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  1. Fulltext The sensitivity of the Malay version of Brief Manual of Sexual Function Inventory in assessing erectile dysfunction secondary to benign prostatic hyperplasia
    Quek KF, Low WY, Razack AH, Chua CB, Loh CS
    Med J Malaysia, 2003 Aug;58(3):356-64.
    PMID: 14750375
    This study aimed to assess the sensitivity of the Malay version of the Brief Manual Sexual Function Inventory (BMSFI) on patients with and without urinary symptoms in Malaysian population. Validity and reliability were studied in patients with lower urinary tract symptoms (LUTS) and patients without LUTS. Reliability and validity was evaluated by using the test-retest method while internal consistency was assessed by Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus post-intervention score in patients who underwent transurethral resection of the prostate (TURP). Internal consistency was excellent. A high degree of internal consistency was observed for each of the 11 items and 5 domains (Cronbach's alpha value = 0.67 and higher and 0.73 and higher respectively). Test-retest correlation coefficient for the 11 items scores was highly significant. Intraclass correlation coefficient was high (ICC = 0.68 and above). The sensitivity and specificity showed a high degree of sensitivity and specificity to the effects of treatment. A high degree of significant level between baseline and post-treatment scores were observed across 3 domains in the treatment corresponds cohort but not in the control group. The Mal-BMSFI is a suitable, reliable, valid and sensitive to clinical change in the Malaysian population.
    Matched MeSH terms: Erectile Dysfunction/diagnosis*; Erectile Dysfunction/etiology*
  2. Co-Morbid Erectile Dysfunction (ED) and Antidepressant Treatment in a Patient - A Management Challenge?
    Zainol M, Sidi H, Kumar J, Das S, Ismail SB, Hatta MH, et al.
    Curr Drug Targets, 2019;20(2):182-191.
    PMID: 28302034 DOI: 10.2174/1389450118666170315110902
    Throughout the world, antidepressants (AD) and phosphodiesterase-5 inhibitors (PDE-5i) are the commonly prescribed psychopharmacological agents for treating patients with co-morbid mental health problem and sexual dysfunction (SD). The serotonergic and noradrenergic ADs, although effective, are not without any SD adverse-effects, especially erectile dysfunction (ED). ED is a failure to obtain a satisfactory erection for rewarding sexual coitus during the phases of male's sexual arousal. It is recognized as an important reason why non-adherence to treatment was observed in patients who were on AD. AD intervention caused remission to some of the pre- treatment psychopathology of ED. However, in many patients, AD potentially magnified the unwanted sexual sideeffects. This made the situation challenging for the mental health professional. These challenges are based on the complexity of ED, its etiology and the associated risk factors, which further add to its AD side-effect. The neuro-psychopharmacological basis for AD treatment selection was deliberated. Bio-psycho-social interventions are recommended at two pivotal stages. Firstly, a step should be taken for proper assessment (e.g. detailed history, psychosocial and laboratory investigations); and identify few modifiable risk factors for ED and associated mental health issues. Secondly, with guidance of an algorithm pathway, a practical intervention should include strategies such as dose reduction, augmentation or changing to an AD with lesser or no sexual adverse-effects. It is recommended that bupropion and mirtazepine to be prescribed when patients develop adverse sexual effects with serotonin selective reuptake inhibitor (SSRI), serotonin norepinephrine reuptake inhibitor (SNRI) and tricyclic antidepressant (TCA). Few suggestions which may be borne in mind are revising sexual scripts and improving sexual techniques, life-style modifications, psychotherapy and other nonpharmacological approaches which may be beneficial to both patients and their partners.
    Matched MeSH terms: Erectile Dysfunction/drug therapy*; Erectile Dysfunction/psychology
  3. The Phosphodiasterase 5-Inhibitors (PDE-5i) for Erectile Dysfunction (ED): A Therapeutic Challenge For Psychiatrists
    Koon CS, Sidi H, Kumar J, Xi OW, Das S, Hatta MH, et al.
