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Do Urologists Really Recognize the Association Between Erectile Dysfunction and Cardiovascular Disease?
Dongjie Li1, Xiucheng Li2, Emin Peng3
1Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, Hunan, China; Department of Geriatric urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Changsha, China.
Insights
Erectile dysfunction (ED) and cardiovascular diseases (CVDs) share risk factors, yet urologists show limited recognition and updated treatment strategies for this association. Many urologists lack confidence in treating ED with PDE5 inhibitors in patients with CVDs.
Area of Science:
- Urology
- Cardiology
- Men's Health
Background:
- Erectile dysfunction (ED) and cardiovascular diseases (CVDs) share common risk factors, with ED potentially predicting CVDs.
- Treating ED may benefit cardiovascular health, but the ED-CVD association is underreported.
- Understanding urologists' perspectives on the ED-CVD link is crucial for integrated patient care.
Purpose of the Study:
- To assess urologists' perceptions regarding the association between ED and CVDs.
- To evaluate urologists' diagnostic and treatment approaches for CVDs in patients presenting with ED.
- To identify potential gaps in knowledge and practice among urologists concerning the ED-CVD relationship.
Main Methods:
- A prospective study conducted from November 2018 to February 2019.
- Involved 449 urologists aged 18-64 years who completed an online survey.
- The survey, distributed via WeChat, assessed urologists' knowledge of ED and its association with CVDs.
Main Results:
- A high percentage (83.5%) of urologists acknowledged the ED-CVD association, but only 51.4% considered ED an independent disorder.
- Awareness was higher in male urologists. While 83.6% believed in consistent disease progression, only 44.9% performed combined assessments.
- Conventional treatments like psychological intervention and PDE5 inhibitors were preferred, with significant concerns (76.6%) regarding PDE5i safety in CVD patients.
Conclusions:
- Urologists' assessment of CVDs in ED patients was suboptimal, particularly among younger, female, or rural practitioners.
- Treatment strategies for ED among urologists were not current, and attitudes towards PDE5 inhibitors in CVD patients were pessimistic.
- There is a need for improved education and updated guidelines for urologists on managing the ED-CVD connection.
Introduction:
Erectile dysfunction (ED) and cardiovascular diseases (CVDs) share many common risk factors. ED could be a strong independent predictive factor of CVDs. Furthermore, the treatment of ED had been shown to be beneficial for cardiovascular diseases. However, the association between ED and CVDs has been reported scarcely in the literature.
Aim:
To investigate urologists' perception, diagnosis, and treatment of CVDs in patients with ED.
Methods:
The study was conducted as a prospective study from November 2018 through February 2019, including urologists aged 18-64 years. All participants completed a survey of the knowledge of ED via an online questionnaire platform in 7 WeChat groups of urologists. WeChat is the most popular multipurpose messaging and social media in China.
Main Outcome Measure:
The main outcomes were the answers that urologists chose or filled.
Results:
449 urologists were included. Most of participants (375, 83.5%) agreed that CVDs are associated with ED. Only 231 participants (51.4%) thought ED was an independent disorder. The awareness of the association between ED and CVDs is significantly higher among male urologists than their female counterparts. Although 378 (83.6%) participants believed that the progression of these 2 diseases was consistent, only 181 (44.9%) would do conjoined assessment of both CVDs and ED. In addition, most urologists only considered conventional treatment, such as psychological intervention (341, 75.4%) and phosphodiesterase type 5 inhibitor (PDE5i) therapy (318, 70.4%) for their patients, whereas 339 urologists (88.3%) claimed that they would treat CVDs in patients with both ED and CVDs. 344 (76.6%) urologists showed some concerns over PDE5is.
Conclusion:
Urologists' assessment of CVDs in patients with ED was disappointing especially among young and female urologists or those working in underserved areas. Besides, the urologists' treatments of ED were not updated, and their attitudes toward the safety and effectiveness of PDE5is for CVDs were not optimistic. Li D, Li X, Peng A, et al. Do Urologists Really Recognize the Association Between Erectile Dysfunction and Cardiovascular Disease? Sex Med 2020;8:195-204.
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