- Email: [email protected]
S61 Quality of sperm and seminal Zn levels
eau 5th south eastern european meeting (seem) / european urology supplements 8 (2009) 607–655
627
S58 The impact of L-Carnitine in spermogram of varicocele patients
6 months was 32%, 25%, 21% respectively in the 3 groups. After 12 months we have recorded important improvement in pregnancy rate in groups A and B (41% and 40%) and little in group C (25.5 %). Conclusions: Our study shows significant improvement in of sperm parameters on both groups (A and B) treated with menotropin than in the group who underwent only surgery.
G. Drenidis *, S. Leontis, L. Leonardopoulos, G. Diamantis, D. Georgoulias, A. Rempelakos. Hippokrateion Hospital, Dept. of Urology, Athens, Greece
S60 Testicular serum chitotriosidase level in varicocele patients
Conclusions: Our study suggests that the usage of laparoscopic approach is a safe and efficient method in the treatment varococele with improvement sperm quality.
Introduction and Objectives: To estimate the role of the L-Carnitine in the improvement of the spermogram’s parameters in patients with varicocele-associated oligoasthenospermia. Material and Methods: Between February 2006 and February 2009 53 patients with varicocele-associated oligoasthenospermia. Mean age of patients was 29(22–36) years and they were chosen based on the criteria of the W.H.O 1999 for the oligoasthenospermia. The varicocele was diagnosed and staged in five-grade classification using echo-colour Doppler ultrasonography. Of these patients, 12 had grade 1 left varicocele (group I)13 had grade 2 left varicocele (group II) 12 had grade 3 left varicocele (group III) 9 had grade 4 left varicocele (group IV) and 7 had grade 5 left varicocele (group V).Patients with testicular pathology,azoospermia, and endocrinological diseases were excluded from our study. One gr of L-Carnitine were administered per os every 8 hours for 4 months. A spermogram was performed before and after the treatment and none sideeffect was observed. Results: Assessed values of sperm concentration, motility and morphology in each of the five patient groups and the median modulation rate after 4 months of treatment. No significant difference in spermogram of patients with grade 4 and 5 before and after varicocele treatment. On the other hand there is a significant improvement in all parameters in patients with grade 1, 2 and 3 varicoceles, especially in concentration and the typical forms of sperm. Conclusions: It seems that the administration of L-Carnitine in patients with low grade varicocele improves significant the parameters of sperm. More studies are needed, in order to educe more validated results for this therapeutical approach. S59 Early use of menotropin in the treatment of varicocele N. Pakevic1 *, N. Bojanic2 , N. Lalic2 , D. Djordjevic2 . 1 General Hospital Valjevo, Serbia, Dept. of Urology, Valjevo, Serbia; 2 Clinical Center of Serbia, Clinic of Urology, Belgrade, Serbia Introduction and Objectives: Varicocele is the most common disease in infertile men and varicocelectomy remains the main standard of treatment. During last years a lot of drugs have been proposed in association with surhery. The aim of this study is verify the effects of association between menotropin and subinguinal varicocelectomy on sperm parameters and pregnancy rate. Material and Methods: Methods Sixty patints with left varicocele were randomized in 3 groups of 20 patients: group A were treated with menothropinsince diagnosis 3 months; group B was treated with menotropin 3 months after the varicocelectomy; gropu C was treated only with the surgicaly. We have tested spermograms before and after 3, 6 and 12 months form sugical therapy. Results: Results After 3 months from operation, sperm parameters were significantly improved in a group A (p < 0.05).After 6 months similar improvement was recorded also in the group B. After 12 months we have registered significant improvement in groups A abd B; the values were significantly higher than in group C. Pregnanacy rate, after
