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Meta-Analysis
. 2022 Jan;10(1):72-81.
doi: 10.1111/andr.13088. Epub 2021 Aug 16.

Erectile dysfunction in hyperuricemia: A prevalence meta-analysis and meta-regression study

Maria Totaro  1 , Sotirios Dimarakis  1 , Chiara Castellini  1 , Settimio D'Andrea  1 , Antonio Parisi  1 , Federica D'Amato  1 , Daniele Tienforti  1 , Sara Palazzi  1 , Marco Giorgio Baroni  2 , Sandro Francavilla  1 , Arcangelo Barbonetti  1
Affiliations
Free article
Meta-Analysis

Erectile dysfunction in hyperuricemia: A prevalence meta-analysis and meta-regression study

Maria Totaro et al. Andrology. 2022 Jan.
Free article

Abstract

Background: Whether and to what extent an association exists between hyperuricemia and erectile dysfunction (ED) has not yet been fully determined.

Objective: To define pooled prevalence estimates and correlates of erectile dysfunction in men with hyperuricemic disorders.

Materials and methods: A thorough search of Medline, Scopus, and Cochrane Library databases was performed. Data were combined using random-effects models and the between-study heterogeneity was assessed by Cochrane's Q and I2 tests. A funnel plot was used to assess publication bias.

Results: Overall, 8 studies included gave information about 85,406 hyperuricemic men, of whom 5023 complained of erectile dysfunction, resulting in a pooled erectile dysfunction prevalence estimate of 33% (95% Confidence Interval: 13-52%; I² = 99.9%). The funnel plot suggested the presence of a publication bias. At the meta-regression analyses, among the available covariates that could affect estimates, only type 2 diabetes mellitus was significantly associated with a higher prevalence of erectile dysfunction (β = 0.08; 95% Confidence Interval: 0.01, 0.15, p = 0.025). At the sub-group analysis, the pooled erectile dysfunction prevalence decreased to 4% (95% Confidence Interval: 0%-8%) when only the largest studies with the lowest prevalence of type 2 diabetes mellitus were included and increased up to 50% (95% Confidence Interval: 17%-84%) when the analysis was restricted to studies enrolling smaller series with higher prevalence of type 2 diabetes mellitus.

Conclusions: A not negligible proportion of men with hyperuricemia can complain of erectile dysfunction. While a pathogenetic contribution of circulating uric acid in endothelial dysfunction cannot be ruled out, the evidence of a stronger association between hyperuricemia and erectile dysfunction in type 2 diabetes mellitus points to hyperuricemia as a marker of systemic dysmetabolic disorders adversely affecting erectile function.

Keywords: diabetes; gout; impotence; metabolic syndrome; sexual function; uric acid.

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References

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