P1098 - Prevalence and Associated Risk Factors of Erectile Dysfunction Among Patients With Inflammatory Bowel Disease: An Updated Meta-Analysis

Farah Alkilani, MD¹, Abdelaziz Awad, ², Malak Hassan, ³, Mohamed Marey, ³, Ahmed Abbas, ⁴, Shrouk Ramadan, ⁵, Mohamed Gamal, ⁶, Mohamed A. Aldemerdash, ⁷, Salma Allam, ⁸, Ahmed Diaa, ², Mohamed Ahmed Ali, ⁹
1University of Miami Miller School of Medicine at Jackson Memorial Hospital, Miami, FL; 2Al-Azhar University, Cairo, Al Qahirah, Egypt; 3Alexandria University, Alexandria, Al Iskandariyah, Egypt; 4Mansoura University, Mansoura, Ad Daqahliyah, Egypt; 5Ain Shams University, Cairo, Al Qahirah, Egypt; 6Tanta University, Tanta, Al Gharbiyah, Egypt; 7Sohag University, Faculty of Medicine, Sohag, Suhaj, Egypt; 8Galala University, Suez, As Suways, Egypt; 9Qena Faculty of Medicine, South valley University, Qena, Egypt., Qena, Qina, Egypt

Introduction: Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic inflammatory disorder increasingly associated with systemic complications, including erectile dysfunction (ED). ED in IBD may result from vascular inflammation, cytokine-driven hormonal changes, depression, and pelvic surgery. Despite emerging evidence, reported prevalence and risk factors vary widely. We conducted a systematic review and meta-analysis to estimate the pooled prevalence of ED among men with IBD and identify clinical determinants.

Methods: We systematically searched PubMed, Embase, Scopus, Cochrane, and Web of Science through 2024 for observational studies evaluating ED in adult males with IBD. Studies comparing IBD to non-IBD controls or reporting prevalence were included. Random-effects meta-analysis was performed for pooled prevalence estimates. ED was stratified by severity (mild, moderate, severe). Subgroup analyses assessed associations with depression, active disease, and prior surgery. Heterogeneity was evaluated using I²; publication bias was assessed via Doi plots and LFK indices.

Results: Eighteen studies comprising 29892 male IBD patients were included. The pooled prevalence of ED was 29.6%, with prevalence by severity at 17% mild, 6% moderate, and 2% severe. Depression, active disease, and prior IBD-related surgery were independently associated with increased ED risk. Sensitivity analyses demonstrated stable estimates despite high heterogeneity across most strata (I² ranging from 81% to 99%). Significant publication bias was observed across most ED severity strata, except for studies limited to UC patients.

Discussion: ED is a prevalent and multifactorial complication of IBD, likely mediated by inflammation, psychological burden, and surgical disruption of pelvic autonomic nerves [1,2]. Our findings support systematic screening for ED in IBD management, particularly in patients with active disease, depression, or prior surgery. Notably, a prior meta-analysis reported an odds ratio of 1.5 for ED among IBD patients compared to non-IBD controls [3], aligning with our elevated prevalence findings. Incorporating sexual health into routine care may improve quality of life. Prospective studies are needed to elucidate causality and assess interventions.


Figure: Figure 1-3. Mild then Moderate then Severe risk of ED, forest plot of (A), sensitivity analysis (B), DOI plot (C)


Figure: Figure 4. ED in UC, forest plot of (A), sensitivity analysis (B), DOI plot (C)

Disclosures:
Farah Alkilani indicated no relevant financial relationships.
Abdelaziz Awad indicated no relevant financial relationships.
Malak Hassan indicated no relevant financial relationships.
Mohamed Marey indicated no relevant financial relationships.
Ahmed Abbas indicated no relevant financial relationships.
Shrouk Ramadan indicated no relevant financial relationships.
Mohamed Gamal indicated no relevant financial relationships.
Mohamed A. Aldemerdash indicated no relevant financial relationships.
Salma Allam indicated no relevant financial relationships.
Ahmed Diaa indicated no relevant financial relationships.
Mohamed Ahmed Ali indicated no relevant financial relationships.

Farah Alkilani, MD¹, Abdelaziz Awad, ², Malak Hassan, ³, Mohamed Marey, ³, Ahmed Abbas, ⁴, Shrouk Ramadan, ⁵, Mohamed Gamal, ⁶, Mohamed A. Aldemerdash, ⁷, Salma Allam, ⁸, Ahmed Diaa, ², Mohamed Ahmed Ali, ⁹. P1098 - Prevalence and Associated Risk Factors of Erectile Dysfunction Among Patients With Inflammatory Bowel Disease: An Updated Meta-Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.