title: Meta-Analysis of Prevalence of Erectile Dysfunction in Mainland China: Evidence Based on Epidemiological Surveys.
abstract: BACKGROUND
  The epidemiologic characteristics of erectile dysfunction (ED) in mainland China remain incompletely understood.
  
  
  OBJECTIVE
  To evaluate the overall prevalence and determine the severity of ED in mainland China.
  
  
  METHODS
  An extensive database search was performed of PubMed, Embase, the Chinese National Knowledge Infrastructure (CNKI) database, the WanFang database, the Chinese Biological Medical Literature (CBM) database, and the Chongqing VIP using the following terms: erectile dysfunction, prevalence, epidemiology, epidemiological, and China. Study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Data were pooled for the random-effects model. Sensitivity analyses were conducted to assess potential bias.
  
  
  METHODS
  All survey studies reporting on the prevalence of ED in mainland China were included. Data extraction was performed independently by two of the authors, and conflicts were resolved by another author.
  
  
  RESULTS
  Of 2,155 retrieved articles, 25 were included in this meta-analysis with a total of 48,254 participants. The pooled prevalence of ED in men was 49.69% (95% CI = 39.29-60.10). The occurrence rates of ED in age groups younger than 30, 30 to 39, 40 to 49, 50 to 59, 60 to 69, and at least 70 years were 20.86%, 25.30%, 40.48%, 60.12%, 79.10%, and 93.72%, respectively. The severity-specific prevalences of mild, moderate, and severe ED were 32.54%, 9.86%, and 13.97%, respectively. Moreover, the prevalences reported by different diagnostic methods were 14.19% for self-reports, 44.60% for the Chinese Index of Erectile Function, and 49.91% for the International Index of Erectile Function-5. The prevalence map based on a geographic information system showed an unequal geographic distribution.
  
  
  CONCLUSIONS
  ED is highly prevalent in mainland China, and its prevalence increases with age. More high-quality surveys on ED with larger samples throughout mainland China are needed to confirm these findings.
authors.affiliation: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Wenying
authors.initials: W
authors.lastname: Wang
authors.affiliation: School of Public Health of Guangxi Medical University; Guangxi Colleges and Universities Key Laboratory of the Prevention and Control of High Prevalence Diseases, Nanning, Guangxi, China.
authors.forename: Jingyuan
authors.initials: J
authors.lastname: Fan
authors.affiliation: School of Public Health of Guangxi Medical University; Guangxi Colleges and Universities Key Laboratory of the Prevention and Control of High Prevalence Diseases, Nanning, Guangxi, China.
authors.forename: Guifeng
authors.initials: G
authors.lastname: Huang
authors.affiliation: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Tian
authors.affiliation: Center for Bioinformatics and Systems Biology, Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA; College of Global Change and Earth System Science, Beijing Normal University, Beijing, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Tan
authors.affiliation: School of Public Health of Guangxi Medical University; Guangxi Colleges and Universities Key Laboratory of the Prevention and Control of High Prevalence Diseases, Nanning, Guangxi, China. Electronic address: bjminiaowwy@sina.com.
authors.forename: Li
authors.initials: L
authors.lastname: Su
keywords: China; Erectile Dysfunction; Meta-Analysis; Prevalence