Penile axial rigidity and Doppler ultrasonography parameters in patients with erectile dysfunction: Association with type 2 diabetes

Objectives. To determine the association between diabetes and changes in penile Doppler ultrasonography and axial penile rigidity parameters in patients with erectile dysfunction (ED). Methods. A total of 1023 male patients with ED were enrolled in this study. Patients were assessed for ED using the International Index of Erectile Function. All patients were also interviewed to obtain medical history, including history of diabetes, duration of diabetes, and diabetes-related complications. Patients underwent routine laboratory investigations, glycosylated hemoglobin, free testosterone, and prolactin assessment. All patients were offered additional assessment for erectile function using color Doppler ultrasonography and the Rigidometer. Of the 1023 patients, 627 accepted additional assessment, of whom 481 had diabetes and 146 did not. Results. The mean age +/- SID was 51.7 +/- 9.7 years. Patients had varying degrees of ED-mild in 10.8%, moderate in 36.9%, and severe in 52.3%. A statistically significant association was found between the presence of diabetes and a poor response to intracorporeal injection and decreasing peak systolic velocity values and Rigidometer values (P <0.001 for each). No statistically significant association was found between the presence of diabetes and increasing values of end-diastolic velocity or decreasing values of the resistive index (P >0.05 for each). In diabetic patients, a statistically significant association was noted between a longer duration of diabetes, poor control of diabetes, and the presence of more than one diabetes-related complication and a decreasing response to intracorporeal injection, decreasing values of peak systolic velocity, resistive index, and Rigidometer, and increasing values of end-diastolic velocity (P <0.05 for each). Conclusions. Diabetes mellitus negatively affects patients' response to intracorporeal injection and is associated with low peak systolic velocity and poor penile axial rigidity.