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Erectile dysfunction and angiographic correlation between coronary artery stenosis and internal iliac-internal pudendal artery stenosis in patients with suspected coronary artery disease: a retrospective study

  • Bong Hee Park1
  • Sung Ho Her2
  • Dong Seok Han1
  • Seung Mo Yuk1
  • Dae Won Kim2
  • Chang Shik Youn1
  • Hoon Jang1,*,

1The Department of Urology, College of Medicine, The Catholic University of Korea, 06591 Seoul, Republic of Korea

2The Department of Cardiology, College of Medicine, The Catholic University of Korea, 06591 Seoul, Republic of Korea

DOI: 10.22514/jomh.2023.042 Vol.19,Issue 6,June 2023 pp.1-8

Submitted: 09 November 2022 Accepted: 15 March 2023

Published: 30 June 2023

*Corresponding Author(s): Hoon Jang E-mail:


This study aimed to assess the angiographic correlation between coronary artery stenosis and internal iliac-internal pudendal artery (II-IPA) stenosis and evaluate its association with erectile dysfunction (ED). We reviewed the data of 91 patients who had undergone pelvic angiography (PA) to evaluate II-IPA stenosis and coronary angiography (CAG) due to suspected coronary artery disease. Erectile function (EF) was evaluated using the International Index of Erectile Function before CAG and PA. CAG was performed first, followed by PA of the bilateral II-IPA. Regardless of the location and number of stenosis sites, based on CAG, we categorized the patients into two groups. Patients with a maximum stenosis <50% and ≥50% on CAG were assigned to Group I and Group II, respectively. Then, the EF domain score and the diameter stenosis (DS) of II-IPA were evaluated and compared. Overall, 55 patients comprised Group I, while 36 patients comprised Group II. ED was present in 96.3% and 97.2% of the patients in Group I and II, respectively. There was no statistical difference between the groups in the severity of ED (p = 0.457). PA revealed that 14.5% and 36.1% of patients in Groups I and II had ≥50% stenosis of the II-IPA. The mean DS of II-IPA in Group II was greater than that in Group I (p = 0.017). There was a statistically significant correlation between the degree of coronary artery stenosis and the degree of II-IPA stenosis (r = 0.295, p = 0.005). This study revealed that coronary artery stenosis correlates with II-IPA stenosis. The presence and degree of coronary artery stenosis or II-IPA stenosis indicate the necessity for more active treatment in patients with ED.


Angiography; Coronary stenosis; Coronary artery disease; Erectile dysfunction

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Bong Hee Park,Sung Ho Her,Dong Seok Han,Seung Mo Yuk,Dae Won Kim,Chang Shik Youn,Hoon Jang. Erectile dysfunction and angiographic correlation between coronary artery stenosis and internal iliac-internal pudendal artery stenosis in patients with suspected coronary artery disease: a retrospective study. Journal of Men's Health. 2023. 19(6);1-8.


[1] Sullivan ME, Keoghane SR, Miller MAW. Vascular risk factors and erectile dysfunction. BJU International. 2001; 87: 838–845.

[2] Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. The American Journal of Medicine. 2007; 120: 151–157.

[3] Blick C, Ritchie RW, Sullivan ME. Is erectile dysfunction an example of abnormal endothelial function? Current Vascular Pharmacology. 2016; 14: 163–167.

[4] Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA. Erectile dysfunction and subsequent cardiovascular disease. JAMA. 2005; 294: 2996–3002.

[5] Montorsi F, Briganti A, Salonia A, Rigatti P, Margonato A, Macchi A, et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. European Urology. 2003; 44: 360–365.

[6] Dong JY, Zhang YH, Qin LQ. Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. Journal of the American College of Cardiology. 2011; 58: 1378–1385.

[7] Gandaglia G, Briganti A, Jackson G, Kloner RA, Montorsi F, Montorsi P, et al. A systematic review of the association between erectile dysfunction and cardiovascular disease. European Urology. 2014; 65: 968–978.

[8] Montorsi P, Ravagnani PM, Galli S, Rotatori F, Veglia F, Briganti A, et al. Association between erectile dysfunction and coronary artery disease. Role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. European Heart Journal. 2006; 27: 2632–2639.

[9] Montorsi P, Ravagnani PM, Galli S, Briganti A, Salonia A, Deho F, et al. Association between erectile dysfunction and coronary artery disease: a case report study. The Journal of Sexual Medicine. 2005; 2: 575–582.

