The Link Between Cigarette Smoking and Erectile Dysfunction: A Systematic Review

Associations between organic erectile dysfunction and the risk of herpes zoster and postherpetic neuralgia in men

BACKGROUND

Whether erectile dysfunction (ED) leads to considerable stress for affected men remains unclear? In this study, we investigated whether organic ED (OED) is associated with increased risks of herpes zoster (HZ) and postherpetic neuralgia (PHN).

METHODS

A representative subset of Taiwan's National Health Insurance Research Database was employed for this study. Enrollees with OED from the years 2000 to 2018 were selected. To ensure comparability between the case and control groups, we implemented 1:1 propensity score matching based on age, index year, comorbidities, and medications.

RESULTS

The case group included 20,808 patients with OED, while the control group consisted of 20,808 individuals without OED. The OED group exhibited a significantly elevated risk of HZ (adjusted hazard ratio [aHR] = 1.74) and PHN (aHR = 1.56) compared to the non-OED group.

CONCLUSIONS

Men experiencing OED seem to face elevated risks of HZ and PHN compared to those without OED. ED may serve as a warning sign for individuals at HZ risk.

Prostate Dimensions and Their Impact on LUTS and Erectile Function: Is Length the Missing Link?

Background/Objectives: The objective of this study is to explore potential correlations between prostate volume, LUTS, and IIEF, with a particular emphasis on the relationship between prostate dimensions-width, height, and length-and both LUTS and IIEF and to assess patients based on risk factors such as hypertension, diabetes, cardiovascular disease, smoking, alcohol consumption, and PSA levels. Methods: A retrospective multicenter study was conducted between January 2007 and December 2023, focusing on male patients over the age of 40. The study evaluated hypertension, diabetes, cardiovascular diseases, smoking, alcohol consumption, and lower urinary tract symptoms (LUTS) through the completion of the IPSS and QoL questionnaires, sexual function using the IIEF-15, and PSA levels. Abdominal ultrasound was performed to determine prostate volume and its dimensions (width, height, and length). Results: A total of 943 patients were included in the study, with a mean age of 61.89 ± 8.51 years. From the 40-49 age group to the 80-90 age group, IPSS increased from 10.29 to 14.26 points, PSA from 1.1 ng/mL to 3.05 ng/mL, and prostate volume from 23.79 mL to 41.16 mL. Meanwhile, over the same age intervals, IIEF showed a decline from 52.57 to 24.76 points. The IPSS demonstrated a statistically significant positive correlation (p < 0.05) with prostate volume and patient age, while showing an inverse correlation with IIEF. The only statistically significant correlation between IPSS and prostate dimensions was with the length diameter of the prostate (p = 0.011). The severity of sexual symptoms was inversely correlated with both prostate volume and age. Additionally, IIEF was negatively correlated with the width and length diameters of the prostate. Hypertension (p = 0.57), diabetes (p = 0.57), smoking (p = 0.76), and alcohol consumption (p = 0.27) did not have a statistically significant impact on IPSS, and IIEF except for cardiovascular diseases, which showed a significant correlation with IPSS in patients experiencing moderate to severe symptoms (p = 0.0001). The statistically significant correlation between cardiovascular diseases and IIEF was observed only in patients with severe symptoms (p = 0.0001). Conclusions: There is a correlation between prostate volume, IPSS, and IIEF. Only length of the prostate shows a statistically significant correlation with both IPSS and IIEF. PSA levels increase progressively with each decade of age. Hypertension, diabetes, smoking, and alcohol consumption do not have a statistically significant impact on LUTS and erectile function. Cardiovascular diseases show a correlation with patients experiencing moderate to severe LUTS, as well as with those who have severe symptoms according to the IIEF evaluation.

