Prevalence of internal pudendal artery disease in diabetic patients with erectile dysfunction and angiographically documented multi-vessel coronary artery disease

Abstract

Objectives: We set out to explore the prevalence of significant atherosclerotic disease of the internal pudendal arteries (IPA) in diabetic men with erectile dysfunction (ED) and angiographically documented multi-vessel coronary artery disease (CAD). Background: ED shares common risk factors of CAD, and is increasingly recognized as a well established risk factor for future cardiovascular events. Methods: We enrolled 30 consecutive diabetic patients with ED undergoing elective coronary catheterization. Erectile function was evaluated using the abbreviated 5-item questionnaire known as the Sexual Health Inventory for Men. Distal aortography was first performed, followed by selective internal iliac arteriography. Significant IPA disease was defined as 50% or more luminal obstruction seen in the projection that best delineates the takeoff of the artery. Results: The mean age of the whole series was 59.6 ± 8.4 years. The mean duration of diabetes mellitus was 8.1 ± 7.1 years, and the mean duration of ED was 4.3 ± 3.2 years. Significant IPA disease (stenosis/occlusion) was found in 11 (36.7%) patients; unilateral in 6 (20%) patients, and bilateral in 5 (16.7%) ones. Significant internal iliac artery disease (stenosis/occlusion) was found in 6 (20%) patients; unilateral in 4 (13.3%) patients, and bilateral in 2 (6.7%) ones. Significant IPA disease correlated positively with age and negatively with estimated creatinine clearance (p < 0.05 for both). Conclusions: In diabetic male patients with ED who have angiographically documented multi-vessel CAD, significant IPA obstruction (stenosis/occlusion) is rather frequent, and it correlates positively with age, and negatively with the estimated creatinine clearance.

Keywords

• Diabetes mellitus
• Coronary artery disease
• Erectile dysfunction
• Internal pudendal artery