Erectile dysfunction in hyperuricemia: A prevalence meta‐analysis and meta‐regression study. (16th August 2021)

• Record Type: Journal Article
• Authors: Totaro, Maria; Dimarakis, Sotirios; Castellini, Chiara; D'Andrea, Settimio; Parisi, Antonio; D'Amato, Federica; Tienforti, Daniele; Palazzi, Sara; Baroni, Marco Giorgio; Francavilla, Sandro; Barbonetti, Arcangelo
• Is Part Of: Andrology. Volume 10:Number 1(2022)
• Page Start: 72
• Page End: 81
• Publication Date: 2021-08-16
• Subjects: diabetes -- gout -- impotence -- metabolic syndrome -- sexual function -- uric acid; Andrology -- Periodicals; 616.65
• DOI: 10.1111/andr.13088
• Languages: English
• ISSNs: 2047-2919

Abstract

Abstract: Background: Whether and to what extent an association exists between hyperuricemia and erectile dysfunction (ED) has not yet been fully determined. Objective: To define pooled prevalence estimates and correlates of erectile dysfunction in men with hyperuricemic disorders. Materials and methods: A thorough search of Medline, Scopus, and Cochrane Library databases was performed. Data were combined using random‐effects models and the between‐study heterogeneity was assessed by Cochrane's Q and I 2 tests. A funnel plot was used to assess publication bias. Results: Overall, 8 studies included gave information about 85, 406 hyperuricemic men, of whom 5023 complained of erectile dysfunction, resulting in a pooled erectile dysfunction prevalence estimate of 33% (95% Confidence Interval: 13–52%; I² = 99.9%). The funnel plot suggested the presence of a publication bias. At the meta‐regression analyses, among the available covariates that could affect estimates, only type 2 diabetes mellitus was significantly associated with a higher prevalence of erectile dysfunction (β = 0.08; 95% Confidence Interval: 0.01, 0.15, p = 0.025). At the sub‐group analysis, the pooled erectile dysfunction prevalence decreased to 4% (95% Confidence Interval: 0%–8%) when only the largest studies with the lowest prevalence of type 2 diabetes mellitus were included and increased up to 50% (95% Confidence Interval: 17%–84%) when the analysis was restricted to studies enrolling smaller series with higher prevalence of type 2 diabetes mellitus. Conclusions: A not negligible proportion of men with hyperuricemia can complain of erectile dysfunction. While a pathogenetic contribution of circulating uric acid in endothelial dysfunction cannot be ruled out, the evidence of a stronger association between hyperuricemia and erectile dysfunction in type 2 diabetes mellitus points to hyperuricemia as a marker of systemic dysmetabolic disorders adversely affecting erectile function.