[The etiology of impotence in 327 diabetic male adults].
摘要
OBJECTIVE: To investigate the etiology of impotence in diabetic male adults. METHODS: 327 diabetic men aged 20 - 70 years were interviewed; 129 (39.6%) of them complained of impotence. All the 129 patients were initially evaluated by diabetologists and then underwent psychosexual assessment by psychiatrists. In addition, evaluation for retinopathy, neuropathy, vascular disease and sex hormone level was carried out. RESULTS: The 327 diabetic patients were divided into four age ranges 25 - 34, 35 - 44, 45 - 54, and 55 - 70. The frequency of diabetic impotence in these groups was 9.7%, 34.2%, 48.0%, 62.7% respectively. Neuropathy was found in 79 (61.2%), psychogenic factor contributed in 66 (51.2%), vascular factor was present in 31 (24.0%), leakage of penile venous cavernosa occurred in 5 (3.9%), and treatment with impotence- related medications was the contributing factor in 2 (1.6%). There are significant differences of glycosylated hemoglobin, peripheral neuropathy, autonomic neuropathy, and proliferative retinopathy between impotent and potent diabetic patients. The degree of psychological problem is more serious in the diabetic impotent patients than in potent patients according to Minnesota multiphasic personality inventory (MMPI) test. No significant difference was found in smoking, alcohol and plasma testosterone level. CONCLUSION: The etiology of diabetic impotence is multifactorial. Neuropathy is the main cause, but vascular and psychological factors also contribute to it significantly.