OBJECTIVE OF THE STUDY:

To find relationship between certain common drugs and surgical treatments being taken for widely prevalent diseases and erectile dysfunction (ED).

STUDY DESIGN:

This study was undertaken in Sannidhya Institute and Research Centre for Sex, Sexuality and Health by principal investigator Dr Pprincipal investigator Dr Paras Shah over a period from November 1997 to January 1999. All patients coming to this institute with complaint of mild, moderate or severe erectile dysfunction of various etiologn of various etiologies (organic, psychogenic or mixed) were enrolled for this study. Thorough history, clinical examination was done. Certain biochemical tests like Haematogram, Lipid profile, Plasma Testosterone, Plasma Prolactin, Blood Sugar, RigiScan Plus, Doppler study and other special investigations as indicated by primary disease of the patient were carried out. The details were filled up in the prescribed proforma and results analyzed.

ANALYSIS:

As shown in fig.1, out of total 550 patients, male patients comprised the majority in study group (N = 512). Still in our society, despite wide spread education and awareness females hesitate coming out with theiing out with their sexual problems. Even as far as married couples are concerned, it is the males who seek professional advice. Fig. 2 shows age distribution of the 550 patients studied. Out of 550, 289 patients' were of age group 46-55 years. This is the period when patients have chronic illnesses like diabetes, hypertension, cancer and they have been taking drugs since long. ED is very commonly seen in these patients and these are the very patients seeking medical advice. Very less patients (N = 23) come from the age group 18-25 years; ED being less common in this age group. They have other sexual problems like early orgasmic response, unconsummated marriage, myths and misconception regarding sex etc. Fig 3 and fig 4 show the caste and income distribution respectively. Fig 5 and fig 6 are about the presenting symptom of ED and its duration. As is evident, moderate ED is very common comprising almost two-thirds of the study group. Another point to be noted is that long standing ED is matter of concern to the patients. (N = 282/ 7 to 9 months). Only when it becomes a major problem these patients come to a physician. Out a physician. Out of 550 patients enrolled for the study, only 112 patients had taken previous treatment without proper investigation and result for ED (fig 7). These patients were more concerned for their primary disease; ED being a secondary factor for them.

The distribution of patients according to their primary etiology is depicted in fig 8. Common scourges in society being diabetes, hypertension, and acid-peptic disease. Common addictions being tobacco, smoking and alcohol. Almost every second patient was suffering from hypertension and diabetes, and/or was consuming tobacco in one form or the other.

Coming to fig 9, most important for this study. The common culprits for ED become evident in form of cimetidine, propranolol and bendrofluozide. As is clear, these drugs if taken for a longer time (> 6 months) lead to ED as their side effect. Before six months, the side effect is not very evident. The miscellaneous group comprise group comprised of certain Ayurvedic, Homeopathic medications or drugs which patient did not know the name. 90 patients underwent surgery like prostectomy, colostomy, spinal surgery, debulking surgery for cancer. Out of these 90 patients, 69 developed ED after surgery. This ED is caused by inadvertent damage during surgery to blood vessels and nerves. Other forms of cancer treatment like chemotherapy, radiotherapy can also lead to ED.

Addictions are very common in leading to ED. Almost all patients having so common in leading to ED. Almost all patients having some form of chronic addiction like alcohol, tobacco or smoking eventually developed ED.

REFERENCES:
1.) Abramowiez M, drugs that caus M, drugs that cause sexual dysfunction Med Lett        29:65, 1987
2.) Erwin J Haeberle, Rolf Gindorf, Sexology Today, 1993
3.) Proceedings from 7 th World Congress of sexology, 1985, page 151-163
4.) R N Srivastav, G D Shukla, B L Verma “Sexual Medicine” A handbook, 1996
5.) Stefan Bechtel “The Practical Encyclopaedia of Sex and Health”, 1998
6.) Urologic clinics of North America, February 1988, page 23-30
7.) Wolfe M M: Impotence of cimetidine treatment. N Engl J Med 300:94, 1979