B. Kuzgunbay1 *, I. Kurt2 , M.T. Eren3 , A. Hasimi2 , G. Kose3 , M. Erdal4 . 1 Baskent University, Dept. of Urology, Ankara, Turkey; 2 Gulhane Military Medical Academy, Dept. of Urology, Ankara, Turkey; 3 Ankara Military Hospital, Dept. of Urology, Ankara, Turkey; 4 Ankara Military Hospital, Dept. of Family Practice, Ankara, Turkey Introduction and Objectives: We evaluated serum chitotriosidase level, which is a functional chitonolytic enzyme and secreted from macrophages, in varicocele patients in order to investigate pathophysiology of varicocele and associated male infertility. Material and Methods: Between March-December 2008, 38 patients underwent left varicocelectomy with diagnose of left varicocele in Ankara Military Hospital. The patients were divided into two groups according to their sperm counts. Group 1 (n = 19) was consist of the patients whose sperm counts were ≤20×106 per ml (oligospermia) and group 2 (n = 19) >20×106 per ml (normospermia). The serum levels of chitotriosidase were supplied from brachial and testicular veins of the patients and compared. Results: The mean age of the patients were 22.7±3.8 years in group 1 and 21.8±1.6 years in group 2. The mean sperm counts of the patients were 13.3±7.2×106 per ml in group 1 and 54.8±23.1×106 per ml in group 2. In group 1, the mean brachial chitotriosidase serum level of the patients was 41.1±27.8 nmol/hour/ml and the mean testicular chitotriosidase serum level was 40.5±27.4 nmol/hour/ml. In group 2, the mean brachial chitotriosidase serum level of the patients was 28.6±22.8 nmol/hour/ml and the mean testicular chitotriosidase serum level was 28.1±22.1 nmol/hour/ml. Although the mean brachial and testicular chitotriosidase levels were higher in group 1 than group 2, the difference was statistically insignificant (p = 0.137 for brachial and p = 0.133 for testicular level). Conclusions: The insignificant increase in testicular chitotriosidase serum levels in oligospermic varicocele patients might reflect a probable increased testicular macrophage activity. However, further investigations are needed. S61 Quality of sperm and seminal Zn levels A. Suhajda1 *, S. Dragicevic2 , B. Bojanic2 , D. Nale2 , S. Micic2 . General Hospital Subotica, Dept. of Urology, Subotica, Serbia; 2 Clinical Center of Serbia, Clinic of Urology, Belgrade, Serbia 1
Introduction and Objectives: Insufficient intake of zinc (Zn) can impair antioxidant defenses and may be an important risk factor in oxidant release, compromising the mechanism of DNA repair, and making the sperm cell highly susceptible to oxidative damage. In the absence of Zn, the possibility of increased oxidative damage exists that would contribute to poor sperm quality. Infertile men and men who smoke are very susceptible to oxidative damage induced by free radicals. In the present study, we hypothesized that major changes in the level of seminal Zn levels are related with low quality of sperm and poor fertilizing capacity. Material and Methods: Semen samples were collected from fertile (smoker [n = 17], nonsmoker [n = 19]) and infertile men
628
eau 5th south eastern european meeting (seem) / european urology supplements 8 (2009) 607–655
