Men with multiple sclerosis at risk of erectile dysfunction

Adult men with multiple sclerosis (MS) are more likely to develop erectile dysfunction (ED), indicating that MS is a potential predictor for ED occurrence, suggest the results of a meta-analysis.

A team of investigators, led by Xu Wu from the Department of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui province, China, conducted a systematic review of literature obtained from the databases of PubMed, Scopus, Web of Science, and the Cochrane Library.

Relevant English-language studies published up to February 2022 that evaluated the prevalence of ED in MS patients were included in the meta-analysis. Two independent investigators examined the full text of the enrolled studies to determine eligibility; if a disagreement arose, a third investigator would decide following a discussion.

The investigators evaluated the quality of cross-sectional studies using assessment tools adapted for prevalence studies and the quality of case-control studies using the Newcastle-Ottawa scale. They also examined the strength of association between MS and ED risk using the relative risk (RR) and its 95 percent confidence interval (CI).

Subgroup analysis was conducted to assess heterogeneity of sources, while sensitivity analysis was carried out to evaluate the stability of the results.

Sixteen studies met the inclusion criteria and provided data about ED in 2,760 men with MS. This corresponded to a pooled prevalence of 49 percent (95 percent CI, 42‒56) for ED with large heterogeneity. Synthesis of data showed the significant association of MS with an increased ED risk (RR, 3.17, 95 percent CI, 2.31‒4.36; p<0.001; heterogeneity: I², 0.0 percent; p=0.716).

The pooled prevalence estimates of ED were 55 percent in the age >40 years subgroup, 63 percent in the International Index of Erectile Function diagnostic tool subgroup, and 57 percent in the mean disease duration >10 years subgroup.

“The present meta-analysis indicates that MS patients had a significantly increased risk of ED, which should raise awareness of the potential association between MS and ED by clinicians,” the investigators said.