INVESTIGATIVE UROLOGY

Immediate Improvement in Penile Hemodynamics after Cessation of Smoking: Previous Results
Sighinolfi MC, Mofferdin A, De Stefani S, Micali S, Cicero AF, Bianchi G
Department of Urology, University of Modena, Modena, Italy
Urology. 2007; 69: 163-5

• Objectives: To assess the chronologic relationship between the cessation of smoking and the restoration of erectile function. Smoking is associated with an increased risk of erectile dysfunction.
• Methods: Twenty active smokers (20 to 40 cigarettes/day) affected by erectile dysfunction (International Index of Erectile Function 5-item score less than 21) were enrolled in the study. The mean age was 40 years. All the patients underwent penile color Doppler ultrasonography during the basic and dynamic phases (10 microg prostaglandin E1). A second Doppler evaluation was performed 24 to 36 hours after cessation of smoking. The peak systolic velocity (PSV) and end-diastolic velocity (EDV) were recorded. The PSV and EDV cutoff value was 30 cm/s and 5 cm/s, respectively.
• Results: Of the 20 patients, 10 (50%) had normal PSV values but only 5 (25%) had normal EDV values at the baseline Doppler evaluation. All the patients (100%) had normal PSV values at the second penile Doppler evaluation after smoking withdrawal, and 17 (85%) also had normal EDV values. The average PSV was 40.1 and 50.3 cm/s (P = 0.09) and the mean EDV was 6.8 and 2.4 cm/s (P < 0.01) at the baseline penile Doppler examination and after smoking withdrawal, respectively.
• Conclusions: Within 24 to 36 hours of the cessation of cigarette smoking, the color Doppler parameters demonstrated a significant improvement in EDV and a trend toward an increase in PSV. Additional clinical evaluation is required to further characterize the expeditious improvement in erectile function after the cessation of smoking.
  
  
• Editorial Comment
  This is a very impressive study, on which the authors evaluated prospectively 20 current smokers (20 to 40 cigarettes/day) with a mean of 7 years of smoking history. It was found that after 24 to 36 hours of smoking cessation, all 20 patients (100%) had normal peak systolic velocity values and 17 (85%) had normal end-diastolic velocity values at Doppler examination. This study is pioneer on the evaluation of short-term effects of the cessation of cigarette smoking in penile hemodynamics parameters. It is impressive how rapidly smoking cessation can improve penile hemodynamics.

Dr. Francisco J.B. Sampaio
Full-Professor and Chair, Urogenital Research Unit
State University of Rio de Janeiro
Rio de Janeiro, RJ, Brazil