(smoker [n = 15], nonsmoker [n = 21]). After collection, semen specimens were allowed to liquefy at room temperature for 30 minutes and used for parameters analysis. On microscopic examination, sperm count, percentage of motile sperm, and sperm with normal morphology were objectively evaluated. Semen samples were centrifuged at 600 g for 10 minutes. After centrifugation, supernatants were diluted 10-fold by deionized water. Levels of Zn were measured by atomic absorption spectroscopy (AAS). Results: Fertile groups (smokers or nonsmokers) demonstrated significantly higher Zn levels in their seminal plasma than any infertile groups (p < 0.001). A trend was observed for lower mean Zn levels in seminal plasma of smokers compared with nonsmokers. Seminal Zn was positively correlated with sperm count (p < 0.01) and normal morphology of sperm (p < 0.001). Conclusions: Decrease of seminal Zn can be a risk factor for sperm abnormality and idiopathic male infertility. Infertile men and men who smoke were susceptible to Zn deficiency in their seminal fluid. We hypothesized that in the absence of Zn, the possibility of increased oxidative damage exists that would contribute to poor sperm quality in the fertile man who smokes. Decreasing the effective concentration of Zn in seminal plasma of infertile and men who smoke, increases the harmful effects of ROS to sperm cells that are associated with abnormal sperm parameters. Poor Zn nutrition may be an important risk factor for low quality of sperm and idiopathic male infertility. S62 Effects of recurrence urinary tract infections on the reproduction system of male paraplegics M. Selimovic *, M. Hiros, H. Spahovic, ´ S. Sadovic. ´ University Clinical Centre, Dept. of Urology, Sarajevo, Bosnia and Herzegovina Introduction and Objectives: The level of knowledge about the effects of urinary tract infections on the reproduction system of male paraplegics, relative to the bladder-related treatment, is inadequate. Urinary tract infection is the most frequent and the most severe type of complication facing this segment of population. A significant amount of such complications may have an adverse effect on the reproductive health of paraplegics in terms of reducing their reproductive power caused by disorders of spermatogenesis, the motility of spermatozoa and ejaculation disorders. Material and Methods: The cross sectional study design is used with a view of conducting a survey of the frequency of occurrence and distribution of urinary infections in the paraplegic population (1992–1996), relative to the method for bladder treatment, and the effects of such infections on the reproductive capabilities of paraplegics. The study included all paraplegics (60 pts.) registered at the Centers for Paraplegia in the BiH Federation. Results: They are assigned to one of the following four groups: paraplegics using indwelling catheter, paraplegics using intermittent catheter, paraplegics using urinary condoms and paraplegics using both, intermittent catheter and condom catheters. Samples were obtained using a vibratory stimulation method or electro-ejaculation with a Saeger rectal probe. Conclusions: The reproductive health of paraplegics was evaluated based on the analysis of their spermatogram results S63 Ezerex in erectile dysfunction D. Djordjevic *, D. Nale, S. Micic. Clinical Center of Serbia, Clinic of Urology, Belgrade, Serbia Introduction and Objectives: Erectile dysfunction is condition correlated with diabetes, hypertension, dyslipidaemia, stress, ageing, inadequate intake of nutritients and environmental
toxins and also, an early symptom of as yet undiagnosed system vascular pathology. Ezerex is propyonil-L-carnitine chlorhydrate, L-arginine and Nicotinic acid and its function is to protect against endothelial damage induced by oxygen free radicals, restores endothelial integrity and function. Material and Methods: We investigated 78 patients, group A Ezerex 1 pckt/day for 12 weeks, B group Cialis 20 mg 2 tabls/week for 12 weeks, group C Ezerex + Cialis and group D placebo. We measured FMD – flow-mediated dilatation (post-hyperemia diameter-basal diameter/basal diameter 100), also used questionnaire on sexual activity (IIEF) and Global Assessment Questions (GAQ’s). Results: