Summary - The objective of this work was to evaluate, in a cohort of patients with erectile dysfunction, the influence of alcohol consumption and the response to alcohol abstinence with and without sildenafil association. We took into consideration 50 patients aged between 22 and 77 years (mean±SD, 56±14) from a population of 150 patients with erectile dysfunction. These 50 patients were divided into three different treatment groups and were screened for three different levels of alcohol risk by a CAGE questionnaire. All of them were evaluated by an IIEF questionnaire before and after a one-month-treatment. Our cohort of 50 patients included 14 patients with high alcohol risk, 34 patients with low alcohol risk and only 2 patients without alcohol risk. After one month, 29 patients responded to the therapy and 21 did not respond. The IIEF questionnaires showed a statistically significant difference between different risk groups (p≤0.05) before and after the one-month-treatment. The three treatment groups had a statistically significant difference between the IIEF before and after the one month treatment (p<0.05). All the patients were examined by a penile Doppler Ultrasound. Only 10 of them presented an abnormal PDV and only 1 presented a pathologic PSV and PDV These 11 patients did not respond to therapies and 10 of them showed a high alcohol risk. The alcohol consumption risk was directly correlated with PDV (p=0,00001 R^sup 2^=0,4). The results of this study demonstrated an important relationship between alcohol consumption and erectile dysfunction. This underlines the important therapeutic aspect of alcohol abstinence in low and high alcohol risk patients.
Key words: alcoholism; C.A.G.E.; erectile dysfunction; Doppler US; therapy; I.I.E.F
The erectile dysfunction (ED) is a significant problem of the western population. One of its important causes is the style of life. One of the aspects of the irregular lifestyle is alcohol consumption. Alcoholism is one of the most common chronic disorders in the world and leads to a large number of multiple diseases. The W.H.O. established that alcohol is responsible for around 9% of diseases in Europe. Even in low doses (>20 g/day fora man and > 10 g/day for a woman), the risk of cirrhoses, arterial hypertension, cardiac infarction, congenital malformations and tumours increases.1,2 Also, the bibliography shows significant evidence of correlation between alcoholism and sexual deficit.3,4,5 In fact, the influence of alcohol consumption on hormonal level in patients with sexual deficit was demonstrated,3 as well as the normalization of hormonal level resulting from the abstinence from alcohol consumption.4 Therefore, authors suggested that the effects of alcohol consumption on the vascular system, liver function and neurological system were an indirect cause of sexual dysfunction.3-6 However, all these studies have taken into consideration high risk patients and the bibliography presents few studies of moderate alcohol drinkers.
In the population of patients with ED the present study aims to evaluate: the correlation between erectile dysfunction and consumption of alcoholic drinks and the effect of alcohol abstinence on this population with and without assonated drugs association.
SUBJECTS AND METHODS
The study involved 155 ED patients screened by the Urology II Unit of the University of Bari, from May 2004 to May 2005. From this population we excluded all patients with clinical causes of ED as described in Table 1. Therefore, only 50 patients aged between 22 and 77 years (mean+SD, 56+14) were included in our study.
All the patients were screened by a CAGE questionnaire (each of the letters in the acronym refers to one of the questions) and by the AUDIT (Alcohol Use Disorders Identification Test). The CAGE questionnaire is a blind questionnaire that permits to identify alcohol dependence. It consists of 4 questions (cut down, annoyed, guilt, eye opened): when 2 or more answers were positive, the risk was considered high, while the presence of 1 positive answer led to a risk considered low. …