Endocrine Abstracts

Introduction: Erectile dysfunction (ED) is common among men with diabetes mellitus (DM). Early diagnosis for such patients is essential in case of other multiple serious endocrine disorders like thyroid cancer (TC). The aim of our presentation is to demonstrate the case of 56-year-old male with DM and TC when the manifestation of ED had been observed only after thyroidectomy.

Clinical presentation: A 56-year-old man attended our clinic with complains of ED and loss of libido. He also represented the complains characteristic to diabetic neuropathy. The symptoms of diabetic neuropathy appeared approximately 10 years ago. The patient is diagnosed with diabetes mellitus type 2 since the age of 46. So diabetes mellitus and diabetic neuropathy was diagnosed at the same time. In November 2016, total thyroidectomy was performed because of papillary microcarcinoma. After several days of surgical intervention the patient represented complaints of ED. Laboratory investigations were performed: HbA1c-6.0%, prolactin and total testosterone within normal range. It had carried out a comprehensive, phased treatment, which included treatment of diabetic neuropathy and hypothyroidism with carrying out non-specific stimulation (Yohimbin Hydrochlorid and L-arginin) as well as the therapy by PDE-5 inhibitor. Above-mentioned treatment led positive results because the treatment of ED was initiated in a timely manner. In our clinical case DM and DN was diagnosed at the same time. It is interesting that the patient underwent to thyroidectomy and soon after he attended our Clinic. The question is: does thyroidectomy and high level of TSH could be the reason of early manifestation of ED?

Conclusion: The early diagnosis of ED is important for successful treatment especially among man who had ED and multiple serious endocrine disorders. So it is important to reveal it in the early stage. The easiest way not to miss ED in diabetic patients is the questionnaires, which we use successfully in our clinic.