Our chief urologist Dr Naveenchandra Acharya just delivered the prestigious Young Scientist Award Lecture on the topic of " Endothelial Dysfunction and its correlation with the Erectile Dyfunction" at 14 th APSSM conference held at Kanazawa,Japan on 1st June 2013.
This paper underlines the importance of the endothelial dysfunction in erectile problems and the need to recognise this entity earlier before the onset of late complications of generalised endothelial dysfunction like CAD and stroke.
The endothelial dysfunction precedes many years before the onset of heart and brain catastrophe and hence its is essential to screen the people with erectile dysfunction.As penile vessels are only 1-2 mm in diameter while the left anterior descending coronary artery is 3-4 mm in diameter the early atherosclerotic and endothelial changes are likely to cause erectile dysfunction first then the myocardial Infarction.
We use Flow Mediated Dilatation Phenomenon for measuring the endothelial dysfunction ( it is done by inducing shear stress in brachial artery by occluding the sphygmomanometer cuff above systolic blood pressure and then relieving it.The reactive hyperemia and the reperfusion injury associated brachial arterial dilatation is measured by greyscale ECHO probe in antecubital fossa over the baseline diameter at "R" wave of ECG...corresponding to the end-diastolic phase).In patients with generalised endothelial dysfunction this response is blunted.
The other way of measuring the endothelial dysfunction is ENDOPAT.It measures the peripheral arterial tone by modified finger plethysmographic probes attached to the index finger of each hand.The procedure is the same like FMD but it is objective and easy to be done.It also eliminates the error by sympathetic overactivity.
We found there is significant decrease in FMD in patients with ED and its correlates with the severity of ED( as per IIEF-5 2 Questionnnaire).The patients were chosen with age less than 40 years and there was no cardiac problems and also no confounding factors like penile structural abnormalities, no medications,hormonal disturbances etc.
This is an important study as this can potentially screen people who will develop CAD in future and preventive steps can be taken in this regard.
This paper was highly regarded and appreciated at Kanazawa.