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

ObjectivesWe 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).BackgroundED shares common risk factors of CAD, and is increasingly recognized as a well established risk factor for future cardiovascular events.MethodsWe 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.ResultsThe 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).ConclusionsIn 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.