    Curr Drug Targets, 2018;19(12):1366-1377.
    PMID: 28215172 DOI: 10.2174/1389450118666170215164747
    Erectile function (EF) is a prerequisite for satisfactory sexual intercourse (SI) and central to male sexual functioning. Satisfactory SI eventually initiates orgasm - a biopsychophysiological state of euphoria - leading to a sense of bliss, enjoyment and positive mental well being. For a psychiatrist, treating ED is self-propelled to harmonize these pleasurable experiences alongside with encouragement of physical wellness and sensuality. Hence, the role of PDE-5i is pivotal in this context and constitutes a therapeutic challenge. PDE-5i work via the dopaminergic-oxytocin-nitric oxide pathway by increasing the availability of endothelial's guanosine monophosphate (GMP), immediately causing relaxation of the penile smooth muscle and an erection. The PDE-5i, like sildenafil, vardenafil and tadalafil, are effective in the treatment of ED with some benefits/ flexibilities and disadvantages compared to other treatment modalities. Prescribed PDE-5i exclusively improve EF, fostering male's self-confidence and self-esteem. Treatment failures are associated with factors such as absent (or insufficient) sexual stimulation, psychosexual conflicts and the co-existence of medical disorders. Managing ED requires dealing with underlying medical diseases, addressing other co-morbid sexual dysfunctions like premature ejaculation (PE), and educating the patient on healthy life-styles. Furthermore, by dealing with interpersonal dynamics within the couple and embracing adequate lifestyles (managing stress and revising one's sexual scripts), PDE-5i treatment benefits may be enhanced. In this review, we propose a holistic conceptual framework approach for psychiatric management of patients with ED.
    Matched MeSH terms: Erectile Dysfunction/drug therapy*; Erectile Dysfunction/psychology
  4. Fulltext Prevalence and predictors of erectile dysfunction in adult male outpatient clinic attendees in Johor, Malaysia
    Nordin RB, Soni T, Kaur A, Loh KP, Miranda S
    Singapore Med J, 2019 Jan;60(1):40-47.
    PMID: 29774359 DOI: 10.11622/smedj.2018049
    INTRODUCTION: Erectile dysfunction (ED) is a serious global burden that affects men as well as their partners. This study aimed to determine the prevalence and predictors of ED among male outpatient clinic attendees in Johor, Malaysia.

    METHODS: We conducted a cross-sectional study of Malaysian men aged ≥ 18 years attending two major outpatient clinics in Johor Bahru and Segamat in Johor, Malaysia, between 1 January 2016 and 31 March 2016. Subjects were chosen via simple random sampling and 400 patients were recruited. The study instrument was a survey form that consisted of three sections: sociodemographic and comorbid profile, validated English and Malay versions of the 15-item International Index of Erectile Function, and the 21-item Depression Anxiety Stress Scale.

    RESULTS: The overall prevalence of self-reported ED was 81.5%. The prevalence of ED according to severity was as follows: mild (17.0%), mild to moderate (23.8%), moderate (11.3%) and severe (29.5%). Multivariate analysis showed that ED was associated with increasing age (odds ratio [OR] 4.023, 95% confidence interval [CI] 1.633-9.913), Indian as compared to Malay ethnicity (OR 3.252, 95% CI 1.280-8.262), secondary as compared to tertiary education (OR 2.171, 95% CI 1.203-3.919), single as compared to married status (OR 6.119, 95% CI 2.542-14.734) and stress (OR 4.259, 95% CI 1.793-10.114).

    CONCLUSION: ED has significant prevalence and severity among adult male outpatient clinic attendees in Johor. Increasing age, Indian ethnicity, lower educational level, singlehood and stress were significant predictors of ED.

    Matched MeSH terms: Erectile Dysfunction/diagnosis*; Erectile Dysfunction/epidemiology*
  5. Fulltext Malaysian cultural differences in knowledge, attitudes and practices related to erectile dysfunction: focus group discussions
    Low WY, Wong YL, Zulkifli SN, Tan HM
    Int J Impot Res, 2002 Dec;14(6):440-5.