Both Group A (EZEREX) and Group B (PDE-5 inhibitor have led to the recovery of endothelial function. Taken in combination (group C) the recovery effect appears to be from the sum of the two products taken individually. Ezerex has led to a statistically significant improvement in erectile function as measured by IIEF Questionnaire and also highly tolerated (96% positive response the GAQs). Conclusions: In conclusion we can say that our clinical investigation has shown that Ezerex improved endothelial functioning, reduced production of oxygen free radicals and increased tolerability. S64 Interrelationships between erectile dysfunction and smoking in men with hypertension G. Sakelariou1 *, C. Vlachopoulos2 , C. Fasoulakis1 , N. Ioakeimidis2 , S. Leontis1 , K. Rokkas1 , A. Rempelakos1 , A. Aggelis2 , C. Stefanadis2 . 1 Hippokrateion Hospital, Dept. of Urology, Athens, Greece; 2 Athens Medical Shool, 1st Dept. of Cardiology, Athens, Greece Introduction and Objectives: Despite the fact that smoking has numerous effects that promote erectile dysfunction (ED), the data regarding its association with ED in the setting of essential hypertension are rather scarce. Aim of this study was to investigate the interactions between smoking and ED in essential hypertensive men. Material and Methods: 159 treated non-diabetic patients with essential hypertension (mean age 59±11 years) and ED (detected with history and score of the 5-item Sexual Health Inventory for Men -SHIM-5, cut-off value <21), were classified according to their smoking habits as current smokers (≥1 cigarette/day, n = 67), ex-smokers who had stopped at any time before completing the questionnaire (n = 33) and the remaining subjects as non-smokers (n = 59). All subjects were submitted for penile Doppler ultrasonography. Venous blood sampling was performed for estimation of metabolic profile, high sensitivity C-reactive protein (hs-CRP) and fibrinogen concentrations. Results: Hypertensive current smokers and ex-smokers compared to non-smokers had increased diastolic BP (88±8 vs 87±9 vs 82±7 mmHg, respectively, P < 0.05 for all), whereas did not differ regarding age, body mass index (BMI), duration of hypertension, b-blockers, diuretics and statines. Although groups exhibited no difference regarding metabolic profile (P = NS), current smokers and also, ex-smokers compared to non-smokers were characterized by higher levels of hs-CRP (2.9±1.8 vs 2.6±1.7 vs 1.9±1.4 mg/l, respectively, P < 0.05 for all) and fibrinogen (328±63 vs 317±66 vs 291±58 mg/dl, respectively, P = 0.01 for all). Mean erectile function score and mean peak systolic velocity (PSV) of cavernous arteries, were comparable among current smokers and ex-smokers but lower compared to controls (15±4 vs. 11±2 vs 11±3, respectively; P = 0.01 for all and 30± 10 vs 33±8 vs 35±9 cm/s, respectively; P < 0.05 for all). These relationships remained significant in multivariate analysis after adjusting for age, mean pressure, length between hypertension documentation and ED onset,
627
S58 The impact of L-Carnitine in spermogram of varicocele patients
6 months was 32%, 25%, 21% respectively in the 3 groups. After 12 months we have recorded important improvement in pregnancy rate in groups A and B (41% and 40%) and little in group C (25.5 %). Conclusions: Our study shows significant improvement in of sperm parameters on both groups (A and B) treated with menotropin than in the group who underwent only surgery.
G. Drenidis *, S. Leontis, L. Leonardopoulos, G. Diamantis, D. Georgoulias, A. Rempelakos. Hippokrateion Hospital, Dept. of Urology, Athens, Greece
S60 Testicular serum chitotriosidase level in varicocele patients
Conclusions: Our study suggests that the usage of laparoscopic approach is a safe and efficient method in the treatment varococele with improvement sperm quality.
