Inflammatory bowel disease tied to high likelihood of erectile dysfunction prescription
Male patients with inflammatory bowel disease (IBD) appear to use erectile dysfunction (ED) medications more frequently than those without the disease, with the association persisting regardless of a history of IBD surgery, according to a study.
The nationwide cohort study based on the Danish registries involved 31,498 men with IBD and 314,980 age-matched men without IBD. In the IBD cohort, 69.7 percent had ulcerative colitis and 30.3 percent had Crohn’s disease. Median age at IBD diagnosis was 39.7 years.
The main outcome of a first prescription of an ED medication was reported in 3,749 patients (11.9 percent) in the IBD cohort and in 30,635 men (9.7 percent) in the control cohort. Adjusted Cox regression analysis revealed that the risk of filling an ED prescription increased by 19 percent in IBD patients who had not had an IBD operation (hazard ratio [HR], 1.19; 95 percent CI, 1.13–1.26) and by 31 percent in those who had undergone an IBD operation (HR, 1.31; 1.20–1.43).
When the separate effects of IBD subtypes were analysed, UC was associated with a 43- and 17-percent increased risk of filling an ED prescription in those who had (HR, 1.43; 1.27–1.61) and had not undergone prior IBD operation (HR, 1.17; 1.10–1.24). The corresponding HRs in CD patients were 1.20 (1.06–1.35) and 1.26 (1.15–1.38).
According to researchers, surgery for IBD that involves pelvic dissection, especially ileoanal pouch surgery and rectal resection, can potentially damage the autonomic nerves. The present data indicate that the highest risk for receiving an ED prescription is in men with UC who have had UC surgery.
Given that only a small percentage of men with IBD discuss sexual dysfunction with their physicians, it is important that clinicians ask about sexual dysfunction so its deleterious impact on quality of life can be alleviated, researchers added. In the presence of sexual dysfunction, patients can then be treated for depression, increased disease activity and/or hypogonadism. Surgical risks can also be discussed and then weighed against continuing medical treatment.