Author(s): Rajendra Prasad Suram1, Prathima Raj Dara2
BACKGROUND One of the most common adverse effects of diabetes mellitus, erectile dysfunction (ED) remains difficult to treat despite advances in pharmacotherapeutic approaches in the field. This unmet need has brought about a late re-focus on the pathophysiology, so as to comprehend the cellular and molecular mechanism prompting ED in diabetes. Diabetes-induced ED is a need to find focuses that may prompt novel approaches for a fruitful treatment. Present study was tried to understand role of vascular and neurogenic alterations in the pathophysiology of diabetic sexual dysfunction.
SUBJECTS AND METHODS The study was carried out on 17 male impotent patients with Diabetes Mellitus: 5 patients (Aged 43-56 years; mean age 48.4) had insulin-dependent DM, and 13 patients (Aged 40-62; mean age 53.5) non-insulin-dependent DM. None of the patients were on medications known to interfere with male erectile sexual function. All patients were told to give informed consent. Every participant underwent a physical examination including complete medical and sexual history and routine laboratory tests. Penile vascular assessment and assessment of nocturnal penile erections investigation were assessed in the study.
RESULTS As showed in Table I. alterations in the vascular system was found in 13 (61.5%) participants. Out of which moderate alteration noticed in 8 (47%) and severe alteration in 5 (16%) patients. Among the patients with non-insulin-dependent DM, 7 (41.1%) had showed Nocturnal Penile Erections abnormalities. According to the history and also to the normal responses to the Nocturnal penile tumescence monitoring (NPTM), patients were diagnosed as having impotence of psychogenic origin.
CONCLUSION Initial involvement of both arterial supply and of the neurological pathways can be of some interest, suggesting the need for an early screening of neural and vascular status even in patients without penile erectile failure. As is the case for other degenerative aliments, the beginning of identification of injury could be the first step towards finding appropriate treatments to prevent more severe damage in near future.