working Group on Professional Issues, European Federation of Internal medicine (EFIM). The changing face of internal medicine: Patient centred care. Eur J Intern Med 2014; 25(2): 125–127.

32. Inventory, classification and encyclopeadia of rare diseases, with genes involved. Dostupné z WWW: <http://www.orpha.net/consor/cgi-bin/index.php?lng=EN>.

33. Gavorník P, Holomáň K, Gašpar Ľ et al. Syndróm vénovej panvovej kongescie – diagnóza a manažment. Odporúčanie Angiologickej sekcie Slovenskej lekárskej komory (2015). Vnitř Lék 2015; 61(3): 244–250.

34. Nehra A, Jackson G, Miner M et al. The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease. Mayo Clin Proc 2012; 87(8): 766–778.

35. Miner M, Seftel AD, Nehra A et al. Prognostic utility of erectile dysfunction for cardiovascular disease in younger men and those with diabetes. Am Heart J 2012; 164(1): 21–28.

36. Abstracts of the 16th World Meeting on Sexual Medicine, October 8–12, 2014, São Paulo, Brazil. J Sex Med 2015; 12(Suppl 1): 1–96. DOI: <http://dx.doi.org/10.1111/jsm.12826>.

37. Anele UA, Burnett AL. Erectile Dysfunction after Sickle Cell Disease–Associated Recurrent Ischemic Priapism: Profile and Risk Factors. J Sex Med 2015; 12(3): 713–719.

38. Burns PR, Rosen RC, Dunn M et al. Treatment satisfaction of men and partners following switch from on-demand phosphodiesterase type 5 inhibitor therapy to tadalafil 5 mg once daily. J Sex Med 2015; 12(3): 720–727.

39. Brody S, Weiss P. Erectile dysfunction and premature ejaculation: Interrelationships and psychosexual factors. J Sex Med 2015; 12(2): 398–404.

40. Popp R, Kleemann Y, Burger M et al. Impaired vigilance is associated with erectile dysfunction in patients with sleep apnea. J Sex Med 2015; 12(2): 405–415.

41. Glina S, Roehrborn CG, Esen A et al. Sexual function in men with lower urinary tract symptoms and prostatic enlargement secondary to benign prostatic hyperplasia: Results of a 6-month, randomized, double-blind, placebo-controlled study of tadalafil coadministered with finasteride. J Sex Med 2015; 12(1): 129–138.

42. Campbell UB, Walker AM, Gaffney M et al. Acute nonarteritic anterior ischemic optic neuropathy and exposure to phosphodiesterase type 5 inhibitors. J Sex Med 2015; 12(1): 139–151.

43. Ulloa J, Sambrotta L, Redko F et al. Detection of a tadalafil analogue as an adulterant in a dietary supplement for erectile dysfunction. J Sex Med 2015; 12(1): 152–157.

44. Davis R, Reveles KR, Ali SK et al. Statins and male sexual health: A retrospective cohort analysis. J Sex Med 2015; 12(1): 158–167.

45. Vlachopoulos C, Jackson G, Stefanadis C et al. Erectile dysfunction in the cardiovascular patient. Eur Heart J 2013; 34(27): 2034–2046.

46. La Vignera S. Increased expression of endothelial-platelet dysfunctional pathway in patients with arterial erectile dysfunction. Int Angiol 2011; 30(5): 408–414.

47. Pohanka M, Stárka L. Erektilní dysfunkce a jejich léčba: průvodce ošetřujícího lékaře. Maxdorf: Praha 2011. ISBN 978–80–7345–264–3.

48. Pohanka M, Kaňovský P. Obstrukční spánková apnoe, hypertenze a erektilní dysfunkce. Vnitř Lék 2005; 51(5): 578–582.

49. Kára T. Obezita, spánková apnoe a erektilní dysfunkce: tři vrcholy jednoho trojúhelníku? Vnitř Lék 2005; 51(5): 501–503.

50. Šobek M. Monoterapia príznakov dolných močových ciest zahrňujúcich benígnu prostatickú obštrukciu a erektilnej dysfunkcie. Klin urol 2013; 9(2–3): 116–118.

51. Rockey DC, Bell PD, Hill JA. Fibrosis – A Common Pathway to Organ Injury and Failure. N Engl J Med 2015; 372(12): 1138–1149.

52. Cai L, Jiang M, Zeng M et al. Age-Specific Clinical Features of Erectile Dysfunction. Health 2014; 6(10): 938–942.

53. Kambou T, Zaré C, Paré AK et al. Erectile Dysfunction among Diabetic Men in Two Medical Centers in Burkina Faso: Epidemiological, Diagnosis and Therapeutic Aspects. ASMed 2014; 4(1): 1–5.

54. Novikova E, Selyatiskaya V, Mitrofanov I et al. Association of Erectile Dysfunction and Hypogonadism with Metabolic Syndrome in Men with Lower Urinary Tract Symptoms of Younger and Older Age Groups. ASM 2014; 4(4): 55–64.

55. Eisenberg ML, Li S, Herder D et al. Testosterone therapy and mortality risk. Int J Impot Res 2015; 27(2): 46–48.

56. Ciftci H, Gumuş K, Yagmur I et al. Assessment of Mean Platelet Volume in men with vasculogenic and nonvasculogenic erectile dysfunction. Int J Impot Res 2015; 27(1): 38–40.

57. Choi H, Kim JH, Shim JS et al. Comparison of the efficacy and safety of 5-mg once-daily versus 5-mg alternate-day tadalafil in men with erectile dysfunction and lower urinary tract symptoms. Int J Impot Res 2015; 27(1): 33–37.

58. Kovac JR, Gomez L, Smith RP et al. Measurement of endothelial dysfunction via peripheral arterial tonometry predicts vasculogenic erectile dysfunction. Int J Impot Res 2014; 26(6): 218–222.

59. Kakkar AK, Dahiya N. Drug treatment of obesity: current status and future prospects. Eur J Intern Med 2015; 26(2): 89–94.

60. Gavorník P, Dukát A, Gašpar Ľ Akútne a chronické aortové choroby hrudníkovej a brušnej aorty u dospelých. Odporúčania Angiologickej sekcie Slovenskej lekárskej komory pre klasifikáciu a diagnózu chorôb aorty (AS SLK, 2014). Vnitř Lék 2015; 61(1): 72–80.

61. Spitzer M, Basaria S, Travison TG et al. Effect of testosterone replacement on response to sildenafil citrate in men with erectile dysfunction: a parallel, randomized trial. Ann Intern Med 2012; 157(10): 681–691.

62. Rogers JH, Goldstein I, Kandzari DE et al. Zotarolimus-eluting peripheral stents for the treatment of erectile dysfunction in subjects with suboptimal response to phosphodiesterase-5 inhibitors. J Am Coll Cardiol 2012; 60(25): 2618–2627.

63. Rosen RC, Cappelleri JC, Smith MD et al. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11(6): 319–326.

64. Breza J. Erektilné poruchy. Osveta: Martin 1994. ISBN 80–217–0313-X.

65. Pastuszak AW, Hyman DA, Yadav N et al. Erectile dysfunction as a marker for cardiovascular disease diagnosis and intervention. J Sex Med 2015; 12(4): 975–984.

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