title: Vascular impairment of erection in patients with diabetes and Peyronie's disease: is that accumulative?
abstract: BACKGROUND
  The vascular impairment of erection has been shown in diabetic patients as well as in patients with Peyronie's disease (PD). However, the impact of both conditions together on vascular impairment has not been well addressed.
  
  
  OBJECTIVE
  The aim of this study was to assess the impact of type 2 diabetes mellitus (DM) and PD solely, and together, on impairment of vascular status of erection in patients with erectile dysfunction (ED).
  
  
  METHODS
  Three hundred four male patients with a clinical diagnosis of ED who visited our Andrology clinic and who had DM and/or PD were enrolled in this study. Of the patients, 214, 28, and 62 had DM, PD, and both DM and PD, respectively. Patients were interviewed for ED using the International Index of Erectile Function. All patients were also interviewed for sociodemographic data and medical comorbidities including DM. The diagnosis of PD was based on a palpable penile plaque or acquired penile curvature. Color Doppler ultrasonography was used to evaluate the hemodynamics of erection in all patients.
  
  
  METHODS
  We assessed the impact of type 2 DM and PD on erectile function (EF) domain and on deterioration of Doppler parameters of erection.
  
  
  RESULTS
  Age, obesity, smoking, and medical comorbidities were significantly higher in patients with both DM and PD than in patients with any of the conditions alone. The means of EF domain, Q3, and Q4 were significantly lower in patients with both DM and PD than in patients with any of the conditions alone. Patients with DM only had significantly lower means of EF domain, Q3, and Q4 than patients with PD only. The means of peak systolic velocity and resistive index were significantly lower, and the means of end-diastolic velocity were significantly higher in patients with both DM and PD than in patients with any of the conditions alone.
  
  
  CONCLUSIONS
  Type 2 DM and PD solely, and together, negatively affect the vascular status of erection. Type 2 DM demonstrated the principal effect; however, presence of PD has an additive impairment effect on erection and Doppler parameters.
authors.affiliation: Department of Urology, Suez Canal University, Ismailia, Egypt;. Electronic address: aielsakka@yahoo.com.
authors.forename: Ahmed I
authors.initials: AI
authors.lastname: El-Sakka
authors.affiliation: Al-Noor Specialist Hospital, Diabetic Centre, Makkah, Saudi Arabia.
authors.forename: Khaled A
authors.initials: KA
authors.lastname: Tayeb
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D010411:Penile Induration / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D010413:Penis / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult