DOI: https://doi.org/10.22141/2224-0721.14.7.2018.148769

Pathogenic mechanisms of erectile dysfunction development in men with type 1 and type 2 diabetes mellitus

V.Ye. Luchytsky, E.V. Luchytskyy

Abstract


Background. Sexual disorders are one of the most common complications of diabetes mellitus (DM). Often, men with diabetes mellitus have erectile dysfunction (ED). The purpose of the study was to investigate the influence of vascular and hormonal factors on the development of erectile dysfunction in men with DM. Materials and methods. A survey of 491 men with DM was conducted. Using immune enzyme method, we determined the concentration of follicle­stimulating hormone, luteinizing hormone, total testosterone. A questioning was conducted using the International Index of Erectile Function. Penile Doppler ultrasonography was carried out. Results. In patients with type 2 DM, there was age dependence of the frequency of ED, which in men up to 40 years old was 6.3 %, in the age group of 41–50 years — 25.4 %, and in persons over the age of 60 — 36.1 %. At the same time, among men with type 1 DM, the majority of patients with impaired sexual function were aged 41–50 years (35.6 %). Doppler ultrasonography revealed a decrease in peak systolic velocity in a.dorsalis penis in men with DM as compared to the controls. Resistance and pulsatility indices in patients with diabetes were also significantly lower. The response to intracavernous administration of vasoactive substance in patients with DM was less intense than in controls. In men with type 2 DM, a significant decrease in testosterone levels was observed as compared to the control group. Conclusions. Pathogenesis of ED in patients with DM is multicomponent and, predominantly, predetermined by vasculogenic factors, and in patients with type 2 DM — by hormonal factors, as well.


Keywords


diabetes mellitus; erectile dysfunction; pathogenesis

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