The Effect of Bio-Electromagnetic Energy Regulation Therapy on Erectile Dysfunction in Patients with Multiple Sclerosis: A Triple-Blind Randomized Clinical Trial

Objectives: To evaluate the effect of bio-electromagnetic energy regulation (BEMER) therapy on erectile dysfunction (ED) in patients with multiple sclerosis (MS). Methods: A triple-blind randomized clinical trial was conducted in two different centers. Fifty-two male participants with MS were randomly allocated into two groups. Patients received either three weeks of BEMER with pelvic floor exercises or sham BEMER with pelvic floor exercises. The primary measure was the International Index of Erectile Function-Erectile Function (IIEF-EF). Secondary measures included the Sexual Health Inventory for Men (SHIM), Erection Hardness Scale (EHS), Arizona Sexual Experience Scale (AXES), Modified Fatigue Impact Scale (MFIS), and Multiple Sclerosis, Intimacy, and Sexuality Questionnaire (MSISQ-19). Results: Compared to the sham BEMER group, the BEMER group showed better improvements in the IIEF-EF (mean difference [MD]: -6.9, p < 0.001), SHIM (MD: -6.1, p < 0.001), EHS (MD: -0.4, p = 0.022), AXES (MD: 2.9, p = 0.030), MSISQ-19 (MD: 15.0, p < 0.001), and MFIS (MD: 31.0, p < 0.001). Conclusions: BEMER therapy improved erectile function and sexual satisfaction and reduced fatigue in patients with MS after three weeks of intervention. Long-term follow-up studies are warranted to ascertain the sustained benefits of BEMER therapy for MS-related ED.

Association between the composite dietary antioxidant index and erectile dysfunction in US men: a cross-sectional study

BACKGROUND

Erectile dysfunction (ED) is a common issue among adult males. The Composite Dietary Antioxidant Index (CDAI) reflects anti-inflammatory levels and has been linked to various diseases, but its relationship with ED is unclear.

MATERIALS AND METHODS

This cross-sectional study utilised comprehensive data on clinical factors from the 2001-2004 National Health and Nutrition Examination Survey (NHANES). To investigate the link between variables and ED, we used multivariate regression analysis, univariate analysis, and subgroup analysis. The linear relationship between CDAI and ED was investigated by dose-response curve analysis. For sensitivity analysis, propensity score matching (PSM) was utilised to exclude the influence of potential confounders. Finally, we investigated the association between CDAI and ED using threshold effects analysis.

RESULTS

We included in our research a total of 2896 persons with data on CDAI from NHANES 2001-2004. Among these, 2,098 participants were thought to be free of ED, whereas 798 participants had ED. We found that compared to the ED group, men in the non-ED group had higher levels of CDAI (p < 0.0001 before PSM and p = 0.0145 after PSM). Additionally, after adjusting for covariates, it was found that an elevated CDAI was associated with a reduced incidence of ED [OR = 0.65(p = 0.001) before PSM and OR = 0.62(p = 0.002) after PSM]. Subgroup analysis indicated stronger associations in high-risk groups, and dose-response curves confirmed a linear negative correlation between CDAI and ED.

CONCLUSIONS

This study revealed a negative linear relationship between CDAI and the incidence of ED. The CDAI can be used as an indicator for assessing ED risk and for ED prevention.

Androgens and erectile dysfunction: from androgen deficiency to treatment

INTRODUCTION

Androgens play important roles in regulating the growth and development of the male reproductive system and maintaining libido and erectile function. The specific mechanisms by which androgen deficiency leads to erectile dysfunction (ED) are not yet fully understood.

OBJECTIVES

To understand the mechanisms and treatment of androgen deficiency-related ED.

METHODS

A literature search in the past 10 years was conducted in PubMed and Google Scholar to determine the effects of androgen deficiency on erectile function and the treatment of androgen deficiency.