    PMID: 12494275
    This qualitative study aimed to examine cultural differences in knowledge, attitudes and practices related to erectile dysfunction (ED) utilizing focus group discussion. Six focus groups consisting of 66 men, 45-70-y-old were conducted-two Malay groups (n=18), two Chinese groups (n=25) and two Indian groups (n=23). Participants were purposely recruited from the general public on a voluntary basis with informed consent. Transcripts were analyzed using qualitative data analysis software ATLASti. The Malay and Chinese traditional remedies for preventing or treating ED are commonly recognized among all races. Many have a negative perception of someone with ED. Malay and Chinese men tended to blame their wife for their problem and thought that the problem might lead to extra-marital affairs, unlike the Indian men who attributed their condition to fate. Malays would prefer traditional medicine for the problem. The Chinese felt they would be more comfortable with a male doctor whilst this is not so with the Malays or Indians. Almost all prefer the doctor to initiate discussion on sexual issues related to their medical condition. There is a need for doctors to consider cultural perspectives in a multicultural society as a lack of understanding of this often contributes to an inadequate consultation.
    Matched MeSH terms: Erectile Dysfunction/ethnology; Erectile Dysfunction/etiology*; Erectile Dysfunction/prevention & control; Erectile Dysfunction/therapy*
  6. Fulltext Prevalence and correlations of lower urinary tract symptoms, erectile dysfunction and incontinence in men from a multiethnic Asian population: Results of a regional population-based survey and comparison with industrialized nations
    Mariappan P, Chong WL
    BJU Int, 2006 Dec;98(6):1264-8.
    PMID: 17034498
    OBJECTIVE: To determine, in a population-based survey, the prevalence of lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and incontinence in community-dwelling men in multiethnic Malaysia, as currently available Western demographic data might not be applicable in the Asian population.
    SUBJECTS AND METHODS: A cross-sectional population-based survey was carried out in the State of Penang, Malaysia, with a target population of men aged > or = 40 years. Using a multistage study design, random systematic sampling was used to represent the target population, who were weighted based on ethnicity and rural-urban ratios so as to represent the general population distribution. Trained field-workers conducted direct interviews and administered the American Urological Association Symptom Index (AUA-SI), the International Index of Erectile Function (IIEF-5) questionnaire and questions on incontinence based on the International Continence Society 2002 definition.
    RESULTS: In all, 418 men aged > or = 40 years were interviewed, of whom 353 completed the AUA-SI questionnaire (84.5% response rate). The prevalence of mild, moderate and severe LUTS was 80.6%, 6% and 0.3%, respectively. The prevalent symptoms were frequency and nocturia. There was moderate and severe ED in 45.9% of men, whereas incontinence was reported by 8.2%. The AUA-SI correlated strongly with age (R = 0.291, P < 0.001), IIEF-5 (R = - 0.265, P < 0.001) and diabetes mellitus.
    CONCLUSION: The prevalence and severity of LUTS, ED and incontinence increased with age in this multiethnic Asian population, in which ED correlated strongly with LUTS. Compared to the Western population, the prevalence of LUTS was significantly lower, while the prevalence of ED and incontinence were comparable.
    Matched MeSH terms: Erectile Dysfunction/ethnology; Erectile Dysfunction/epidemiology*
  7. Erectile Dysfunction among People Who Use Ketamine and Poly-Drugs
    Suppiah B, Vicknasingam B, Singh D, Narayanan S
    J Psychoactive Drugs, 2016 Apr-Jun;48(2):86-92.
