Does impotence improve after parathyroidectomy in men with primary hyperparathyroidism?
BACKGROUND
Erectile dysfunction (ED) is a common diagnosis associated with age, hypertension, cardiovascular disease, and diabetes. Primary hyperparathyroidism (PHP) is also seen with these comorbidities, but its association with ED has yet to be studied. We evaluated the rate and resolution of impotence after curative surgery for PHP.


METHODS
Prospectively collected data, including a self-reported questionnaire of symptoms, were reviewed for men who had curative parathyroid exploration for sporadic PHP from July 2010 to January 2014. Data were compared with an age-matched cohort of men who had thyroidectomy during the same period.


RESULTS
Among 160 men with PHP and mean age of 60 years (range, 19-88), preoperative ED was reported by 13%, and this group was older than patients without ED (mean age, 70 vs 58 years, P < .01). Self-reported resolution of ED after parathyroidectomy occurred in 67% compared with 43% of patients in a thyroidectomy cohort. Preoperative mean arterial blood pressure was less in men with postoperative resolution of ED (96.6 vs 105.4 mm Hg, P = .03). Among 3 of 21 men on specific ED medications, 2 no longer required them postoperatively.


CONCLUSIONS
Impotence is reported often by men undergoing parathyroidectomy for PHP. After curative surgery, 67% of those affected may self-report ED resolution, which may be more pronounced in those patients with a lesser preoperative mean arterial blood pressure.
Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
Jenny Y
JY
Yoo
Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
Linwah
L
Yip
Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
Michaele J
MJ
Armstrong
Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
Sally E
SE
Carty
Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
Meghan L
ML
Kelley
Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
Michael T
MT
Stang
Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, PA. Electronic address: mccoykl@upmc.edu.
Kelly L
KL
McCoy
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D007172:Erectile Dysfunction / Q000209:etiology / Q000601:surgery*; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D012189:Retrospective Studies; D055815:Young Adult