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Abstract

Volume 16, Issue 3 (May 2014) 16, 461–466; 10.4103/1008-682X.123678

The role of statins in erectile dysfunction: a systematic review and meta-analysis

Xiang Cai, Ye Tian, Tao Wu, Chen-Xi Cao, Si-Yuan Bu, Kun-Jie Wang

Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China.

Correspondence: Dr. KJ Wang (wangkunjie@gmail.com)

【原创论文】去势对膀胱功能、膀胱及血管组织变化的时间依赖性影响 我们研究了去势大鼠中雄性激素对其膀胱血流、膀胱功能和组织学变化的影响。雄性wistar大鼠分为未手术组(对照组),8周龄手术去势组(8周去势组)和4周龄手术去势组(4周去势组),实验时每只鼠的周龄均为20周。膀胱血流用荧光微球法测定。膀胱测压在大鼠无麻醉,无约束的状态下进行。先用生理盐水,然后用0.25%的乙酸溶液进行膀胱灌注。测量最大排尿压和排尿间隔。评估膀胱和髂动脉的组织学变化,检测平滑肌和胶原纤维的含量来分析去势对平滑肌成份的影响。去

Abstract

To evaluate the effect of statins for erectile dysfunction (ED), a systematic review of the literature was conducted in the Cochrane Library, EMBASE, and PUBMED from the inception of each database to June 2013. Only randomized, controlled trials (RCTs) comparing treatment for ED with statins were identified. Placebo RCTs with the International Index of Erectile Function (IIEF) as the outcome measure were eligible for meta-analysis. A total of seven RCTs including two statins with a total of 586 patients strictly met our criteria for systematic review, and five of them qualified for the meta-analysis. A meta-analysis using a random effects model showed that statins were associated with a significant increase in IIEF-5 scores (mean difference (MD) 3.27, 95% confidential interval (CI) [1.51, 5.02]; P< 0.01) and an overall improvement of lipid profiles including total cholesterol (MD -1.08, 95% CI [-1.68, -0.48]; P < 0.01), low density lipoprotein (LDL) cholesterol (MD -1.43, 95% CI [-2.07, -0.79]; P < 0.01), high density lipoprotein (HDL) cholesterol (MD 0.24, 95% CI [0.13, 0.35]; P < 0.01), and triglycerides (TGs) (MD -0.55, 95% CI [-0.61, -0.48]; P < 0.01). In summary, our study revealed positive consequences of these lipid-lowering drugs on erectile function, especially for non-responders to phosphodiesterase type 5 inhibitors (PDE5Is). However, it has been reported that statin therapy may reduce levels of testosterone and aggravate symptoms of ED. Therefore, larger, well-designed RCTs are needed to investigate the double-edged role of statins in the treatment of ED.

Keywords: dyslipidemia; endothelial dysfunction; erectile dysfunction; statins

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