الفهرس 
INTRODUCTION
Erectile DysfunctionOnly 14 pages are availabe for public view
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Abstract
Erectile dysfunction is defined as the consistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. chronic hepatitis C and/or treatment by interferon, both of which increase the risk of erectile dysfunction in men.
The present study was conducted in Assiut University Hospitals, Assiut, Egypt. The study was done in collaboration between Department of Dermatology, Venereology and Andrology and Department of Tropical Medicine and Gastroenterology. This work has been carried out on 100 married patients suffering from chronic hepatitis C virus infection. They are subclassified according to IIEF-5 scores into two groups, 50 HCV patients with erectile dysfunction (group I) and 50 HCV patients without erectile dysfunction (group II).
After proper patient selection, history taking and examination, each patient was subjected to The abridged form of International Index of Erectile Function questionnaire (IIEF-5),patients who reported IIEF-5 score >21 were considered as not having erectile dysfunction (group II). Patients who reported IIEF-5 score ≤ 21 were considered as having erectile dysfunction (group I).
1. Laboratory tests
Laboratory tests has been done including serum prolactin, serum estradiol, serum total testosterone and serum free testosterone. Laboratory tests has been done to the interferon treated patients and statistically compared to the non interferon treated patients of the whole study population.
2. Pharmaco-Penile Duplex Ultrasound
Duplex sonography evaluation was performed to hepatitis C patients with erectile dysfunction (group I). Pharmacopenile duplex ultrasound has been done to interferon treated cases and statistically compared to the non interferon treated group.
3-Child’s classification of hepatocellular function(Modified Child-Pugh score)(Sheila and James 2002)
The mild and moderate groups were included in the study. Laboratory tests was performed for the mild group and statistically compared to the moderate group.
The data were fed into personal IBM computer, analysis was done and the results were represented as follows:
As regards hormonal evaluation of group I and group II patients
We found that the serum levels of total and free testosterone of group I patients have statistically significant lower level than group II. On the other hand, serum estradiol level reported statistically significant higher levels among group I than group II patients.
Regarding the hormonal profile of interferon versus non interferon treated groups
We found that serum levels of total and free testosterone among interferon treated group reported statistically significant lower levels than the non interferon treated group. On the contrary was the result of serum estradiol level, as interferon treated patients showed statistically significant higher levels than the non interferon treated patients.
As regards hormonal profile of group A versus group B according to modified Child-pugh score
On studying the serum levels of total and free testosterone among the moderate group (group B), they reported statistically significant lower level than the mild group (group A). Also, there were highly significant difference between the two groups as regards serum estradiol level, as the moderate group reported higher serum estradiol level than the mild group.
Pharmaco-Penile Duplex Ultrasound of HCV patients with erectile dysfunction (group I)
We found that 30% of patients have normal study, 14% of patients have arterial insufficiency, 30% of patients have venous leakage and 26% of patients showed combined findings of arterial insufficiency and venous leakage. Abnormal penile duplex patients reported statistically significant lower levels regarding serum total testosterone than the normal duplex group. Also the abnormal duplex group showed statistically significant higher serum estradiol level than the normal duplex group.
from the present results, it could be concluded that:
• Hepatitis C infection cause marked impairment of erectile function, lowering the serum levels of total and free testosterone and associated with high serum estradiol level.
• Hepatitis C infection associated with organic impairment of veno-occlusive mechanism of corpora cavernoa evidenced by pharmacopenile duplex ultrasonography.
• Interferon had negative impact on male sexual function. Men on interferon therapy showed loss ofsexual desire, lower IIEF-5 score, lower total and free testosterone levels and higher estradiol level compared to those not receiving interferon. However, interferon did not affect penile hemodynamics.
• Severity of hepatitis C virus infection had marvelous effect, as group B hepatic affection showed loss of sexual desire, lower serum free and total testosterone levels and higher serum estradiol level compared to group A hepatic affection.