    PMID: 27014841 DOI: 10.1080/02791072.2016.1156790
    Despite the rise in recreational use of ketamine in Malaysia, there have been no studies of users or of the health-related consequences they face. This study was initiated to examine ketamine use and its health consequences. A structured questionnaire was used to elicit information. A final sample of 127 males was divided into persons who used only ketamine and those who were poly-drug users. Each group was further divided into long-period and short-period users. Urine toxicology screening for ketamine and other illicit drugs commonly used in Malaysia was also done. Our findings corroborate those of earlier studies that link ketamine use to urological problems such as frequent urination, dysuria, incontinence, painful bladder, nocturia, and urinary urgency. A new finding in this study is the significant association between ketamine use and erectile dysfunction, such that higher odds of reporting erectile dysfunction were linked to long-period users. Our findings strengthen the case for early intervention, as ketamine users are drawn from young and unmarried male participants. The association of ketamine use with erectile dysfunction, if substantiated, will help physicians in their diagnosis of erectile dysfunction, particularly among youths.
    Matched MeSH terms: Erectile Dysfunction/chemically induced*; Erectile Dysfunction/epidemiology
  8. Epidemiology of erectile dysfunction in four countries: cross-national study of the prevalence and correlates of erectile dysfunction
    Nicolosi A, Moreira ED, Shirai M, Bin Mohd Tambi MI, Glasser DB
    Urology, 2003 Jan;61(1):201-6.
    PMID: 12559296 DOI: 10.1016/s0090-4295(02)02102-7
    OBJECTIVES:
    To measure the prevalence of erectile dysfunction (ED) in community-based populations in Brazil, Italy, Japan, and Malaysia and to study its association with the demographic characteristics, medical conditions, and health-related behavior.

    METHODS:
    In each country, a random sample of approximately 600 men aged 40 to 70 years was interviewed using a standardized questionnaire. All the data were self-reported. ED was assessed by the participants' "ability to attain and maintain an erection satisfactory for sexual intercourse," and the men were classified as not having ED if they answered "always" and as having mild, moderate, or complete ED if they answered "usually," "sometimes," or "never," respectively.

    RESULTS:
    The age-adjusted prevalence of moderate or complete ED was 34% in Japan, 22% in Malaysia, 17% in Italy, and 15% in Brazil. The overall age-specific prevalence of moderate or complete ED was 9% for men aged 40 to 44 years, 12% for 45 to 49 years, 18% for 50 to 54 years, 29% for 55 to 59 years, 38% for 60 to 64 years, and 54% for those 65 to 70 years. The increased risk of ED was associated with diabetes, heart disease, lower urinary tract symptoms, heavy smoking, and depression and increased by 10% per year of age. It was inversely associated with education, physical activity, and alcohol drinking.

    CONCLUSIONS:
    ED is an international problem, the prevalence and severity of which increases with age. Despite national variations in prevalence, uniform associations were found between ED and medical conditions and lifestyle habits.
    Matched MeSH terms: Erectile Dysfunction/diagnosis; Erectile Dysfunction/epidemiology*
  9. New therapies for erectile dysfunction
    Tan HM
    Int. J. Androl., 2000;23 Suppl 2:87-8.
    PMID: 10849506
    The quest for improving and maintaining sexual function has been going on since time immemorial. The advent of an effective oral drug, sildenafil, has brought about unprecedented open discussion on male erectile dysfunction, and gas accelerated the pace of development of new therapies for erectile dysfunction. New knowledge in the physiology of sexual function has enabled researchers to target drug treatment at the whole network of the central nervous system and the numerous cascadic enzymatic reactions leading to relaxation of the corporal smooth muscle. One of the brightest potential applications of future molecular technology in the study of erectile dysfuction is in the utilization of gene therapy.
    Matched MeSH terms: Erectile Dysfunction/drug therapy*; Erectile Dysfunction/physiopathology
  10. Fulltext Prevalence and factors associated with erectile dysfunction in male patients with human immunodeficiency virus in a teaching hospital in West Malaysia
    Enoma A, Ching SM, Hoo FK, Omar SFS
    Med J Malaysia, 2017 06;72(3):186-189.