RESULTS

Androgen deficiency can be caused by hypothalamic-pituitary lesions and injuries, testicular-related diseases and injuries, endocrine and metabolic disorders, the side effects of medication, and age. Androgen deficiency can lead to ED by inhibiting the NOS/NO/cGMP pathway (nitric oxide synthase/nitric oxide/cyclic guanosine monophosphate) and altering the expression of ion channel proteins, as well as by inducing oxidative stress, death, and fibrosis in penile corpus cavernosum cells. Testosterone replacement therapy is effective at improving the serum testosterone levels and erectile function in patients with androgen deficiency. For patients who need to maintain a low androgenic state, erectile function can be improved by lifestyle changes, treatment with phosphodiesterase type 5 inhibitors, low-intensity extracorporeal shock wave therapy, and stem cell therapy.

CONCLUSIONS

Androgen deficiency can affect the structure and function of the penile corpus cavernosum, leading to ED. Areas of further study include how androgen replacement therapy can improve erectile function and how to improve the maintenance of erectile function in patients with hypoandrogenic status.

Higher oxidative balance score was associated with decreased risk of erectile dysfunction: a population-based study

BACKGROUND

Erectile dysfunction (ED) is a prevalent condition that is thought to be significantly impacted by oxidative stress. The oxidative balance score (OBS) has been built to characterize the state of antioxidant/pro-oxidant balance. There is less known regarding the relationship of OBS with ED.

METHODS

This study conducted cross-sectional analyses on 1860 males who participated in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2004. OBS was constructed by the 16 dietary components and 4 lifestyle factors. Self-reported ED was defined as men who indicated that they "never" or "sometimes" could achieve or keeping an erection adequate for satisfactory intercourse. Multivariate logistic regression models were applied to examine the association between OBS and the risk of ED.

RESULTS

Among 1860 participants, the median OBS was 20 (IQR 15-26), and OBS was lower in males with ED vs. those without ED (P = 0.001). The results of our analyses indicated a negative correlation between OBS and ED among male subjects. Specifically, each one-unit increase in the continuous OBS was relate to 3% reduction in the odds of ED after full adjustment. Moreover, when extreme OBS quartiles were compared, the adjusted odds ratio (95% confidence interval) for the 4th OBS category was 0.53 (0.32 to 0.88) after full adjustment (P for trend < 0.05). There was also statistical significance in the relationships between dietary/lifestyle OBS with ED, and the association between lifestyle OBS and ED may be even tighter. For each unit increase in lifestyle OBS, the odds of ED decreased by 11% after full adjustment.

CONCLUSION

Higher OBS was associated with reduced risk of ED in U.S. males. These findings suggested that adopting an antioxidant-rich diet and engaging in antioxidant-promoting lifestyle behaviors may contribute to a lower incidence of ED. These results provided recommendations for a comprehensive dietary and lifestyle antioxidants for ED patients.

The relationship between social support and erectile dysfunction in middle-aged and older males

Background

Erectile dysfunction (ED) is a prevalent condition that affects middle-aged and older men, impacting their sexual health and overall wellbeing. We aimed to investigate the relationship between social support and ED among this specific population.

Methods

Data were collected from the National Health and Nutrition Examination Survey. Social support was assessed through various dimensions, including emotional support, material support, and network support. Multivariate logistic regression was performed to examine the association between social support and ED, and a propensity-score-matched (PSM) analysis was further conducted.

Results

Among 1938 middle-aged and older males in the United States, 49.9% had a history of ED. ED was more prevalent in older individuals and those with comorbidities such as hypertension, prostate disease, higher serum creatinine level, and mental problems. Males with lower social support scores had a higher weighted rate of ED (P < 0.001). After adjusting for multiple variables in logistic regression analysis, a higher social support score was associated with a 19% lower likelihood of ED (weighted odds ratio [OR] 0.81, 95% confidence interval [CI] 0.66-0.98, P = 0.032). The association remained consistent after propensity score matching (OR 0.80, 95% CI 0.66-0.98, P = 0.028).

Conclusion

Social support appears to be associated with a reduced risk of ED in middle-aged and older men. Further research is needed to better understand this relationship and explore interventions that enhance social support, potentially leading to improved sexual health outcomes.

