Relationship between the MELD score with severity erectile dysfunction in cirrhotic patients

Doddy Afprianto(1*), Siti Nurdjanah(2), Muhammad Robikhul Ikhsan(3)

(*) Corresponding Author


Background. Liver cirrhosis is a pathological condition that describes the end stage of hepatic fibrotic which progressively ongoing that signed by distortion from hepar architecture and the formation of the regenerative modulus. Liver cirrhosis causes impairment in most of the liver function including the hormonal balance and metabolism of steroids. In the male patients, liver cirrhosis causes hypogonadism and feminization. Sexual dysfunction in cirrhotic patients is still underestimated and underdiagnosed. The most common sexual dysfunction in male cirrhotic patients is impotence or erectile dysfunction. Erectile dysfunction (ED) is define as a persistence inability to reach and/ or maintain enough erection to satisfy the sexual activity. International Index of Erectile Function 5/IIEF-5 could mark erectile dysfunction. Despite the prevalence of erectile dysfunction is high in patients with liver cirrhosis, only a few studies revealing the relationship between severity of liver cirrhosis and severity of erectile dysfunction.

Objective. The purpose of this study is to determine the correlation between MELD score and severity of erectile dysfunction (IIEF-5 score) in cirrhosis patients.

Methods. This study is observational with a cross-sectional method. Subjects were patients with liver cirrhosis, male, age 18 to 65 years old, married, have a partner, and agreed participated to this study. We used Pearson the correlation to assess correlation between severity of liver cirrhosis (Child Pugh score) and severity of erectile dysfunction (IIEF-5 score) if the data were distributed normally and Spearman correlation if the distribution is abnormal.

Conclusion. There is negative correlation with the moderate strength degree between MELD score (the degreee of severity in liver cirrhosis) with the IIEF-5 score (the degree of erectile dysfunction).


Keywords: liver cirrhosis, MELD score, erectile dysfunction, IIEF-5, correlation.


liver cirrhosis, MELD score, erectile dysfunction, IIEF-5, correlation.

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Nurdjanah, S. 2009. Sirosis Hati. In: A. W. Sudoyo, B. Setiyohadi, I. Alwi, et al. (eds.) Buku Ajar Ilmu Penyakit Dalam. Jakarta: InternaPublishing, 668-673.

G a r c i a- Ts a o, G. & L i m, J. 2009. Management and Treatment of Patients with Cirrhosis and Portal Hypertension: Recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program. Am J Gastroenterol; 104:1802–1829.

McCormick, P. 2011. Hepatik Cirrhosis. In : Sherlock’s Diseases Of The Liver And Biliary System 12Th Ed., A John Wiley & Sons, Ltd., Publication, 103-117.

Durand, F. O. dan Valla, D. 2005. Assessment of the prognosis of cirrhosis: Child–Pugh versus MELD. Journal of Hepatology, 42, S100-S107.

Chan,H.L.Y., Chim, A.M.L., Lau, J.T.F., Hui, A.Y., Wong, V.W.S., Sung, J.J.Y. 2006. Evaluation of model for end-stage liver disease for prediction of mortality in decompensated chronic hepatitis B. Am J Gastroenterology 101:1516-23

Kruszynska, Y. T. dan Bouloux, P. M. 2007. The effect of liver disease on the endocrine system. In: J. Rodes (ed.) textbook of hepatology : from basic science to clinical practice Malden mass: Blackwell.

Karagiannis, A. dan Harsoulis, F. 2005. Gonadal dysfunction in systemic diseases. European Journal of Endocrinology 152, 501-513.

Shabsigh, R. 2006. Epidemiology of Erectile Dysfunction. In: J. J. Mulcahy (ed.) Male Sexual Function A Guide to Clinical Management Humana.

Impotence, N. C. C. 1993. NIH concensus development panel on impotence. JAMA, 270, 83 - 90.

Rosen, R. C., Riley, A., Wagner, G., Hosterloh, I., Kirkpatrick, J. dan Mishra, A. 1997. The International Index of Erectile Function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49, 822-830.

Toda, K., Miwa, Y., Kuriyama, S., Fukushima, H., Shiraki, M., Murakami, N., et al. 2005. Erectile dysfunction in patients with chronic viral liver disease: its relevance to protein malnutrition. J Gastroenterol 40, 894-900.

Tumbelaka A.R., Riono P., Wirjodiarjo M., Pudjiastuti P., Firman K. 2002. Pemilihan uji hipotesis dalam S Sastroasmoro dan S Ismail (eds) Dasar dasar metodologi penelitian klinis edisi kedua . Jakarta , Sagung Seto, 240-258.

Sugiyono 2004. Statistik Non Parametris Untuk Penelitian. Bandung, Alfabeta.

Huyghe, E., Kamar, N., Wagner, F., Capietto, A. H., El-Kahwaji, L., Muscari, F., et al. 2009. Erectile dysfunction in end-stage liver disease men. J Sex Med, 1395-1401.

Finger, W. W. dan Slangle, M. A. 2007. Pharmacological agent causing male sexsual dysfunction. In: F. R. Kandeel (ed.) Male Sexual and Reproductive Dysfunction: Male Sexual Dysfunction: Pathophysiology and Treatment. New York: Informa Healthcare.


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