IMPOTENCE IN DIABETIC MEN

Impotence is the inability of achieving an erection sufficient for vaginal penetration in 50 or more percent of attempts at coitus. Various researchers have found 35%-75% of men with diabetes to have problems with erection. In 1798, Rollo was the first to report on impotence in persons with diabetes, and in 1906 Naunyn observed it to be the most frequent complication of diabetes in males. McCulloch et al. have reported that 9% of diabetic men aged 20-29 years, and 95% of those aged more than 70 years have erectile impairment. Impotence occurs in patients with IDDM as well as in those with NIDDM. According to our observations, it is somewhat more frequent in insulin-dependent patients. Some authors have reported an association of diabetes duration and impotence, while others did not find this association. Erectile dysfunction in men with diabetes mellitus can occur as: 1. a consequence of diabetes, i.e. as its complication ; 2. impotence as the first sign of diabetes ; or 3. transitory erectile dysfunction as a sign of insufficient regulation of carbohydrate metabolism. Making the diagnosis of erectile dysfunction in persons with diabetes requires team work including a diabetologist-endocrinologist, psychologist, neurologist, angiologist and urologist. Upon making the diagnosis, the patient is given appropriate treatment depending on the cause. In the treatment of erectile dysfunction in persons with diabetes, numerous vasoactive substances as well as various types of prostheses and blood vessel surgery are available today.