Cigarette smoking and air pollution exposure and their effects on cardiovascular diseases

Cardiovascular disease (CVD) has no socioeconomic, topographical, or sex limitations as reported by the World Health Organization (WHO). The significant drivers of CVD are cardio-metabolic, behavioral, environmental, and social risk factors. However, some significant risk factors for CVD (e.g., a pitiable diet, tobacco smoking, and a lack of physical activities), have also been linked to an elevated risk of cardiovascular disease. Lifestyles and environmental factors are known key variables in cardiovascular disease. The familiarity with smoke goes along with the contact with the environment: air pollution is considered a source of toxins that contribute to the CVD burden. The incidence of myocardial infarction increases in males and females and may lead to fatal coronary artery disease, as confirmed by epidemiological studies. Lipid modification, inflammation, and vasomotor dysfunction are integral components of atherosclerosis development and advancement. These aspects are essential for the identification of atherosclerosis in clinical investigations. This article aims to show the findings on the influence of CVD on the health of individuals and human populations, as well as possible pathology and their involvement in smoking-related cardiovascular diseases. This review also explains lifestyle and environmental factors that are known to contribute to CVD, with indications suggesting an affiliation between cigarette smoking, air pollution, and CVD.

Efficacy and safety assessment of traditional Chinese medicine for erectile dysfunction: A meta-analysis and trial sequential analysis

BACKGROUND

Several patients with erectile dysfunction do not accept or benefit from conventional therapy with phosphodiesterase type 5 inhibitors; thus, alternative and complementary therapies are in need. Traditional Chinese medicine has been treating erectile dysfunction in China, but its clinical value is inconclusive.

OBJECTIVE

To systematically evaluate the efficacy and safety of traditional Chinese medicine in treating erectile dysfunction.

METHODS

Randomized controlled trials were retrieved from a comprehensive search in the literature published in the past decade from the Web of Science, PubMed, Embase, Cochrane Library, SinoMed, China National Knowledge Internet, WanFang, and VIP. We performed a meta-analysis of the International Index of Erectile Function 5 questionnaire scores, clinical recovery rates, and testosterone levels using Review Manager 5.4 software. The trial sequential analysis was conducted to check the results.

RESULTS

A total of 45 trials with 5016 patients were included. Meta-analysis results showed that traditional Chinese medicine effectively improved the International Index of Erectile Function 5 questionnaire scores (weighted mean difference = 3.78, 95% confidence interval: 3.12, 4.44; p < 0.001), clinical recovery rates (risk ratio = 1.57, 95% confidence interval: 1.38, 1.79; p < 0.001), testosterone levels (weighted mean difference = 2.42, 95% confidence interval: 1.59, 3.25; p < 0.001) compared with the controls. The single and add-on applications of traditional Chinese medicine could improve the International Index of Erectile Function 5 questionnaire score (p < 0.001). The trial sequential analysis confirmed the robustness of the analysis of the International Index of Erectile Function 5 questionnaire scores. A significant difference in the incidence of adverse effects between the treatment and control groups was not observed (risk ratio = 0.82, 95% confidence interval: 0.65, 1.05; p = 0.12).

CONCLUSION

Traditional Chinese medicine can gain better responses in improving the International Index of Erectile Function 5 questionnaire scores, clinical recovery rates, and testosterone levels as an alternative and complementary treatment, with no increase in side effects. However, more standardized, long-term, traditional Chinese medicine and integrative therapy clinical trials are needed to support the clinical application of traditional Chinese medicine.

Awareness of hazards due to tobacco among people aged 15 years and older in Chongqing, China, in 2020: A cross-sectional analysis

INTRODUCTION

Tobacco smoke contains a large number of harmful substances and carcinogens. Smoking and secondhand smoke cause a variety of cancers and diseases, seriously endangering human health. However, the status and characteristics of the awareness of hazards due to tobacco among people aged ≥15 years in Chongqing, China, are still unknown.

METHODS

A multistage stratified cluster random sampling method was used to select ten districts and counties in Chongqing Municipality, China and a total of 6622 people were investigated between August and October 2020. The chi-squared test was used to analyze the awareness of hazards due to tobacco in various populations after the data had been cleaned and weighted.