    PMID: 28733567 MyJurnal
    INTRODUCTION: Erectile dysfunction (ED) has been associated with the treatment of human immunodeficiency virus (HIV) and chronic diseases. Sexual dysfunction data of male patients infected with HIV are still scarce in Malaysia, and ED appears to be under-reported. Therefore, this study aims to determine the prevalence and predictors of ED among male HIV patients at the University Malaya Medical Centre.

    METHODS: A cross sectional study was conducted among male HIV patients on antiretroviral therapy (ART) attending the outpatient clinic of a teaching hospital in Malaysia. A systematic random sampling method was employed in the selection of respondents. Participants were interviewed using a structured questionnaire with a 15-item international index of erectile function (IIEF-15). An appropriate statistical analysis was used to determine the associate and potential risk factors.

    RESULTS: A total of 220 males participated in this study with a mean age of 37.9±9.9; prevalence of ED among HIV patients was 82.3 % (n=180). The severity of ED was further categorized into: severe (24.1%), moderate (19.1%), mild to moderate (20.9%), and mild (18.3%). In a multivariate logistic regression analysis, patients with a lower educational background were more likely to be associated with ED (odds ratio [OR] 2.62, 95% confidence interval [CI] 1.02-6.72; pvalue 0.046).

    CONCLUSION: This study reports that ED was prevalent among adult HIV males who are on an ART regimen. Those with a lower educational background are more likely to have ED. Hence, in managing patients with HIV, physicians should seek to identify those patients at risk of developing ED for further intervention.
    Matched MeSH terms: Erectile Dysfunction/etiology*; Erectile Dysfunction/epidemiology
  11. The triad of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome: findings from a multi-ethnic Asian men study (The Subang Men's Health Study)
    Tan WS, Ng CJ, Khoo EM, Low WY, Tan HM
    Aging Male, 2011 Dec;14(4):231-6.
    PMID: 22115177 DOI: 10.3109/13685538.2011.597463
    The etiology of erectile dysfunction (ED) is multi-factorial. This paper examines the association between ED, testosterone deficiency syndrome (TDS) and metabolic syndrome (MS) in Malaysian men in an urban setting. One thousand and forty-six men aged ≥ 40 years from Subang Jaya, Malaysia were randomly selected from an electoral-roll list. The men completed questionnaires that included: socio-demographic data, self-reported medical problems and the International Index of erectile function (IIEF-5). Physical examination and the following biochemical tests were performed: lipid profile, fasting blood glucose (FBG) and total testosterone. The response rate was 62.8% and the mean age of men was 55.8 ± 8.4 (41-93) years. Ethnic distribution was Chinese, 48.9%; Malay, 34.5%; Indian, 14.8%. The prevalence of moderate-severe ED was 20.0%, while 16.1% of men had TDS (< 10.4 nmol/L) and 31.3% of men had MS. Indian and Malay men were significantly more likely to have ED (p  = 0.001), TDS (p  < 0.001) and MS (p < 0.001) than the Chinese. Multivariate regression analysis showed that elevated blood pressure, elevated FBG, low high-density lipoprotein and heart disease were predictors of ED while all MS components were independently associated with TDS. Malay and Indian men have a higher disease burden compared to Chinese men and were more likely to suffer with ED, TDS and MS. MS components were closely related to TDS and ED.
    Matched MeSH terms: Erectile Dysfunction/blood; Erectile Dysfunction/etiology; Erectile Dysfunction/epidemiology*
  12. Fulltext Sex among Asian men and women: the Global Better Sex Survey in Asia
    Tan HM, Marumo K, Yang DY, Hwang TI, Ong ML
    Int J Urol, 2009 May;16(5):507-14; discussion 514-5.
    PMID: 19467120 DOI: 10.1111/j.1442-2042.2009.02283.x
    OBJECTIVES:
    To explore by a pooled subanalysis of the Global Better Sex Survey sexual aspirations and unmet needs of men and women from Hong Kong, Indonesia, Japan, Malaysia, Singapore, South Korea, Taiwan, and Thailand.

