Sanches Brunno Cf, Laranja Walker W, Alonso João Cc, Rejowski Ronald F, Simões Fabiano A, Reis Leonardo O
Pontifical Catholic University of Campinas, PUC-Campinas, São Paulo, Brazil.
University of Campinas, PUC-Campinas, São Paulo, Brazil.
Int J Impot Res. 2018 Aug;30(4):158-162. doi: 10.1038/s41443-018-0039-1. Epub 2018 Jun 21.
The aim of this study is to assess the impact of objective (stretched) and subjective penile size in the erectile function in a urological check-up program on a cross-sectional study including 689 men aged 35-70 years. IIEF-5 questionnaire, physical examination (penile length, prostate volume, blood pressure, body mass index-BMI), metabolic syndrome (MS), comorbidities, habits (sexual intercourse frequency, physical activity, alcohol, and tobacco use), level of education, serum glucose, total testosterone, estradiol, PSA, lipid profile, and self-perceptions (ejaculation time and subjective penile size) were examined in multivariate models using logistic and linear regressions. Penile objective mean length was 13.08 cm ± 2.32 and 67 (9.72%) patients referred small penis self-perception. Seventy-six (11.03%) participants had severe erectile dysfunction (ED), 75 (10.88%) had mild to moderate and moderate ED, 112 (16.25%) had mild ED and 426 (61.83%) had no ED. Risk factors for ED that held statistical significance were self-perceived small penis (OR = 2.23, 95% CI 1.35-3.69, p = .0017), sexual intercourse frequency (per week) (OR = 0.45, 95% CI 0.38-0.52, p < .0001), satisfactory ejaculation time (no vs. yes, OR = 2.06, 95% CI 1.46-2.92, p < .0001), comorbidity (yes vs. no, OR = 2.01, 95% CI 1.46-2.76, p < .0001), age >65 years (OR = 2.93, 95% CI 1.53-5.61, p < .0001), tobacco use (yes vs. no, OR = 1.41, 95% CI 1.02-1.96, p < .0375), regular physical activity (no vs. yes, OR = 1.59, 95% CI 1.13-2.23, p < .0083), serum total testosterone < 200 ng/dl (OR = 3.48, 95% CI 1.69-7.16, p = 0.0009), serum glucose > 100 mg/dl (OR = 1.69, 95% CI 1.18-2.43, p = 0.0044) and systolic blood pressure > 130 mmHg (OR = 1.60, 95% CI 1.16-2.19, p = 0.0037). Results suggest that in addition to previously reported risk factors, patient's subjective impressions of penile size negatively impacts sexual life in about 10% of men considered healthy, while objective penile length does not play significant role in erectile function.
本研究旨在通过一项横断面研究，评估在一个泌尿外科检查项目中，客观（拉伸后）阴茎大小和主观阴茎大小对689名年龄在35至70岁男性勃起功能的影响。使用逻辑回归和线性回归的多变量模型对国际勃起功能指数-5问卷、体格检查（阴茎长度、前列腺体积、血压、体重指数-BMI）、代谢综合征（MS）、合并症、习惯（性交频率、体育活动、饮酒和吸烟）、教育程度、血清葡萄糖、总睾酮、雌二醇、前列腺特异性抗原、血脂谱以及自我认知（射精时间和主观阴茎大小）进行了检查。阴茎客观平均长度为13.08厘米±2.32，67名（9.72%）患者自述阴茎尺寸小。76名（11.03%）参与者患有严重勃起功能障碍（ED），75名（10.88%）患有轻度至中度ED，112名（16.25%）患有轻度ED，426名（61.83%）没有ED。具有统计学意义的ED危险因素包括自我感觉阴茎小（比值比[OR]=2.23，95%置信区间[CI]1.35 - 3.69，p = 0.0017）、性交频率（每周）（OR = 0.45，95% CI 0.38 - 0.52，p < 0.0001）、射精时间满意（否与是，OR = 2.06，95% CI 1.46 - 2.92，p < 0.0001）、合并症（是与否，OR = 2.01，95% CI 1.46 - 2.76，p < 0.0001）、年龄>65岁（OR = 2.93，95% CI 1.53 - 5.61，p < 0.0001）、吸烟（是与否，OR = 1.41，95% CI 1.02 - 1.96，p < 0.0375）、规律体育活动（否与是，OR = 1.59，95% CI 1.13 - 2.23，p < 0.0083）、血清总睾酮<200 ng/dl（OR = 3.48，95% CI 1.69 - 7.16，p = 0.0009）、血清葡萄糖>100 mg/dl（OR = 1.69，95% CI 1.18 - 2.43，p = 0.0044）以及收缩压>130 mmHg（OR = 1.60，95% CI 1.16 - 2.19，p = 0.0037）。结果表明，除了先前报道的危险因素外，患者对阴茎大小的主观印象对约10%被认为健康的男性的性生活有负面影响，而客观阴茎长度在勃起功能中不起重要作用。
