Endothelial dysfunction has an important place in the pathogenesis of erectile dysfunction (ED). The aim of this study was to evaluate the relationship between ED severity and systemic immune inflammation index (SII) and neutrophil lymphocyte ratio (NLR).

The data of male patients over the age of 18 who applied to the urology clinic with the complaint of ED between January 2018 and September 2021 were analyzed. Patients with known diabetes mellitus, hypertension, coronary artery disease, and previous pelvic surgery were excluded from the study. The erectile functions of the patients were evaluated with the international erectile function index-erectile function (IIEF-EF). The patients were divided into two groups according to the severity of ED as mild (IIEF-EF>17) and moderate-severe (IIEF-EF≤17). Demographic data of the patients were recorded. SII value was calculated by neutrophil*platelet/lymphocyte formula and NLR was recorded.

A total of 185 patients were included in the study (mild ED: 74, moderate- severe: 111). The mean age of the patients was 48.18±11.58(20-79), and the mean IIEF-EF was 13.34±6.55 (0-25). The mean SII was 594.89±348.90, and the mean NLR was 2.27±1.19. The mean total testosterone level of the patients was 3.25±1.48ng/dl.
When the patients were divided into two groups according to the severity of ED, a significant difference was observed between IIEF-EF scores and SII values of the patients (p<0.001 for IIEF-EF, p=0.008 for SII). No significant difference was found with NLR values (p=0.950)(Table-1 ). There was a moderate negative correlation between IIEF-EF score and SII value (p=0.042, r=-0.569). No significant correlation was observed between NLR and IIEF-EF (p=0.625, r=-0.124). SII cut-off value was determined as 436.73 and AUC was 0.674 (CI 95%: 0.448-0.717). At this value, the sensitivity was 70.1% and the specificity was 64.8%.

SII has taken its place as an important inflammatory marker in determining the severity of Erectile dysfunction. The severity of the Erectile dysfunction degree can be determined with a cut-off score of 463 for SII. SII index was negatively correlated according to the severity of Erectile dysfunction, and erectile functions decreased with the increase in systemic inflammation.

It was determined that the SII index was negatively correlated according to the severity of ED, and erectile functions decreased with the increase in systemic inflammation. During the evaluation of patients, the severity of ED can be revealed more clearly with the use of SII. Further randomized studies are needed to better understand the relationship between SII and ED.

Continence 2S2 (2022) 100391
DOI: 10.1016/j.cont.2022.100391