Introduction and Objectives: To estimate the role of the L-Carnitine in the improvement of the spermogram’s parameters in patients with varicocele-associated oligoasthenospermia. Material and Methods: Between February 2006 and February 2009 53 patients with varicocele-associated oligoasthenospermia. Mean age of patients was 29(22–36) years and they were chosen based on the criteria of the W.H.O 1999 for the oligoasthenospermia. The varicocele was diagnosed and staged in five-grade classification using echo-colour Doppler ultrasonography. Of these patients, 12 had grade 1 left varicocele (group I)13 had grade 2 left varicocele (group II) 12 had grade 3 left varicocele (group III) 9 had grade 4 left varicocele (group IV) and 7 had grade 5 left varicocele (group V).Patients with testicular pathology,azoospermia, and endocrinological diseases were excluded from our study. One gr of L-Carnitine were administered per os every 8 hours for 4 months. A spermogram was performed before and after the treatment and none sideeffect was observed. Results: Assessed values of sperm concentration, motility and morphology in each of the five patient groups and the median modulation rate after 4 months of treatment. No significant difference in spermogram of patients with grade 4 and 5 before and after varicocele treatment. On the other hand there is a significant improvement in all parameters in patients with grade 1, 2 and 3 varicoceles, especially in concentration and the typical forms of sperm. Conclusions: It seems that the administration of L-Carnitine in patients with low grade varicocele improves significant the parameters of sperm. More studies are needed, in order to educe more validated results for this therapeutical approach. S59 Early use of menotropin in the treatment of varicocele N. Pakevic1 *, N. Bojanic2 , N. Lalic2 , D. Djordjevic2 . 1 General Hospital Valjevo, Serbia, Dept. of Urology, Valjevo, Serbia; 2 Clinical Center of Serbia, Clinic of Urology, Belgrade, Serbia Introduction and Objectives: Varicocele is the most common disease in infertile men and varicocelectomy remains the main standard of treatment. During last years a lot of drugs have been proposed in association with surhery. The aim of this study is verify the effects of association between menotropin and subinguinal varicocelectomy on sperm parameters and pregnancy rate. Material and Methods: Methods Sixty patints with left varicocele were randomized in 3 groups of 20 patients: group A were treated with menothropinsince diagnosis 3 months; group B was treated with menotropin 3 months after the varicocelectomy; gropu C was treated only with the surgicaly. We have tested spermograms before and after 3, 6 and 12 months form sugical therapy. Results: Results After 3 months from operation, sperm parameters were significantly improved in a group A (p < 0.05).After 6 months similar improvement was recorded also in the group B. After 12 months we have registered significant improvement in groups A abd B; the values were significantly higher than in group C. Pregnanacy rate, after
B. Kuzgunbay1 *, I. Kurt2 , M.T. Eren3 , A. Hasimi2 , G. Kose3 , M. Erdal4 . 1 Baskent University, Dept. of Urology, Ankara, Turkey; 2 Gulhane Military Medical Academy, Dept. of Urology, Ankara, Turkey; 3 Ankara Military Hospital, Dept. of Urology, Ankara, Turkey; 4 Ankara Military Hospital, Dept. of Family Practice, Ankara, Turkey Introduction and Objectives: We evaluated serum chitotriosidase level, which is a functional chitonolytic enzyme and secreted from macrophages, in varicocele patients in order to investigate pathophysiology of varicocele and associated male infertility. Material and Methods: Between March-December 2008, 38 patients underwent left varicocelectomy with diagnose of left varicocele in Ankara Military Hospital. The patients were divided into two groups according to their sperm counts. Group 1 (n = 19) was consist of the patients whose sperm counts were ≤20×106 per ml (oligospermia) and group 2 (n = 19) >20×106 per ml (normospermia). The serum levels of chitotriosidase were supplied from brachial and testicular veins of the patients and compared. Results: The mean age of the patients were 22.7±3.8 years in group 1 and 21.8±1.6 years in group 2. The mean sperm counts of the patients were 13.3±7.2×106 per ml in group 1 and 54.8±23.1×106 per ml in group 2. In group 1, the mean brachial chitotriosidase serum level of the patients was 41.1±27.8 nmol/hour/ml and the mean testicular chitotriosidase serum