RESULTS

In 2020, the awareness rates of people aged ≥15 years in Chongqing, China, about a specific disease caused by smoking were lung cancer (77.1%), heart disease (45.1%), stroke (40.1%), and penile erectile dysfunction (24.2%). However, only 22.1% of the respondents knew that smoking could simultaneously lead to all four diseases mentioned above. Adult lung cancer was the disease with the highest awareness rating (72.5%), followed by children's lung disease (54.2%) and adult heart disease (46.1%). A total of 42.0% of respondents knew that secondhand smoke could cause the three diseases simultaneously. Only 22.0% of those correctly understood the harm of low-tar cigarettes. The logistic regression results showed that education level and occupation were risk factors for lack of awareness of hazards due to tobacco. In contrast, media campaigns on tobacco control were a protective factor.

CONCLUSIONS

The awareness of hazards due to tobacco among people aged ≥15 years in Chongqing, China, still needs to be improved. More graphic health warning labels and mass media campaigns about the hazards of tobacco should be carried out to raise people's awareness and warn about the health risks of smoking.

Cigarette Consumption Patterns of Non-Smokers, Occasional Smokers, and Daily Smokers in Selected ASEAN Countries

Background:

This study investigates the socio-demographic factors associated with smoking status in five Southeast Asian countries: Malaysia, Thailand, Indonesia, Vietnam, and Philippines.

Methods:

This cross-sectional study utilizes data of adults ≥15 years who completed the Global Adult Tobacco Surveys. Ordered probit analysis is used to account for the smoking statuses of non-smokers, occasional smokers, and daily smokers.

Results:

Malaysian and Vietnamese households with more family members face lower smoking likelihoods than otherwise. Urbanites in Philippines and rural residents in Thailand and Indonesia are more likely to smoke on occasional and daily basis than others. Males are consistently more likely to smoke occasionally or daily and less likely to be non-smokers than females across all countries. Younger middle-age (retiree) individuals aged 30-35 (≥60) years in Malaysia and Thailand exhibit higher (lower) likelihoods to smoke occasionally or daily than their younger cohorts aged 15-29 years. Individuals aged 30 years and above in Indonesia, Vietnam, and Philippines display higher daily smoking propensities than others. Higher education levels dampens smoking likelihoods and increases non-smoking propensities in all countries. Non-government or self-employed workers in all countries are more likely to smoke occasionally or daily than unemployed persons. Being married is associated with higher non-smoking likelihoods in Thailand although this association is not evident in Malaysia.

Conclusion:

These findings suggest that a portfolio of targeted interventions is necessary to meet the needs of specific subpopulations within the various countries.

Importance of active and passive smoking as one of the risk factors for female sexual dysfunction in Chinese women

OBJECTIVE

To assess possible risk factors for female sexual dysfunction (FSD), aiming especially at smoking in China.

METHODS

Female Sexual Function Index (FSFI) for assessing FSD; 621 women (24-75 years) divided into 'group FSD' (FSFI≤ 26.55) and 'group No FSD' (FSFI > 26.55). Univariate and multivariate analysis to detect potential risk factors for FSD.

RESULTS

Active smoking was the strongest risk factor after multiple adjustments (OR= 6.226, 95%CI = 1.561 ∼ 24.822), but passive smoking also was significantly associated with a risk of FSD (OR = 1.887, 95%CI = 1.092 ∼ 3.260) (p < .05). Other risk factors included age (OR = 1.040, 95%CI = 1.005 ∼ 1.076), medical comorbidities (OR= 1.688, 95%CI =1.044 ∼ 2.729), postmenopausal stage (OR= 2.021, 95%CI = 1.073 ∼ 5.717), and dissatisfied marital relations (OR= 3.771, 95%CI = 1.768 ∼ 8.045). The prevalence of FSD for smokers regarding disorders of sexual arousal, orgasm and sexual satisfaction increased in active smokers; sexual desire disorder, sexual arousal disorder and pain in secondhand smokers (p < .05).