    METHODS:
    To qualify, respondents must have had sexual intercourse at least once in the past 12 months. Women must have had heterosexual intercourse. Data were weighted by population size between countries.

    RESULTS:
    Of 3538 Asian respondents (1776 men and 1762 women), 52% were aged <40 years, 40% were aged 40-59 years, and 8% were aged >or=60 years. The majority were married or in a relationship. Men and women reported having sexual intercourse 5.1 and 4.0 times monthly, respectively. Attraction to partner, foreplay, intercourse, and achieving orgasm were important to most men and women. Two thirds were less than very satisfied with their sex life, and 36% of men were interested in improving sex. For a good sexual experience, the man's ability to get and maintain an erection and erection hardness were important to the majority of Asian men and women. Few respondents reported using a prescription erectile dysfunction medication, but many showed interest in using these medications to improve their sex lives. A comparison between individual countries suggests that attitudes about sex differ from country to country, and between men and women in each country.

    CONCLUSIONS:
    Sex is very important to Asian men and women, but many of them are not fully satisfied with their sex lives and want to improve them.
    Matched MeSH terms: Erectile Dysfunction/drug therapy; Erectile Dysfunction/ethnology*; Erectile Dysfunction/psychology
  13. Fulltext Assessment of marital dissatisfaction and its association with sexual dysfunction and psychiatric morbidities among primary health attenders in Malaysia
    Ahmad Faizal S, Sidi H, Wahab S, Lenny SS, Mat Zin N, Baharuddin N
    International Medical Journal Malaysia, 2017;16:19-26.
    Introduction: Marital satisfaction is vital to the wellbeing and functioning of the individual and family. Marital dissatisfaction can lead to detrimental effects on mental, physical and family health. The study aimed to determine the proportion of marital dissatisfaction in outpatient setting and its association with sexual functioning and psychiatric morbidity in Kuala Lumpur, Malaysia.
    Materials & Methods: A cross-sectional study was conducted in selected primary care using purposive sampling. Data collection was done using socio-demographic questionnaire and several validated Malay version of self-administered questionnaires. Marital satisfaction was measured by the Malay version of Golombok-Rust Inventory of Marital State (Mal-GRIMS).
    Results: The prevalence of marriage dissatisfaction in sample population was about 37.3% with almost equal prevalence in both, 36.5% (male) and 37.8% (female). Using a regression analysis, the significant factors that affect marital dissatisfaction were respondent's age group between 31- 40 years old (Adjusted Odds Ratio, AOR. =11.4, 95% Confidence Interval, CI. =1.2-110.9), spouse's salary of RM1000-RM2000 (lower income category) (AOR=7.3, 95% CI= 1.9-28.1), anxiety case (AOR= 4.8, 95% CI=1.1- 21.5), depression case (AOR= 4.8, 95% CI=1.0-22.8), female sexual dysfunction in term of arousal function (AOR= 0.01, 95% CI=0.0-0.7), satisfaction dysfunction (AOR= 9.4, 95% CI= 1.5-58) and pain function (AOR=43.7, 95% CI=1.28 - 1489.2).
    Conclusion: Marital dissatisfaction can be influenced by financial factor, sexual dysfunction and presence of psychiatric morbidity. Hence, in management of marital discord, thorough screening of these factors should be prioritized in clinical setting.
    Matched MeSH terms: Erectile Dysfunction
  14. Author's reply to editorial comment to sex among Asian men and women: The global better sex survey in Asia
    Tan HM
    International Journal of Urology, 2009;16:515.
    DOI: 10.1111/j.1442-2042.2009.02295.x
    Matched MeSH terms: Erectile Dysfunction
  15. Depression, hormonal status and erectile dysfunction in the aging male: results from a community study in Malaysia
    Low WY, Khoo EM, Tan HM, Hew FL, Teoh SH
    Journal of Men's Health and Gender, 2006;3:263-270.
