The relationship between chronic viral hepatitis and erectile dysfunction in male patients more than 65 years old

458 CMJ Original Research December 2020, Volume: 42, Number: 4 Cumhuriyet Tıp Dergisi (Cumhuriyet Medical Journal) 458-465 http://dx.doi.org/10.7197/cmj.835306 The relationship between chronic viral hepatitis and erectile dysfunction in male patients more than 65 years old 65 Yaş üzerindeki erkek hastalarda kronik viral hepatit ile erektil disfonksiyon arasındaki ilişki Sedat Taştemur1, *Ahmet Aktaş2 1 Ankara City Hospital, Department of Urology, Ankara, Turkey Sivas Cumhuriyet University Medical School, Department of Internal Medicine, Sivas, Turkey Corresponding author: Ahmet Aktaş, MD, Sivas Cumhuriyet University Medical School, Department of Internal Medicine, Sivas, Turkey E-mail: Received/Accepted: December 03, 2020 /December 17, 2020 Conflict of interest: There is not a conflict of interest. 2 Sedat Taştemur Ahmet Aktaş SUMMARY Objective: Erectile dysfunction is defined as the incomplete failure of penile erection for satisfying sexual intercourse. Its incidence is quite high in male patients over 65 years of age. Many diseases, such as Diabetes Mellitus, obesity, and psychiatric diseases, affect erectile dysfunction. In our study, we aimed to show the relationship between chronic viral hepatitis and erectile dysfunction in male patients over 65 years of age. Method: A single-center retrospective study. Sixty-five male patients over 65 years old, 35 chronic viral hepatitis, 30 healthy controls were included in our study. Patients with comorbidities facilitating erectile dysfunction such as diabetes mellitus, obesity, and psychiatric disease were excluded from our study. Results: Erectile dysfunction was found in 49 of the 65 patients included in our study. There was no significant difference between HDL, Triglyceride, AST, ALT, GGT, LDH, Total Protein, and Albumin levels in the control group with hepatitis (p> 0.05). On the other hand, age and erectile dysfunction were found statistically significantly higher in the group with hepatitis (p <0.001, p = 0.002, respectively). IIEF, Total cholesterol and LDL were statistically significantly higher in the Control group (p <0.001, p = 0.01 and p = 0.02, respectively). Conclusions: The incidence of erectile dysfunction was higher in male patients over 65 years of age with chronic viral hepatitis compared to the control group. There was a significant relationship between erectile dysfunction and chronic viral hepatitis and advanced age. Keywords: Erectile dysfunction, chronic viral hepatitis, over 65 years old ORCID IDs of the authors: S.T. 0000-0003-0534-2520 A.A. 0000-0001-9464-0700 ÖZET Amaç: Erektil disfonksiyon, cinsel ilişkiyi devam ettirebilmek için penil ereksiyonunun başarısızlığı olarak tanımlanmaktadır. 65 yaş üstü erkek hastalarda görülme sıklığı oldukça yüksektir. Diabetes Mellitus, obezite ve psikiyatrik hastalıklar gibi birçok hastalık erektil disfonksiyonu etkiler. Çalışmamızda 65 yaş üstü erkek hastalarda kronik viral hepatit ile erektil disfonksiyon arasındaki ilişkiyi göstermeyi amaçladık. Yöntem: Tek merkezli retrospektif bir çalışma. Çalışmamıza 35’ i kronik viral hepatitli, 30 sağlıklı kontrol olmak üzere toplam da 65 yaş üstü altmış beş erkek hasta dahil edildi. Diabetes mellitus, obezite, psikiyatrik hastalık gibi erektil disfonksiyonu kolaylaştıran komorbiditeleri olan hastalar çalışma dışı bırakıldı. 459 Bulgular: Çalışmamıza dahil edilen 65 hastanın 49'unda erektil disfonksiyon saptandı. Hepatit grubunda ve kontrol grubunda HDL, Trigliserid, AST, ALT, GGT, LDH, Total Protein ve Albümin düzeyleri arasında anlamlı fark yoktu (p> 0.05). Öte yandan, yaş ve erektil disfonksiyon hepatiti olan grupta istatistiksel olarak anlamlı yüksek bulundu (sırasıyla p <0,001, p = 0,002). IIEF, Total kolesterol ve LDL, kontrol grubunda istatistiksel olarak anlamlı derecede daha yüksekti (sırasıyla p <0.001, p = 0.01 ve p = 0.02). Sonuç: Kronik viral hepatitli 65 yaş üstü erkek hastalarda erektil disfonksiyon insidansı kontrol grubuna göre daha yüksekti. Erektil disfonksiyon ile kronik viral hepatit ve ileri yaş arasında önemli bir ilişki vardı. Anahtar sözcükler: Erektil Disfonksiyon, kronik viral hepatit, 65 yaş üstü INTRODUCTION Failure to achieve or maintain an adequate penis erection to achieve satisfactory sexual activity is defined as Erectile dysfunction (ED). Since sexual functions are an essential component of quality life, ED; has become an increasingly important topic 1. According to the Massachusetts Male Aging Study (MMAS), the frequency of ED is 52% in men aged 40–70 2. Turkish Society of Andrology, based on his research in Turkey, was found in 69.2% of ED over 40 years of age 3. It is known that there are many interrelated factors in the emergence and continuation of ED. These etiological causes are divided into three as psychogenic, organic, and mixed type. Organic and psychogenic etiologies are intertwined in many cases in ED may create difficulties in the differential diagnosis. In the past, very few of the ED cases were thought to be of organic origin, but now 80% of ED cases are known to be responsible for organic causes. Emerging due to an organic etiology, ED generally causes anxiety in the person and causes ED to progress further. Psychogenic causes in ED etiology; Personality disorders such as performance anxiety, obsessive disorder, anxiety disorders, depression, and psychotic disorders. Organic factors include various causes such as cardiovascular disease, genitourinary disease, diabetes mellitus, malignancies, thyroid diseases, and hypertension 4,5. ED is a more common problem as the age progresses due to increased hypertension, hyperlipidemia, smoking, Diabetes Mellitus (DM), obesity, and vascular diseases with advanced age. Studies have shown that drugs such as phosphodiesterase inhibitors (PDE5-I) for ED are not used alone in the treatment. However, the treatment of diseases such as DM and obesity increases the frequency of ED, and cessation of diseases such as DM, obesity, and cessation of smoking. Some evidence suggests that ED can be significantly improved not only by some medications but also by direct treatment of risk factors. All this happens due to an improvement in endothelial functions 6. There is a close relationship between ED, endothelial dysfunction, and aging. Risk factors that seem insignificant such as hypoxia, inflammation, oxidative stress, are also associated with endothelial dysfunction and ED. ED problems originating from organic etiologies account for about 80% of cases, and the most common pathophysiology of ED is vascular disease. According to previous studies, ED is an early symptom of endothelial dysfunction in the presence or absence of cardiovascular risk factors. Therefore, patients with ED have an increased risk of cardiovascular, and ED may appear as a sentinel symptom in patients with unknown cardiovascular disease. However, the ED rate also increases after 60, independent of comorbidities such as coronary artery disease, diabetes, an (...truncated)