Effect of Sarcopenia on Treatment of Erectile Dysfunction

Erectile dysfunction (ED) and sarcopenia share common risk factors, particularly advanced age. This study aimed to assess the effect of sarcopenia on ED treatment outcomes.

A prospective observational study was conducted, involving patients receiving ED treatment from six different centres. Sarcopenia was evaluated using the Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls (SARC-F) questionnaire, the 30-Second Chair Stand Test, and the 4-Meter Walk Test. The International Index of Erectile Function (IIEF) questionnaire was used to assess ED severity. The treatment response in patients regularly using phosphodiesterase type 5 inhibitors (PDE5i) for ED was analysed in relation to sarcopenia.

The study included 137 patients (mean age = 54.91 ± 12.46 years) who regularly used PDE5i. Sarcopenia suspicion was present in 15.33% (n = 21) of patients. Those with suspected sarcopenia were older (mean age = 64.62 ± 5.83 years) and had lower baseline IIEF scores (8.76 ± 3.57) than patients without suspected sarcopenia (p < 0.001 for both). Whilst the IIEF scores significantly increased after PDE5i treatment in patients without suspected sarcopenia (from 11.64 ± 4.82 to 17.28 ± 5.70; p < 0.001), the increase was not significant in those with suspected sarcopenia (from 8.76 ± 3.57 to 9.81 ± 5.14; p = 0.283).

Sarcopenia may contribute to a poor response to ED treatment, particularly in older patients. It could be a significant factor in ED treatment resistance, especially at an advanced age.