Erectile Dysfunction in Young Men with Congenital Heart Disease

  • Dr David Tanous, Australia
  • Dr Adrienne Kovacs, Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network/Toronto General Hospital, Canada
  • Dr Matthias Greutmann, Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network/Toronto General Hospital, Canada
  • Dr Olga Balint, Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network/Toronto General Hospital, Canada
  • Dr Nicholas Collins, Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network/Toronto General Hospital, Canada
  • Dr Miguel Llano, Murray Koffler Urologic Wellness Centre, Mount Sinai Hospital, Toronto, Canada
  • Dr Candice Silversides, Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network/Toronto General Hospital, Canada
  • Dr Erwin Oechslin, Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network/Toronto General Hospital, Canada

    • Background
    Men with acquired heart disease are at risk for erectile dysfunction (ED); however, the extent to which this is an issue in young men with congenital heart disease (CHD) is unknown. The goal of this study was to determine the prevalence and risk factors of ED in men with CHD.

    Methods

    Males attending an adult CHD clinic completed the International Index of Erectile Function, International Prostate Symptom Score; Short Form-12; and Satisfaction with Life Survey. Univariate and independent risk factors were determined for the presence of ED.

    Results

    Of 128 respondents, 102 (mean age 36±13 years) were in stable relationships and/or sexually active and therefore, suitable for analysis. Twenty-eight percent reported some degree of ED. The predictors of ED were age (p<0.01) and hypertension (p<0.05), yet functional class (p=0.53), defect complexity (p=0.46), pulmonary hypertension (p=0.53) or ventricular dysfunction (p=0.86) were not. Patients with ED had poorer perceived health (p<0.01) and lower life satisfaction (p<0.05). Using a multivariate logistic regression model, age was the only independent predictor of ED (OR 1.04/year, 95 % CI 1.01 to 1.08, p=0.01, or OR 4.2, 95 % CI 1.4 to 12.8, p=0.01, for age>50 years in a repeat analysis).

    Conclusions

    Erectile dysfunction was present in 28 % of the men and correlated with poorer quality of life measures. Age and hypertension, but not disease complexity or functional class were the predictors of ED, suggesting that CHD per se does not contribute to the presence of ED, rather that it relates to underlying vascular disease.