Erectile Dysfunction, Endothelium Dysfunction, and Microvascular Damage in Patients with Systemic Sclerosis

Abstract Introduction Erectile dysfunction (ED) prevalence in men with systemic sclerosis (SSc) is high and can be considered a manifestation of endothelium damage. Aim This study aims to correlate ED with endothelial dysfunction and digital vascular damage in SSc patients. Main Outcome Measures The main outcome measures were erectile function, Doppler indices of cavernous arteries, flow‐mediated dilation (FMD), capillaroscopic damage, skin perfusion, and digital pulsatility. Methods In 23 SSc patients, erectile function was investigated using the International Index of Erectile Function‐5 (IIEF‐5). Doppler indices of cavernous arteries, peak systolic velocity (PSV), end‐diastolic velocity (EDV), and resistive index (RI) were measured at the penoscrotal junction before and after pharmacostimulation with 20 mg prostaglandin E1. FMD and nailfold videocapillaroscopy (NVC) were used to evaluate endothelial dysfunction and capillaroscopic damage. Skin perfusion and digital sphygmic waves were measured by laser Doppler perfusion imaging (LDPI) and digital photoplethysmography (PPG), respectively. Results IIEF‐5 score was reduced in 83% of patients. PSV was reduced in 96%, while EDV was increased in 48% of patients. A positive correlation was observed between IIEF‐5 score and FMD ( r  = 0.71, P r  = 0.76, P r  = −0.509, P r  = 0.743, P r  = 0.714, P r  = −0.677, P r  = 0.752, P r  = 0.747, P r  = −0.689, P Conclusion In SSc patients, ED correlates with endothelial dysfunction and digital microvascular damage.