Endocrine Abstracts

Introduction: UK NICE guidelines recommend that men with diabetes mellitus (DM) should be reviewed annually regarding symptoms of erectile dysfunction (ED) in view of possible phosphodiesterase-5 (PDE-5) inhibitor treatment. Previous studies have shown that 70% of men with ED have concomitant lower urinary tract symptoms (LUTS). It has been suggested that there may be some common patho-physiology accounting for the improvement in LUTS seen in men with ED and LUTS treated with PDE-5 inhibitors.

Aims: Our primary aim was to assess the prevalence and management of erectile dysfunction and concomitant LUTS in a diabetic cohort. Male patients attending a diabetic clinic in SWBH, Birmingham were consented to answer questions regarding their erectile function (IIEF) and urinary storage and voiding problems (IPSS).

Results: 60 men (mean age 64 years) answered the questions (July–Oct 14). 53% reported moderate (n=27) or severe (n=5) LUTS. The most commonly reported symptoms were urgency, frequency, and weak stream. Nine men said they had no partner or no opportunity for sexual activity. Of those that did have a partner (n=51), 78% (n=40) reported symptoms of erectile dysfunction (IIEF score <25). Prevalence of moderate/severe LUTS in patients wishing to be sexually active but suffering from ED was 58% (n=23) vs 27% (n=3) in those with normal erections. Only six patients were already taking PDE-inhibitors.

Discussion: This survey has shown that of men with diabetes managed in a hospital clinic and who have partners (n=51), 70% (n=36) have symptoms of erectile dysfunction and aren’t on any medication for this. Of these men, 61% (n=23) have concomitant LUTS. Overall a high proportion of men seen in a hospital diabetes clinic (presumably more complicated diabetic patients) had erectile dysfunction and urinary symptoms. These patients would potentially benefit from consideration for PDE-5 inhibitor treatment in the secondary care setting.