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Association Between Inflammatory Bowel Disease and Erectile Dysfunction: A Nationwide Population-Based Study

Kao, Chien-Chang MD; Lin, Cheng-Li MSc; Huang, Wen-Yen MD; Cha, Tai-Lung MD; Lin, Te-Yu MD; Shen, Chih-Hao MD; Kao, Chia-Hung MD

doi: 10.1097/MIB.0000000000000695
Original Article

Background: To determine whether inflammatory bowel disease (IBD) is associated with an increased risk of subsequent erectile dysfunction (ED).

Methods: We identified 1845 patients who received a diagnosis with IBD between 2000 and 2011 from Taiwan's National Health Insurance Research Database. For the comparison cohort, we randomly extracted the data of 7380 patients matched by sex, age, and baseline year. Follow-up continued until the development of ED, withdrawal from the National Health Insurance program, or the end of 2011. The cumulative incidences and hazard ratios (HRs) for ED development were determined.

Results: After 12 years of follow-up, subsequent ED incidence rates in the IBD and comparison cohorts were 2.23 and 1.29 per 10,000 person-years, respectively (adjusted hazard ratio = 1.64; 95% confidence interval [CI], 1.07–2.52; P < 0.05). Compared with the non-IBD cohort without comorbidity, the risk of ED was higher in the IBD cohort with comorbidity (adjusted hazard ratio = 2.46, 95% CI, 1.32–4.58). Patients with ulcerative colitis were 2.27-fold more likely to develop ED than were patients without IBD (95% CI, 1.22–4.20). Compared with patients without IBD who were aged ≤49 years, patients with IBD aged ≥65 years were 3.36-fold more likely to develop ED (95% CI, 1.42–7.96).

Conclusions: We found that the patients with IBD had a 1.64-fold higher risk of developing ED than did the comparison group. Physicians should be aware of the link to ED when assessing patients with IBD.

Article first published online 10 February 2016.

*Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;

Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan;

College of Medicine, China Medical University, Taichung, Taiwan;

§Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;

Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan;

Division of Infectious disease, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;

**Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;

††Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; and

‡‡Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.

Reprints: Chia-Hung Kao, MD, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 404, Taiwan (e-mail: d10040@mail.cmuh.org.tw).

This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW105-TDU-B-212-133019), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037), NRPB Stroke Clinical Trial Consortium (MOST 104-2325-B-039 -005), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan; and CMU under the Aim for Top University Plan of the Ministry of Education, Taiwan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.

The authors have no conflict of interest to disclose.

Received October 9, 2015

Accepted November 5, 2015

© Crohn's & Colitis Foundation of America, Inc.
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