BACKGROUND: Erectile dysfunction(ED) is common in patients with chronic liver disease(CLD). Although it significantly worsens the quality of life, caregivers and researchers often neglect it. AIM: Evaluating the prevalence of ED in patients with CLD, associated factors, and response to therapy with tadalafil, a phosphodiesterase-5 inhibitor. METHODS: A total of 60 males with Child-Pugh score between 5 and 10 and no overt hepatic encephalopathy were studied. ED was assessed based on the 15-question International Index of Erectile Function (IIEF) questionnaire. Patients were classified as ED+ if score was <25. Patients with ED were given 10 mg of tadalafil for 4 weeks. RESULTS: The mean age was 45.2 he 7.8 years. The mean Child-Turcotte-Pugh (CTP) score was 6.4 sc 1.7, and model for end-stage liver disease (MELD) score was 12.1 sc 4.5. Twenty-seven (45%) patients had compensated cirrhosis, and 45(75%) had alcohol as etiology. Twenty-five (42%) had an IIEF score <25, suggestive of ED. The IIEF score had significant correlation with the presence of ascites(r = -0.27, P 0.04) and serum creatinine (r -0.26, P = 0.05); however, there was no correlation with CTP, MELD, or alcohol as etiology. Among ED group, IIEF scores improved significantly with 4 weeks of tadalafil therapy (15.1 ± 5.6 vs 22.0 ± 3.4, P < 0.001), and 11(44%) had resolution of ED. CONCLUSION: ED is common in patients with cirrhosis. Tadalafil administration significantly improves ED in these patients.
BACKGROUND: Erectile dysfunction(ED) is common in patients with chronic liver disease(CLD). Although it significantly worsens the quality of life, caregivers and researchers often neglect it. AIM: Evaluating the prevalence of ED in patients with CLD, associated factors, and response to therapy with tadalafil, a phosphodiesterase-5 inhibitor. METHODS: A total of 60 males with Child-Pugh score between 5 and 10 and no overt hepatic encephalopathy were studied. ED was assessed based on the 15-question International Index of Erectile Function (IIEF) questionnaire. Patients were classified as ED+ if score was <25. Patients with ED were given 10 mg of tadalafil for 4 weeks. RESULTS: The mean age was 45.2 he 7.8 years. The mean Child-Turcotte-Pugh (CTP) score was 6.4 sc 1.7, and model for end-stage liver disease (MELD) score was 12.1 sc 4.5. Twenty-seven (45%) patients had compensated cirrhosis, and 45(75%) had alcohol as etiology. Twenty-five (42%) had an IIEF score <25, suggestive of ED. The IIEF score had significant correlation with the presence of ascites(r = -0.27, P 0.04) and serum creatinine (r -0.26, P = 0.05); however, there was no correlation with CTP, MELD, or alcohol as etiology. Among ED group, IIEF scores improved significantly with 4 weeks of tadalafil therapy (15.1 ± 5.6 vs 22.0 ± 3.4, P < 0.001), and 11(44%) had resolution of ED. CONCLUSION: ED is common in patients with cirrhosis. Tadalafil administration significantly improves ED in these patients.
Entities:
Keywords:
CLD, Chronic Liver Disease; CTP, Child-Turcotte-Pugh; ED, Erectile Dysfunction; HE, Hepatic Encephalopathy; HRQOL, Health-Related Quality of Life; IIEF-15, International Index for Erectile Function; MELD, Model for End-Stage Liver Disease; MMSE, Mini-Mental State Examination; PDE, Phosphodiesterase; cirrhosis; erectile dysfunction; phosphodiesterase inhibitors; tadalafil
Authors: Naomi M Gades; Ajay Nehra; Debra J Jacobson; Michaela E McGree; Cynthia J Girman; Thomas Rhodes; Rosebud O Roberts; Michael M Lieber; Steven J Jacobsen Journal: Am J Epidemiol Date: 2005-02-15 Impact factor: 4.897
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