Dupless: Toward a patient-friendly approach for erectile dysfunction nature differentiation - a study of 291 penile duplex Doppler ultrasound assessments.

IF 3.2 2区 医学 Q1 ANDROLOGY
Andrology Pub Date : 2025-02-27 DOI:10.1111/andr.70017
Hille J Torenvlied, Kim E de Jager, Loes I Segerink, Rob C M Pelger, Jack J H Beck
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引用次数: 0

Abstract

Background: Erectile dysfunction (ED) is a condition commonly classified as either psychogenic or organic. Traditional age-based categorizations are considered overly simplistic, yet many clinicians continue to rely on initial evaluation-patient symptoms and history, physical examination, blood tests, and questionnaires-for diagnosis due to limited modern tools.

Objectives: This study aims to evaluate the predictive value of patient characteristics in individuals with "ED of indeterminate origin" following initial evaluation. Identifying these variables could enhance early diagnosis and reduce reliance on invasive procedures.

Materials and methods: A retrospective cohort study was conducted on patients who underwent penile duplex Doppler ultrasound between January 2018 and January 2024 due to "ED of indeterminate origin". Patient data, including demographics, lifestyle factors, and medical history, were collected and analyzed using unpaired t-tests, chi-squared tests, Fisher's exact tests, and multivariate logistic regression to assess their predictive value.

Results: Among the 291 patients in the cohort, 165 (56.7%) were diagnosed with organic ED and 113 (38.8%) with psychogenic ED. Significant differences in age, history of diabetes mellitus, and drug use were noted. Logistic regression revealed multicollinearity among the variables and explained only 5.8% of the variance in ED etiology. Subgroup analysis revealed that diabetes mellitus predicts organic ED in patients aged 40 years and older, while psychopathology is linked to psychogenic ED. No significant predictors were identified for patients under 40 years.

Discussion and conclusion: The findings of this "Dupless" study highlight the limitations of relying solely on initial evaluation to differentiate ED etiology, stressing the need for additional diagnostic tools. While some predictive factors were identified, they proved insufficient for clinical use. Thus, an urgent need exists for the development of modern, noninvasive diagnostic tools to enhance ED classification. Future research could explore machine learning models to uncover complex patterns not evident in traditional statistical methods.

对291例阴茎双多普勒超声评估的研究:一种对患者友好的方法来鉴别勃起功能障碍的性质。
背景:勃起功能障碍(ED)是一种通常分为心因性和器质性的疾病。传统的以年龄为基础的分类被认为过于简单,然而由于现代工具的限制,许多临床医生仍然依赖于最初的评估——患者的症状和病史、体格检查、血液检查和问卷调查——进行诊断。目的:本研究旨在评估患者特征在初始评估后对“不明原因ED”患者的预测价值。识别这些变量可以提高早期诊断,减少对侵入性手术的依赖。材料与方法:回顾性队列研究2018年1月至2024年1月因“不明原因ED”接受阴茎双多普勒超声检查的患者。收集患者资料,包括人口统计学、生活方式因素和病史,并使用非配对t检验、卡方检验、Fisher精确检验和多变量逻辑回归分析,以评估其预测价值。结果:291例患者中,器质性ED 165例(56.7%),心因性ED 113例(38.8%),年龄、糖尿病史、用药史差异有统计学意义。逻辑回归显示变量之间多重共线性,仅解释5.8%的ED病因变异。亚组分析显示,糖尿病可预测40岁及以上患者的器质性ED,而精神病理与心因性ED相关。40岁以下患者未发现显著的预测因子。讨论和结论:这项“重复”研究的发现强调了仅仅依靠初步评估来区分ED病因的局限性,强调了需要额外的诊断工具。虽然确定了一些预测因素,但它们不足以用于临床应用。因此,迫切需要发展现代的、无创的诊断工具来加强ED的分类。未来的研究可以探索机器学习模型,以发现传统统计方法中不明显的复杂模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Andrology
Andrology ANDROLOGY-
CiteScore
9.10
自引率
6.70%
发文量
200
期刊介绍: Andrology is the study of the male reproductive system and other male gender related health issues. Andrology deals with basic and clinical aspects of the male reproductive system (gonads, endocrine and accessory organs) in all species, including the diagnosis and treatment of medical problems associated with sexual development, infertility, sexual dysfunction, sex hormone action and other urological problems. In medicine, Andrology as a specialty is a recent development, as it had previously been considered a subspecialty of urology or endocrinology
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