CONCLUSION

The risk of FSD was closely related to depletion of ovarian function. Active smokers had the highest risk, but passive smoking also had a significant relationship to FSD. Although female smokers are rare in China, 'husband smoking' is frequent. Thus, our results should have significant healthcare consequences.

People smoke for nicotine, but lose sexual and reproductive health for tar: a narrative review on the effect of cigarette smoking on male sexuality and reproduction

PURPOSE

To systematically review the impact of smoking habits on cardiovascular (CV) as well as on male sexual and reproductive function and to provide updated evidence on the role of electronic cigarettes (e-Cig) on the same topics.

METHODS

A comprehensive Medline, Embase, and Cochrane search was performed including the following words: smoking, CV system, CV risk, erectile dysfunction (ED), and male fertility. Publications from January 1, 1969 up to February 29, 2020 were included.

RESULTS

Smoking has a tremendous negative impact on CV mortality and morbidity. Current smoking behavior is also negatively associated with erectile dysfunction (ED) and impaired sperm parameters. E-Cig can release significantly lower concentrations of harmful substances when compared to regular combustible cigarettes. Whether or not the latter can result in positive CV, sexual, and fertility outcomes is still under study. Preliminary studies showed that exposure to e-Cig leads to lower vascular damage when compared to the traditional cigarette use. However, data on the long-term effects of e-Cig are lacking. Similarly, preliminary data, obtained in animal models, have suggested a milder effect of e-Cig on erectile function and sperm parameters.

CONCLUSION

Available evidence showed that e-Cig are much less dangerous when compared to the traditional tobacco use. However, it should be recognized that the risk related to e-Cig is still higher when compared to that observed in non-smoking patients. Hence, e-Cig should be considered as a potential tool, in the logic of harm reduction, to reduce the CV, sexual and fertility risk in patients refractory to the fundamental, healthy choice to definitively quit smoking.

Practical Approaches to Treat ED in PDE5i Nonresponders

Erectile dysfunction (ED) is a common sexual disorder in adult males and one of the most important factors affecting their quality of life and that of their partners. Although PDE5 inhibitors (PDE5is) are the first choice for improving erectile function, there is a substantial proportion of ED patients, termed PDE5i nonresponders, who do not respond to PDE5is. Because of the lack of effective therapies, these patients always have serious social and psychological problems due to ED, which should be addressed. Here, we review the available literature about ED and PDE5is and propose several strategies for mitigating ED in PDE5i nonresponders.

Effect of cigarette smoking on sexual functions, psychological factors, and disease activity in male patients with ankylosing spondylitis

OBJECTIVE

This study aims to investigate the effect of smoking on sexual functions in AS patients.

PATIENTS AND METHODS

A total of 67 male AS patients with a median age of 34 years (range: 18-57) reporting sexual activity at least for the past 4 weeks period were included. Patients were divided into smokers (Group 1, n = 47) and non-smokers (Group 2, n = 20). Fagerström test for nicotine dependence, smoking history, exhaled carbon monoxide test were recorded for smoking AS patients. Visual analogue scale (VAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life (ASQoL), International Index of Erectile Function (IIEF), Beck Depression Inventory (BDI) were filled for both groups.

RESULTS

There was no significant difference between smokers and non-smokers in all evaluation parameters. BASMI scores were significantly lower in the mild dependency subgroup as compared to those with moderate or severe dependency (p = .005 and p = .007, respectively). Total IIEF score and IIEF categories correlated significantly with BASDAI, BASFI, BASMI, ASQoL, pain, fatigue, and cumulative smoking. BDI showed an inverse correlation with the IIEF score and IIEF category (p < .001 r = -0.520, p < .001 r = -0.508, respectively).

CONCLUSIONS

Sexual function in AS patients is associated with the pain, fatigue, disease activity, functional status, quality of life, depression as well as the cumulative exposure to smoking, and that sexual functions tend to decline with increasing degree of cigarette dependency.