[10] Rajendran P, Rengarajan T, Thangavel J, Nishigaki Y, Sakthisekaran D, Sethi G, et al. The vascular endothelium and human diseases. International Journal of Biological Sciences. 2013; 9: 1057–1069.

[11] Park K, Park WJ. Endothelial dysfunction: clinical implications in cardiovascular disease and therapeutic approaches. Journal of Korean Medical Science. 2015; 30: 1213–1225.

[12] Ganz P, Vita JA. Testing endothelial vasomotor function: nitric oxide, a multipotent molecule. Circulation. 2003; 108: 2049–2053.

[13] Woywodt A, Bahlmann FH, De Groot K, Haller H, Haubitz M. Circulating endothelial cells: life, death, detachment and repair of the endothelial cell layer. Nephrology Dialysis Transplantation. 2002; 17: 1728–1730.

[14] Bookstein JJ, Valji K, Parsons L, Kessler W. Pharmacoarteriography in the Evaluation of Impotence. The Journal of Urology. 1987; 137: 333–337.

[15] Mueller SC, Wallenberg-pachaly HV, Voges GE, Schild HH. Comparison of selective internal iliac pharmaco-angiography, penile brachial index and duplex sonography with pulsed doppler analysis for the evaluation of vasculogenic (arteriogenic) impotence. The Journal of Urology. 1990; 143: 928–932.

[16] Rosen MP, Greenfield AJ, Walker TG, Grant P, Guben JK, Dubrow J, et al. Arteriogenic impotence: findings in 195 impotent men examined with selective internal pudendal angiography. Young investigator’s award. Radiology. 1990; 174: 1043–1048.

[17] Park HW, Her SH, Park BH, Han DS, Yuk SM, Kim DW, et al. Correlation between internal pudendal artery stenosis and erectile dysfunction in patients with suspected coronary artery disease. PLOS ONE. 2019; 14: e0225179.

[18] Rogers JH, Karimi H, Kao J, Link D, Javidan J, Yamasaki DS, et al. Internal pudendal artery stenoses and erectile dysfunction: Correlation with angiographic coronary artery disease. Catheterization and Cardiovascular Interventions. 2010; 76: 882–887.

[19] Sanad AM, Younis SE, Oraby MA, Hegazy H, El-Sakka AI. Relation between severity of coronary artery disease and aorto-ilio-pudendal artery disease in patients with ischemic heart disease-associated vascular erectile dysfunction. The Journal of Sexual Medicine. 2020; 17: 1086–1093.

[20] Johannes CB, Araujo AB, Feldman HA, Derby CA, Kleinman KP, McKinlay JB. Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study. The Journal of Urology. 2000; 163: 460–463.

[21] Kloner RA, Mullin SH, Shook T, Matthews R, Mayeda G, Burstein S, et al. Erectile dysfunction in the cardiac patient: how common and should we treat? The Journal of Urology. 2003; 170: S46–S50.

[22] Greenstein A, Chen J, Miller H, Matzkin H, Villa Y, Braf Z. Does severity of ischemic coronary disease correlate with erectile function?International Journal of Impotence Research. 1997; 9: 123–126.

[23] Valji K, Bookstein JJ. Transluminal angioplasty in the treatment of arteriogenic impotence. Cardiovascular and Interventional Radiology. 1988; 11: 245–252.

[24] Rogers JH, Goldstein I, Kandzari DE, Köhler TS, Stinis CT, Wagner PJ, et al. Zotarolimus-eluting peripheral stents for the treatment of erectile dysfunction in subjects with suboptimal response to phosphodiesterase-5 inhibitors. Journal of the American College of Cardiology. 2012; 60: 2618–2627.

[25] Diehm N, Marggi S, Ueki Y, Schumacher D, Keo HH, Regli C, et al. Endovascular therapy for erectile dysfunction—who benefits most? insights from a single-center experience. Journal of Endovascular Therapy. 2019; 26: 181–190.

[26] von Allmen RS, Nguyen DP, Birkhauser FD, Bednar R, Kammer R, Do DD, et al. Lesion pattern in patients with erectile dysfunction of suspected arterial origin: an angiographic study. Journal of Endovascular Therapy. 2016; 23: 76–82.

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