Fikret ERDEMİR, Orhan ÖNALAN, Adem YAŞAR, Köksal CEYLAN, Doğan ATILGAN, Nihat ULUOCAK, Bekir Süha PARLAKTAŞ

Hiperlipidemi ve erektil disfonksiyon tanısı olan hastalarda statin tedavisinin etkinliği

Giriş: Erektil disfonksiyon (ED) vajinal penetrasyonu sağlayacak nitelikte penis ereksiyonunun sağlanması ve/veya sürdürülmesindeki aksaklık olarak tanımlanmaktadır. Sistemik ve kronik bir bozukluk olarak kabul edilen hiperlipideminin ED için risk faktörü olduğu gösterilmiştir. Bu çalışmamızda hiperlipidemi tanısı ile statin tedavisi verilen hastalarda erektil fonksiyonun değerlendirilmesi amaçlanmıştır. Gereç ve yöntem: Çalışmaya Ocak 2008–Mart 2009 tarihleri arasında hiperlipidemi tanısı ile atorvastatin 40 mg/gün başlanan 83 erkek hasta alındı. Hastalar fizik muayene, rutin hematolojik ve biyokimyasal parametreler, elektrokardiografi (EKG), kardiyovasküler ekografi, akciğer grafisi ve gerektiğinde anjiografi ile değerlendirildi. Erektil fonksiyonlar Uluslararası Ereksiyon İşlevi Değerlendirme Formu (IIEF) kullanılarak değerlendirildi. Hastalar atorvastatin tedavisi sonrası en erken 3. ayda biyokimyasal analizler ve IIEF skalası ile tekrar değerlendirmeye tabi tutuldular. Bulgular: Hastaların yaş ortalaması 53±4.5 yıl idi. Ortalama takip süresi ise 6.7 (3-12) ay olarak saptandı. Yapılan takiplerde toplam dört hastada erektil fonksiyonların tedavi sonrası daha da kötüye gittiği tespit edildi. Geriye kalan 79 vakanın 5’i iyileşirken 74 vaka ise tedavi öncesi değerler ile karşılaştırıldığında istatistiksel olarak anlamlı olacak şekilde iyileşme olmadığı anlaşıldı (p>0.05). Sonuç: Bazı metodolojik sınırlamalar ve olgu sayısının nispeten az olmasına rağmen sunulan bu çalışmada statin tedavisinin erektil disfonksiyon üzerine etkili olmadığı tespit edildi. Bundan başka, bu sonuçları desteklemek için geniş olgu sayısına sahip prospektif ve randomize çalışmaların yapılmasına gerek olduğu söylenebilir.

The effect of statin treatment on erection function in patient with the diagnosis of erection dysfunction and hyperlipidemia

Objective: Erectile dysfunction (ED) characterized by the inability to develop or maintain an erection of the penis sufficient for satisfaction sexuel performance. Hyperlipidemia which a chronic and systemic disorder is a risk factor for ED. In this study, the effect of statin treatment on erectile functions were evaluated in patients with hyperlipidemia. Material and methods: Between January 2008 and March 2009 a total of 83 consecutive male patients with the diagnosed of hiperlipidemia and started atorvastatin 40 mg/day were included to the study. The patients were evaluated with physical examination, routine hematologic and biochemical parameters, electrocardiogram (ECG), cardiovascular echography, chest X-rays and angiography if needed. Erectile functions were evaluated with the International Index of Erectile Function (IIEF) scale. Patients were evaluated with routine cardiac and biochemical analysis and IIEF determined at least 3 months after atorvastatin treatment. Results: The mean age of the patients was 53±4.5 years. The mean follow up period was 6.7 (range 3-12 months) months. In four patients, erectile functions had worsened in follow up periods. While in five subjects of remain 79 patients erectile functions improved, no changes were detected according to erectile functions in 74 patients when compared with pre-treatment values. When comparing pretreatment and posttreatment results we did not find statistically significant difference with regards erectile functions (p>0.05). Conclusion: Despite some methodological limitations and lower number of patients, the present study suggest that statins does not improve erectile dysfunction in patients with hiperlipidemia. In addition, it can be concluded that more randomized and controlled studies with larger series are needed to support these results.

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