title: Organic, relational and psychological factors in erectile dysfunction in men with diabetes mellitus.
abstract: OBJECTIVE
  Diabetes mellitus-induced erectile dysfunction (DMED) is thought to be multifactorial in aetiology and to include vascular, neurological, and psychological components. The aim of the present study is to determine the contribution of organic, relational, and intrapsychic components to the pathogenesis of ED in diabetic in comparison with non-diabetic patients.
  
  
  METHODS
  We studied a consecutive series of 1027 using SIEDY structured interview. A complete physical examination and a series of metabolic, biochemical, hormonal, psychometric, penile vascular tests and nocturnal penile tumescence and rigidity evaluations were performed.
  
  
  RESULTS
  15% of patient studied were affected by DMED. Diabetic patients with DMED have a greater severity of erectile dysfunction and are more likely to have an organic, rather than an intrapsychic, component. Impaired sexual desire is less frequent in these patients and they had an higher prevalence of hypogonadism than non-diabetic individuals.
  
  
  CONCLUSIONS
  Diabetic patients seeking treatment for erectile dysfunction have a greater severity of disease, less impaired sexual desire, suggesting that the need for medical care in diabetic patients with ED could be even greater than in their non-diabetic counterparts. Considering the higher prevalence of obesity-related decrease of testosterone levels in DMED, an appropriate screening and treatment of hypogonadism might improve the outcome of pharmacotherapy for ED in diabetic patients.
authors.affiliation: Andrology Unit, Department of Clinical Physiopathology, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Corona
authors.forename: E
authors.initials: E
authors.lastname: Mannucci
authors.forename: R
authors.initials: R
authors.lastname: Mansani
authors.forename: L
authors.initials: L
authors.lastname: Petrone
authors.forename: M
authors.initials: M
authors.lastname: Bartolini
authors.forename: R
authors.initials: R
authors.lastname: Giommi
authors.forename: G
authors.initials: G
authors.lastname: Forti
authors.forename: M
authors.initials: M
authors.lastname: Maggi
mesh_terms: D048909:Diabetes Complications / Q000453:epidemiology / Q000523:psychology; D007172:Erectile Dysfunction / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires