title: Erectile dysfunction of sclerodermic patients correlates with digital vascular damage.
abstract: BACKGROUND
  The prevalence of erectile dysfunction (ED) in men with systemic sclerosis (SSc) can be considered a manifestation of endothelium damage. Aim of the study is to investigate ED in SSc patients by color Doppler ultrasound examination and to correlate it with disease severity and digital vascular damage.
  
  
  METHODS
  In 20 males SSc patients blood flow velocity in the cavernous artery was determined with Duplex ultrasonography. Naifold videocapillaroscopy, Sexual Health Inventory for Men (SHIM) and Medsger Disease Severity Scale (DSS) were performed. Arteriogenic ED was defined by the presence of a reduced peak systolic velocity (PSVs), while diastolic velocity (EDV) and the resistive index (RI) were estimated to evaluate venocclusive dysfunction. SSc patients are classified by capillaroscopic pattern and vascular domain of DSS into two groups: low vascular damage (early or active capillaroscopic pattern and score of vascular domain of DSS≤2) and high vascular damage (late capillaroscopic pattern and score of vascular domain of DSS≥3).
  
  
  RESULTS
  In all SSc patients a reduction of SHIM is present (mean 13.5±6.3). Patients with less vascular damage have a significantly (p<0.001) higher score of SHIM than patients with greater vascular damage (19.2±2.4 vs 7.9±2.7). No significant difference (p>0.5) between the two groups of vascular damage was found in PSVs. Venocclusive dysfunction was present only (p<0.001) in the group with high vascular damage.
  
  
  CONCLUSIONS
  We can assert that there is a relationship between SSc vascular digital damage and ED.
authors.affiliation: Sapienza University of Rome, Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosato
authors.forename: Antonio
authors.initials: A
authors.lastname: Aversa
authors.forename: Ilenia
authors.initials: I
authors.lastname: Molinaro
authors.forename: Simonetta
authors.initials: S
authors.lastname: Pisarri
authors.forename: Giovanni
authors.initials: G
authors.lastname: Spera
authors.forename: Felice
authors.initials: F
authors.lastname: Salsano
mesh_terms: D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging; D007172:Erectile Dysfunction / Q000000981:diagnostic imaging; D006801:Humans; D018783:Impotence, Vasculogenic / Q000000981:diagnostic imaging*; D008297:Male; D020678:Microscopic Angioscopy; D008875:Middle Aged; D010413:Penis / Q000098:blood supply* / Q000000981:diagnostic imaging; D011928:Raynaud Disease / Q000000981:diagnostic imaging*; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color