Endocrine Abstracts

Aim of the study: Assessing prevalence and severity of erectile dysfunction in patients with pituitary diseases.

Materials and methods: International Index of Erectile Function (IIEF) and Sexual Health Inventory for Men (SHIM) questionnaires were used to assess erectile dysfunction (ED) in 83 patients having pituitary diseases (31 patients had hypopituitarism, 11 diabetes insipidus, 10 prolactinomas, 11 nonfunctional adenomas, 16 operated acromegaly, 4 GH deficiency). The presence and severity of erectile dysfunction were quantified by using IIEF questionnaire scores for erectile function (IIEF-FE) validated by Altho and Juliano in 2006. Correlation between plasma testosterone levels and severity of ED was ianalized by using Pearson correlations.

Results: Erectile function was most severely affected in patients with hyperprolactinemia, with a mean IIEF-FE score of 5.7, and among them 60% had severe dysfunction, 30% moderate, 10% mild dysfunction. Plasma testosterone levels were in inverse relation with prolactin levels. Acromegalic patients had severe impairment of EF, mean IIEF-FE 9.2, and weak correlation with testosterone levels (r²=0.235). ED severity decreases progressively in patients presenting nonfunctional adenomas, mean IIEF-FE 12, followed by hypopituitarism, mean IIEF-FE 12.45, GH deficiency having a mean IIEF-FE 15 and diabetes insipidus IIEF-FE 18.5. Patients having nonfunctional adenomas showed a strong direct correlation between testosterone levels and IIEF-FE score (r²=0.286). In patients with hypopituitarism IIEF test showed a high prevalence of severe ED, 41.9%, displaying a weak correlation with testosterone levels (r²=0.054). In GH deficient patients IIEF-FE score shows moderate ED, close to the mean value of the other subjects.Patients with diabetes insipidus showed elevated prevalence of ED, 63.7%, but most of them had mild to moderate ED. There was no correlation between testosterone levels and severity of ED.

Conclusions: The prevalence and severity of ED are different between the groups studied. The most severe erectile dysfunction was seen for prolactinomas, followed by acromegaly, nonfunctional adenomas, hypopituitarism, GH deficiency and diabetes insipidus.