Erectile dysfunction in ankylosing spondylitis: a systematic review and meta-analysis

Area of Science:

• Rheumatology
• Urology
• Public Health

Background:

• Erectile dysfunction (ED) prevalence in ankylosing spondylitis (AS) patients is infrequently reported.
• Existing data often involves small sample sizes, necessitating a comprehensive analysis.

Purpose of the Study:

• To determine the prevalence of ED in men diagnosed with AS.
• To investigate whether AS independently serves as a risk factor for developing ED.

Main Methods:

• Systematic literature search across multiple databases (PubMed, Web of Science, etc.) up to October 2022.
• Quality assessment of included studies using established tools (Newcastle-Ottawa Scale).
• Meta-analysis employing relative risk (RR) and standard mean difference (SMD) to evaluate AS-ED association, with subgroup and sensitivity analyses.

Main Results:

• The pooled prevalence of ED among AS patients was 44% (95% CI, 25%–63%).
• Men with AS exhibited a significantly higher risk of ED (RR, 2.04; 95% CI, 1.28–3.25).
• AS patients reported significantly lower International Index of Erectile Function (IIEF) scores, particularly in the erectile function domain (SMD, -0.60; 95% CI, -0.80–-0.41).

Conclusions:

• Ankylosing spondylitis is associated with a high prevalence of erectile dysfunction.
• AS is identified as a significant risk factor contributing to ED in affected men.
• This meta-analysis underscores the need for managing ED in AS patient care.