level was 40.5±27.4 nmol/hour/ml. In group 2, the mean brachial chitotriosidase serum level of the patients was 28.6±22.8 nmol/hour/ml and the mean testicular chitotriosidase serum level was 28.1±22.1 nmol/hour/ml. Although the mean brachial and testicular chitotriosidase levels were higher in group 1 than group 2, the difference was statistically insignificant (p = 0.137 for brachial and p = 0.133 for testicular level). Conclusions: The insignificant increase in testicular chitotriosidase serum levels in oligospermic varicocele patients might reflect a probable increased testicular macrophage activity. However, further investigations are needed. S61 Quality of sperm and seminal Zn levels A. Suhajda1 *, S. Dragicevic2 , B. Bojanic2 , D. Nale2 , S. Micic2 . General Hospital Subotica, Dept. of Urology, Subotica, Serbia; 2 Clinical Center of Serbia, Clinic of Urology, Belgrade, Serbia 1
Introduction and Objectives: Insufficient intake of zinc (Zn) can impair antioxidant defenses and may be an important risk factor in oxidant release, compromising the mechanism of DNA repair, and making the sperm cell highly susceptible to oxidative damage. In the absence of Zn, the possibility of increased oxidative damage exists that would contribute to poor sperm quality. Infertile men and men who smoke are very susceptible to oxidative damage induced by free radicals. In the present study, we hypothesized that major changes in the level of seminal Zn levels are related with low quality of sperm and poor fertilizing capacity. Material and Methods: Semen samples were collected from fertile (smoker [n = 17], nonsmoker [n = 19]) and infertile men
628
eau 5th south eastern european meeting (seem) / european urology supplements 8 (2009) 607–655
(smoker [n = 15], nonsmoker [n = 21]). After collection, semen specimens were allowed to liquefy at room temperature for 30 minutes and used for parameters analysis. On microscopic examination, sperm count, percentage of motile sperm, and sperm with normal morphology were objectively evaluated. Semen samples were centrifuged at 600 g for 10 minutes. After centrifugation, supernatants were diluted 10-fold by deionized water. Levels of Zn were measured by atomic absorption spectroscopy (AAS). Results: Fertile groups (smokers or nonsmokers) demonstrated significantly higher Zn levels in their seminal plasma than any infertile groups (p < 0.001). A trend was observed for lower mean Zn levels in seminal plasma of smokers compared with nonsmokers. Seminal Zn was positively correlated with sperm count (p < 0.01) and normal morphology of sperm (p < 0.001). Conclusions: Decrease of seminal Zn can be a risk factor for sperm abnormality and idiopathic male infertility. Infertile men and men who smoke were susceptible to Zn deficiency in their seminal fluid. We hypothesized that in the absence of Zn, the possibility of increased oxidative damage exists that would contribute to poor sperm quality in the fertile man who smokes. Decreasing the effective concentration of Zn in seminal plasma of infertile and men who smoke, increases the harmful effects of ROS to sperm cells that are associated with abnormal sperm parameters. Poor Zn nutrition may be an important risk factor for low quality of sperm and idiopathic male infertility. S62 Effects of recurrence urinary tract infections on the reproduction system of male paraplegics M. Selimovic *, M. Hiros, H. Spahovic, ´ S. Sadovic. ´ University Clinical Centre, Dept. of Urology, Sarajevo, Bosnia and Herzegovina Introduction and Objectives: The level of knowledge about the effects of urinary tract infections on the reproduction system of male paraplegics, relative to the bladder-related treatment, is inadequate. Urinary tract infection is the most frequent and the most severe type of complication facing this segment of population. A significant amount of such complications may have an adverse effect on the reproductive health of paraplegics in terms of reducing their reproductive power caused by disorders of spermatogenesis, the motility of spermatozoa and ejaculation disorders. Material and Methods: The cross sectional study design is used with a view of conducting a survey of the frequency of occurrence and distribution of urinary infections in the paraplegic population (1992–1996), relative to the method for bladder treatment, and the effects of such infections on the reproductive capabilities of paraplegics. The study included all paraplegics (60 pts.) registered at the Centers for Paraplegia