title: Testosterone deficiency causes penile fibrosis and organic erectile dysfunction in aging men. Evaluating association among Age, TDS and ED.
abstract: BACKGROUND
  We studied the possible correlation between age, testosterone deficiency, cavernosal fibrosis and erectile dysfunction (ED).
  
  
  METHODS
  47 patients with ED were enrolled between September 2010 and October 2011. IIEF-EF score, NPTR test using the Rigiscan method, total and free testosterone levels, and cavernosum biopsy were carried out on all patients. Patients aged 65 or over were defined as Old Age (OA) while patients under 65 were defined Young age (YA). The strength of the relationships found was estimated by Odds Ratio.
  
  
  RESULTS
  74% of patients with values of over 52% collagen fibers in the corpora cavernosa were found to have organic ED. A significant difference was found in age, percentage of collagen fibers, testosterone levels between patients with Positive Rigiscan (PR) and Negative Rigiscan (NR). Hypotestosteronaemia increased the risk of ED with PR (OR: 21.4, 95% CI: 20.2-22.6) and in both young age patients (OR: 4.3, 95% CI: 2.4-6.2) and old age patients (OR: 15.5, 95% CI: 13.4-17.6). Moreover cavernosal fibrosis increased the risk of ED with PR in both young age patients (OR: 8.2, 95% CI: 6.4-10.0 and old age patients (OR: 24.6, 95% CI: 20.8-28.4).
  
  
  CONCLUSIONS
  This study demonstrates a strong association among age, testosterone deficiency, cavernosal fibrosis and ED with PR. Age, testosterone deficiency and cavernosal fibrosis are potentially correctable factors of cavernosal fibrosis and organic ED. Further, prospective studies are needed to evaluate if testosterone treatment, alone or in association with PDE5 inhibitors, may lower the risk of cavernosal fibrosis or decrease the severity the fibrosis in ED patients.
authors.affiliation: Department of Urology, University Federico II of Naples, Via Pansini 5, 80131 Naples, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Iacono
authors.forename: Domenico
authors.initials: D
authors.lastname: Prezioso
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruffo
authors.forename: Ester
authors.initials: E
authors.lastname: Illiano
authors.forename: Leo
authors.initials: L
authors.lastname: Romis
authors.forename: G
authors.initials: G
authors.lastname: Di Lauro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Romeo
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D007172:Erectile Dysfunction / Q000097:blood / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010411:Penile Induration / Q000097:blood / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D012372:ROC Curve; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood / Q000172:deficiency*
chemical_list: D015415:Biomarkers; D013739:Testosterone