title: Chronic lead exposure may be associated with erectile dysfunction.
abstract: BACKGROUND
  Heavy metals constitute significant potential threats to human health in both occupational and environmental settings. Research examining the etiology of lead toxicity-induced hypertension reveals that the free radical production and lowering of inherent antioxidant reserves resulting from lead toxicity are directly related to vasoconstriction underlying lead-induced hypertension. A similar mechanism would affect smooth muscle relaxation in the cavernous tissue leading to erectile dysfunction (ED).
  
  
  OBJECTIVE
  Is to study the possible hazardous effect of chronic lead exposure on the erectile function, and to document the deposition of lead in the cavernous tissue.
  
  
  METHODS
  The study group consisted of 34 men with ED, consecutively scheduled for penile implant insertion at Cairo University Hospital, as well as 15 controls. We determined the blood lead level for the two groups by the use of atomic absorption spectrophotometry. Sixteen of the 34 patients, and none of the 15 controls, had elevated lead serum levels (above 25 [g/dL]).
  
  
  METHODS
  We estimated the levels of two reactive oxygen species (ROS) and four antioxidants in peripheral blood for the two groups. At the time of penile implant insertion, we prepared cavernous tissue paraffin sections stained with Mallory-Parker stain to study lead deposition. We also prepared ultrathin sections for electron microscopy. We estimated cavernous tissue lead level.
  
  
  RESULTS
  The ED group had significantly higher blood lead level when compared with the control group. A significant positive correlation was found between the blood lead level and cavernous tissue lead level of the ED group. Individuals with high blood lead had significantly higher levels of serum ROS and significantly lower levels of serum antioxidants, compared with those having low blood lead. Histological sections from patients with high blood lead showed deposition of grayish lead granules in the cavernous tissue.
  
  
  CONCLUSIONS
  Chronic lead exposure may be associated with ED.
authors.affiliation: Cairo University-Department of Andrology and Sexology, Cairo, Egypt. mohamedtarekanis@gmail.com
authors.forename: Tarek H
authors.initials: TH
authors.lastname: Anis
authors.forename: Ahmed
authors.initials: A
authors.lastname: ElKaraksy
authors.forename: Taymour
authors.initials: T
authors.lastname: Mostafa
authors.forename: Amr
authors.initials: A
authors.lastname: Gadalla
authors.forename: Hager
authors.initials: H
authors.lastname: Imam
authors.forename: Lamya
authors.initials: L
authors.lastname: Hamdy
authors.forename: Omayma
authors.initials: O
authors.lastname: Abu el-Alla
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004534:Egypt; D004784:Environmental Monitoring; D007172:Erectile Dysfunction / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007854:Lead / Q000032:analysis / Q000097:blood; D007855:Lead Poisoning / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D017382:Reactive Oxygen Species / Q000097:blood; D013052:Spectrometry, X-Ray Emission / Q000379:methods
chemical_list: D015415:Biomarkers; D017382:Reactive Oxygen Species; D007854:Lead