Cigarette Smoking Is Significantly Linked to Sexual Dissatisfaction in Chinese Heroin-Dependent Patients Receiving Methadone Maintenance Treatment

Background: Cigarette smoking is associated with sexual dysfunction in the general population. Both smoking and sexual dysfunction are common in heroin-dependent patients (HDPs) receiving methadone maintenance treatment (MMT), but their association in MMT HDPs is rarely studied. This study examined the association between smoking and sexual dissatisfaction in Chinese HDPs receiving MMT. Methods: In total, 480 Chinese HDPs, who had sex with their regular or irregular sex partners within one month prior to the study, were included from three MMT clinics in Wuhan, China. Sexual dissatisfaction was assessed with one single question. Socio-demographic and clinical data and smoking characteristics were collected with a standardized questionnaire. Multiple binary logistic regression was used to analyze the association between smoking and sexual dissatisfaction, as well as the associations between levels of smoking and nicotine dependence and sexual dissatisfaction. Results: The prevalence of current smoking was 95.6% in HDPs receiving MMT. Rates of sexual dissatisfaction were higher in current smokers than non-smokers (32.9% vs. 14.3%) with a borderline significant P value of 0.074. After adjusting potential socio-demographic and clinical confounders, current smoking was significantly linked to sexual dissatisfaction (OR = 1.95, P = 0.026), and heavy smoking and severe nicotine dependence were significantly linked to sexual dissatisfaction (OR = 1.80, P = 0.025; OR = 3.27, P < 0.001). Conclusion: Smoking is significantly associated with sexual dysfunction in HDPs receiving MMT. It deserves further investigation as to whether quitting smoking can improve the sexual function of methadone-maintained patients.

Perceived health effects of vaping among Hungarian adult e-cigarette-only and dual users: a cross-sectional internet survey

BACKGROUND

Knowledge about the health effects of e-cigarette use (or vaping) among past and current combustible cigarette users is limited. Several studies have assessed vaping-related adverse events (AEs) and beneficial health effects, however, most studies focused on AEs in general and examined only a few physiological changes that vapers experience. This study aims to explore self-reported AEs and perceived health changes due to e-cigarette use among Hungarian adult e-cigarette-only users (former smokers who switched completely to e-cigarette use) and dual users (smokers who use e-cigarettes and combustible tobacco cigarettes concomitantly).

METHODS

A cross-sectional, web-based survey of 1042 adult Hungarian e-cigarette users was conducted in 2015. Participants reported AEs and changes in physiological functions since they switched from smoking to e-cigarette use or while dually using e-cigarettes and combustible cigarettes. Confirmatory factor analysis with covariates was applied to explain perceived health changes due to e-cigarette-only use and dual use.

RESULTS

Dual users (17.6%) were significantly more likely to report AEs of vaping than e-cigarette-only users (26.2% vs. 11.8%, p < 0.001). Experiencing health improvements were significantly more likely among e-cigarette-only users than for dual users for all surveyed physiological functions. E-cigarette-only users reported larger effects of vaping on sensory, physical functioning, and mental health factors compared to dual users. Self-reported changes in sensory and physical functioning were significantly higher among individuals using e-cigarettes more than a year and people who were past heavy smokers (smoked ≥20 cigarettes per day). Gender was related to sensory improvement only; males reported greater improvement than females.

CONCLUSIONS

The majority of e-cigarette-only users reported more perceived beneficial changes in physiological functions and fewer AEs than dual users. Perceived short-term benefits of e-cigarette use may reinforce users despite the uncertainty of long-term health consequences. Health professionals should provide balanced information regarding the possible short- and long-term positive and negative health effects of e-cigarette use during consultations with patients.

The impact of thoracotomy on psychological and sexual function in men with lung cancer

OBJECTIVE

We aimed to investigate the effect of major thoracic surgery on sexual functions and psychogenic aspects of men who underwent surgery for lung cancer.