    DOI: 10.1016/j.jmhg.2006.02.007
    Background: Depression and erectile dysfunction (ED) are common in aging and the two conditions often co-exist. These conditions have been shown to be associated with hormonal changes in men. This paper examines the association between depression, ED, and hormonal status of men aged above 50 years in the Klang Valley, Malaysia.
    Methods: Five hundred men aged 50 years and above were randomly selected via the electoral roll and invited to participate in a community-based study on men's health: 351 men responded. Respondents were interviewed individually based on a self-developed questionnaire, which included information on socio-demographic data. Erectile function was measured using the International Index for Erectile Function-5 (IIEF-5) and depression was measured using the 15 item Geriatric Depression Scale (GDS-15).
    Results: Sixty-nine percent of the men were diagnosed with ED. Mean GDS score was 3.33 (SD = 3.29). Nineteen percent (n = 67) of the men had abnormal levels of testosterone (≤11 nmol/l) and this comprised 73% of men with ED (n = 49) and 27% of men without ED (n = 18). There was no significant association between testosterone level and ED (χ2 = 0.68, p = 0.41). Significant association was found between depression (GDS ≥ 5) and men with ED (χ2 = 6.07, p = 0.014). Sex hormone binding globulin and luteinising hormone were negatively correlated with erectile function. Results of the multiple linear regression showed that age and depression are predictors of erectile function.
    Conclusion: Depression and ED should be screened for when either exists in the male patient and treatment directed accordingly. © 2006 WPMH GmbH.
    Matched MeSH terms: Erectile Dysfunction
  16. The aging male in Malaysia: Opening speech at the first Asian ISSAM meeting
    Jui YBDC
    Aging Male, 2001;4:106-108.
    Matched MeSH terms: Erectile Dysfunction
  17. Prevalence of erectile dysfunction in primary care setting, Malaysia
    Abdul Rahman AA, Al Sadat N, Low WY
    Journal of Men's Health, 2011;8:S50-S53.
    DOI: 10.1016/S1875-6867(11)60021-3
    Background: The objective of this study was to identify the prevalence and associated factors of erectile dysfunction (ED) among men who frequented public primary care clinics in an urban district in Malaysia.
    Methods: A total of 1331 men aged 40-76 years participated in this cross-sectional study. Information on demographic information, medical history and lifestyle factors were obtained through self administered questionnaire. ED was assessed using the International Index of Erectile Function (IIEF-5).
    Results: The participants' age ranged from 40-79 years with a mean of 54.7 (±8.3) years. The prevalence of ED was 69.5%. In terms of severity, 33.1% had mild, 26.6% moderate and 9.8% severe ED. The participants with increased age had reportedly higher prevalence of ED. The prevalence of ED increased from 49.7% of men in their 40s to 66.5%, 92.8% and 93.9% of men in their 50s, 60s and 70s respectively. The prevalence of moderate and severe ED also increased with age. The prevalence of severe ED was only 2.1% of men in their 40s and rose to 22.4% of men aged more than 60 years. The prevalence of ED among those with diabetics or heart disease was the highest (89.2%) followed by hypertensives (80.4%) and hypercholesterolaemia (78.9%). Men in their 50s (OR = 2.0) and 60s (OR = 13.5) had higher odds in ED.
    Conclusions: This study found that ED was common among men aged 40 years and above at the primary care setting. The prevalence and severity of ED increased with age. © 2011 WPMH GmbH.
    Matched MeSH terms: Erectile Dysfunction
  18. Erectile dysfunction management: a critical appraisal of clinical practice guidelines with the AGREE II instrument
    Hazir B, Haberal HB, Asci A, Muneer A, Gudeloglu A
    Int J Impot Res, 2021 May 03.