in the BiH Federation. Results: They are assigned to one of the following four groups: paraplegics using indwelling catheter, paraplegics using intermittent catheter, paraplegics using urinary condoms and paraplegics using both, intermittent catheter and condom catheters. Samples were obtained using a vibratory stimulation method or electro-ejaculation with a Saeger rectal probe. Conclusions: The reproductive health of paraplegics was evaluated based on the analysis of their spermatogram results S63 Ezerex in erectile dysfunction D. Djordjevic *, D. Nale, S. Micic. Clinical Center of Serbia, Clinic of Urology, Belgrade, Serbia Introduction and Objectives: Erectile dysfunction is condition correlated with diabetes, hypertension, dyslipidaemia, stress, ageing, inadequate intake of nutritients and environmental
toxins and also, an early symptom of as yet undiagnosed system vascular pathology. Ezerex is propyonil-L-carnitine chlorhydrate, L-arginine and Nicotinic acid and its function is to protect against endothelial damage induced by oxygen free radicals, restores endothelial integrity and function. Material and Methods: We investigated 78 patients, group A Ezerex 1 pckt/day for 12 weeks, B group Cialis 20 mg 2 tabls/week for 12 weeks, group C Ezerex + Cialis and group D placebo. We measured FMD – flow-mediated dilatation (post-hyperemia diameter-basal diameter/basal diameter 100), also used questionnaire on sexual activity (IIEF) and Global Assessment Questions (GAQ’s). Results: Both Group A (EZEREX) and Group B (PDE-5 inhibitor have led to the recovery of endothelial function. Taken in combination (group C) the recovery effect appears to be from the sum of the two products taken individually. Ezerex has led to a statistically significant improvement in erectile function as measured by IIEF Questionnaire and also highly tolerated (96% positive response the GAQs). Conclusions: In conclusion we can say that our clinical investigation has shown that Ezerex improved endothelial functioning, reduced production of oxygen free radicals and increased tolerability. S64 Interrelationships between erectile dysfunction and smoking in men with hypertension G. Sakelariou1 *, C. Vlachopoulos2 , C. Fasoulakis1 , N. Ioakeimidis2 , S. Leontis1 , K. Rokkas1 , A. Rempelakos1 , A. Aggelis2 , C. Stefanadis2 . 1 Hippokrateion Hospital, Dept. of Urology, Athens, Greece; 2 Athens Medical Shool, 1st Dept. of Cardiology, Athens, Greece Introduction and Objectives: Despite the fact that smoking has numerous effects that promote erectile dysfunction (ED), the data regarding its association with ED in the setting of essential hypertension are rather scarce. Aim of this study was to investigate the interactions between smoking and ED in essential hypertensive men. Material and Methods: 159 treated non-diabetic patients with essential hypertension (mean age 59±11 years) and ED (detected with history and score of the 5-item Sexual Health Inventory for Men -SHIM-5, cut-off value <21), were classified according to their smoking habits as current smokers (≥1 cigarette/day, n = 67), ex-smokers who had stopped at any time before completing the questionnaire (n = 33) and the remaining subjects as non-smokers (n = 59). All subjects were submitted for penile Doppler ultrasonography. Venous blood sampling was performed for estimation of metabolic profile, high sensitivity C-reactive protein (hs-CRP) and fibrinogen concentrations. Results: Hypertensive current smokers and ex-smokers compared to non-smokers had increased diastolic BP (88±8 vs 87±9 vs 82±7 mmHg, respectively, P < 0.05 for all), whereas did not differ regarding age, body mass index (BMI), duration of hypertension, b-blockers, diuretics and statines. Although groups exhibited no difference regarding metabolic profile (P = NS), current smokers and also, ex-smokers compared to non-smokers were characterized by higher levels of hs-CRP (2.9±1.8 vs 2.6±1.7 vs 1.9±1.4 mg/l, respectively, P < 0.05 for all) and fibrinogen (328±63 vs 317±66 vs 291±58 mg/dl, respectively, P = 0.01 for all). Mean erectile function score and mean peak systolic velocity (PSV) of cavernous arteries, were comparable among current smokers and ex-smokers but lower compared to controls (15±4 vs. 11±2 vs 11±3, respectively; P = 0.01 for all and 30± 10 vs 33±8 vs 35±9 cm/s, respectively; P < 0.05 for all). These relationships remained significant in multivariate analysis after adjusting for age, mean pressure, length between hypertension documentation and ED onset,