MATERIAL AND METHODS

This study was conducted to assess depression and erectile function in patients who underwent surgical treatment for lung cancer. The data of 50 patients in the study group, and 39 participants in the control group who met the criteria were analyzed. Erectile dysfunction (ED) and symptoms of depression were assessed in patients before and three months after surgery.

RESULTS

The mean ages were 58.4±11.6 and 61.3±6.9 years; the mean BMIs were 25.6±4.3kg/m² and 24.8±5.7kg/m²; the mean forced vital capacities (FVC) were 3.1±0.6L and 3.4±1.4L; the mean FEV1/FVC were 86.1±10.3 and 80.3±4.1; the mean Beck Depression Inventory scores were 9.3±6.9 and 6.0±6.2, and the mean FVC% were 82.9±14.9 and 82.0±26.2 for the study and control groups, respectively. The mean preoperative International Index of Erectile Function (IIEF-5) scores were 14.1±4.1 and 10.8±4.7 postoperative in the study group, and 17.4±8.6 in the control group. The logistic regression analysis showed that postoperative complications resulted in a 3.95-times higher risk of suffering from ED.

CONCLUSION

Our study supported that surgical treatment of lung cancer adversely affected psychogenic status and sexual function due to its stringent nature. The fear of death affects the quality of life and the psychogenic aspect of the patients with lung cancer. Clinicians should thoroughly inform the patients about sexual dysfunction and psychogenic disorders, and when needed providing an appropriate sexual counseling and treatment is necessary. Good communication contributes to a better quality of life.

Increased Use of Medications for Erectile Dysfunction in Men With Ulcerative Colitis and Crohn's Disease Compared to Men Without Inflammatory Bowel Disease: A Nationwide Cohort Study

BACKGROUND

Men with inflammatory bowel disease (IBD) may have decreased sexual function due to factors related to the underlying disease, medication, and/or surgery. We aimed to examine the use of erectile dysfunction (ED) medications in men with IBD.

METHODS

This is a nationwide cohort study based on the Danish registries, comprising all men >18 years old with IBD during 1 January 1995 through December 2016. The cohorts included 31,498 men with IBD and 314,980 age-matched men without IBD. Our main outcome was a first prescription of an ED medication. Cox regression analyses were used to estimate the hazard rate (HR) for use of ED medications, controlled for multiple time-varying covariates.

RESULTS

Overall, 21,966 (69.7%) men had ulcerative colitis (UC) while 9532 (30.3%) had Crohn's disease (CD). Men with a first ED prescription numbered 3749 (11.9%) (men with IBD) and 30,635 (9.7%) (men without IBD). Adjusting for central nervous system and intestinal anti-inflammatory medications, systemic corticosteroids and co-morbidities, the HR was 1.19 (95% CI: 1.13-1.26) (IBD and no prior IBD operation), and 1.31 (95% CI: 1.20-1.43) (IBD and prior IBD operation). The adjusted HR for UC was 1.17 (95% CI: 1.10-1.24) (no operation) and 1.43 (95% CI: 1.27-1.61) (prior operation), and for CD 1.26 (95% CI: 1.15-1.38) (no operation) and 1.20 (95% CI: 1.06-1.35) (prior operation).

DISCUSSION

Men with IBD are more likely to fill an ED prescription than men without IBD. This result is significant regardless of a history of IBD surgery.

Urological disease and tobacco. A review for raising the awareness of urologists

CONTEXT

Smoking is the leading cause of preventable death in our community. Its relationship with urological disease is well documented.

OBJECTIVE

To present an updated review on the relationship between urological disease and tobacco consumption and the importance of involving urologists in smoking prevention.

ACQUISITION AND SYNTHESIS OF EVIDENCE

We conducted a review of current literature, primarily by searching PubMed and using as the main base the report on the consequences of smoking on health performed by the Surgeon General.

CONCLUSION

Urologists play an essential role in informing patients of the relationship between smoking and urological disease. It is the duty of every urologist to play a more active role in educating patients and promoting smoking cessation.