الفهرس 
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Abstract
SUMMARY
Erectile dysfunction is known as the persistent inability to achieve and/or maintain an erection sufficient to allow for sexual satisfaction. In turn, it has an effect on the physical and psychosocial health and may affect the quality of life negatively.
Erectile dysfunction is the most common arousal disorder diagnosed in men. In order to achieve erection, a complex phenomenon composed of a delicate and coordinated equilibrium of neurological, vascular, and tissue compartments; smooth muscle relaxation, arterial dilation, and activation of the corporeal veno-occlusive mechanism. chronic diseases such as diabetes mellitus and hypertension, and lifestyle factors such as obesity and a lack of physical exercise, increasing age, and lower urinary tract symptoms have been linked to the development of erectile dysfunction.
The most important contributor to erectile dysfunction among aging men is organic disease due to vascular disturbances that are often caused by atherosclerosis. In recent years, studies have shown that atherosclerosis can manifest as an active inflammatory process rather than as passive vascular injury caused by lipid infiltration. The neutrophil/lymphocyte ratio and the platelet/lymphocyte ratio has been determined to be an important marker of inflammation, and consequently of erectile dysfunction.
Oral medications have been successful in the treatment and management of erectile dysfunction. One of the medications, Tadalafil, is known to successfully treat erectile dysfunction by inhibiting the phosphodiesterase type 5 (PDE5), which in turn enhances erectile function by increasing the amount of cGMP.
Endothelial dysfunction plays important roles in the development of erectile dysfunction. Many studies have shown that the initiation and severity of erectile dysfunction are closely associated with elevated levels of inflammatory markers. Based on this premise, we aim to examine the association of erectile dysfunction with the neutrophil/lymphocyte ratio and the platelet/lymphocyte ratio.
The aim of this study was to evaluate the effect of Tadalafil on the neutrophil/lymphocyte ratio and the platelet/lymphocyte ratio in patients with erectile dysfunction.
This was conducted as a randomized-control case study. It was conducted on patients attending Andrology clinic at El Kasr El Einy University Hospital and Beni Suef University Hospital. Subjects were divided into 3 groups: 30 subjects with erectile dysfunction were given Tadalafil (chosen randomly by names drawn from a box). 30 with erectile dysfunction who were not receiving Tadalafil. 30 healthy individuals who were not received Tadalafil.
The results of our present study can be summarized as follows:
The current study showed that the average age in ED with treatment group was; 44.90±4.78, average age in ED without treatment group was 44.63±4.26, while the average age in the control group was 30.13±7.53 with highly statistically significant difference.
Our study showed that, there was a highly statistically significant difference between ED with treatment group, ED without treatment group and the control group regarding neutrophil before treatment, while there was no statistically significant difference between ED with treatment group, ED without treatment group and the control group regarding neutrophil after treatment, platelet before treatment and platelet after treatment.
Our study showed that, there was highly statistically significant difference between ED with treatment group, ED without treatment group and the control group regarding IIEF5 Score after treatment, and there was no statistically significant difference between ED with treatment group, ED without treatment group and the control group regarding IIEF5 Score before treatment. [The average IIEF5 Score Before Treatment in ED with treatment group was; 12.97±1.87, while average IIEF5 Score before Treatment in ED without treatment group was 13.47±2.05, the average IIEF5 Score after treatment in ED with treatment group was; 15.13±2.06, while the average IIEF5 Score after treatment in ED without treatment group were 13.47±2.05].
The present study revealed that, there was a highly statistically significant difference found between before treatment and after treatment regarding IIEF5 Score.
The present study revealed that, there was a highly statistically significant difference found between before treatment and after treatment regarding the neutrophil/lymphocyte ratio and platelet/lymphocyte ratio.
The present study revealed that, there was a highly statistically significant difference found between before treatment and after treatment regarding IIEF5 Score.
The present study revealed that, there was no statically significant correlation between IIEF5 Score and neutrophil/lymphocyte ratio before treatment, platelet/lymphocyte ratio before treatment. Receiver operating characteristic curve (ROC) shows that the best cut off point of neutrophil/lymphocyte ratio before treatment to ED group was found < 1.51 with sensitivity of 68.3%, specificity of 53.3%, Lower Bound of 0.558, Upper Bound of 0.789 and total accuracy of 67.4%, and Receiver operating characteristic curve (ROC) shows that the best cut off point of neutrophil/lymphocyte ratio after treatment to ED group was found < 1.51 with sensitivity of 58.3%, specificity of 53.3%, Lower Bound of 0.517, Upper Bound of 0.757 and total accuracy of 63.7%, the best cut off point of platelet/lymphocyte ratio before treatment to ED group was found < 5.89 with sensitivity of 65%, specificity of 63.3%, Lower Bound of 0.515, Upper Bound of 0.755 and total accuracy of 63.5% and the total accuracy of Platelet/Lymphocyte ratio after treatment to ED group was found 56.1% with Lower Bound of 0.435, Upper Bound of 0.687and P-value 0.341.