    PMID: 33941879 DOI: 10.1038/s41443-021-00442-7
    Our study aimed to assess the methodological strengths and weaknesses of erectile dysfunction clinical practice guidelines (CPGs) for individuals using the AGREE II tool. Erectile dysfunction related CPGs were identified from three databases: the National Guideline Clearinghouse, the Guidelines International Network, and PubMed between 2000 and 2020. We designed an independent assessment for each of the erectile dysfunction related CPGs using the AGREE II tool. Four appraisers performed these assessments. The literature search identified 8 CPGs that met our inclusion criteria. The evaluation of the AGREE II domains of each individual revealed that the median scores of domains related to applicability were quite low (39%). Also, the median scores of domains related to the rigour of development and the stakeholder involvement were relatively low (53% and 63%). We determined the highest median scores in three AGREE II domains: clarity of presentation (80.5%), editorial independence (77%), and scope and purpose (89.5%). We found that the European Association of Urology (EAU), the American Urological Association (AUA), and the British Society for Sexual Medicine (BSSM) guidelines had >60% in >4 domains and that their average AGREE II scores were over 70%. In the Canadian Diabetic Association (CDA) and the Japanese Society for Sexual Medicine (JSSM) guidelines, we found that >4 domains were >60%, but their average AGREE II scores were below 70%. The British Medical Journal (BMJ), the Canadian Urologic Association (CUA), and the Malaysian Urologic Association (MUA) guidelines had >60% in <3 domains. We highly recommended EAU, AUA and BSSM guidelines, while we moderately recommended CDA and JSSM guidelines. BMJ, CUA and MUA guidelines were weakly recommended. The quality of the guidelines for erectile dysfunction was variable according to AGREE II. We noted significant deficiencies in the methodological quality of the CPGs developed by different organisations in the areas of applicability and rigour of development.
    Matched MeSH terms: Erectile Dysfunction
  19. Fulltext Management of erectile dysfunction: barriers faced by general practitioners
    Low WY, Ng CJ, Tan NC, Choo WY, Tan HM
    Asian J Androl, 2004 Jun;6(2):99-104.
    PMID: 15154082
    Aim: To explore the barriers faced by general practitioners (GPs) in the management of patients with erectile dysfunction (ED).
    Methods: This was a qualitative analysis of focus group discussions and in-depth interviews involving 28 Malaysian GPs.
    Results: GPs' perception of ED being not a serious condition was a major determinant of their prescribing practice. Doctor's age (younger), gender (female), short consultation time and lack of experience were cited as barriers. The GPs' prescribing habits were heavily influenced by the feedback from the first few patients under treatment, the uncertainty of etiology of ED without proper assessment and the profit margin with bulk purchase. Other barriers include Patients' coexisting medical conditions, older age, lower socio-economic status, unrealistic expectations and inappropriate use of the anti-impotent drugs. Cardiovascular side effects and cost were two most important drug barriers.
    Conclusion: The factors influencing the management of ED among the general practitioners were multiple and complex. An adequate understanding of how these factors (doctors, patients and drugs) interact can assist in the formulation and implementation of strategies that encourage GPs to identify and manage ED patients.
    Matched MeSH terms: Erectile Dysfunction/epidemiology; Erectile Dysfunction/psychology; Erectile Dysfunction/therapy*
  20. Fulltext Koro-like symptoms with associated erectile dysfunction in a Rohingya refugee
    Abdullah KHA, Wahab S
    ASEAN Journal of Psychiatry, 2012;13(2):221-223.
    MyJurnal
    This case report highlights Koro-like symptoms with erectile dysfunction.
    Methods: We report a case of a Rohingya refugee who presented with Koro-like symptoms associated with erectile dysfunction and severe religious guilt.
    Results: Sexual dysfunction, i.e. erectile dysfunction may be a predisposing factor for a Koro incidence. Religious issues complicated by superstitious beliefs pose a treatment challenge.
    Conclusion: Treating patient with sexual dysfunction should involve exploring and addressing patient's conflicts to avoid worsening of symptoms. As this case illustrates, severe anxiety can present with Koro-like symptoms.
    Matched MeSH terms: Erectile Dysfunction
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