Abstract
OBJECTIVES: To determine the frequency and severity of erectile dysfunction (ED) in Child Turcot Pugh (CTP) classes of liver cirrhosis using international index for erectile function -5 (IIEF - 5).

METHODOLOGY: This 1½ year study was started in January 2010. 589 cirrhotic patients meeting our selection criteria were enrolled from Hepatology clinic of C.M.C, Larkana and asked 5 questions of IIEF-5 to assess the frequency and severity of ED. Clinical examination was performed to detect ascites and hepatic encephalopathy. Blood samples were drawn for serum bilirubin, albumin and INR.
Data was transferred and analyzed using SPSS-19. Categorical response variables such as age, severity of ED, CTP class, bilirubin, albumin, INR, ascites and hepatic encephalopathy were compared in erectile dysfunction positive and negative cases by Chi-square test. P value of less than 0.05 was taken statistically significant.

RESULTS: ED was reported by 476 (80.8%) participants. 219 (37.2%) reported severe ED, 133 (22.6%) moderate ED, 58 (9.8%) mild to moderate ED and 66 (11.2%) mild ED. Patients with ED were more likely to be in CTP class C (p < 0.000) with odd risk of 8.49 (95% CI: 4.73 – 16.53). Patients with ED had elevated INR (p < 0.000), serum bilirubin (p < 0.000) and decreased serum albumin (p < 0.000) with odds of 8.49 (95% CI: 3.86 – 18.65), 3.79 (2.02 – 7.12) and 3.25 (95% CI: 1.94 – 5.45) respectively. ED reporting patients tend to have severe or resistant ascites and higher grades of encephalopathy with odds of 3.00 (95% CI: 1.94 – 4.64) and 4.14(95% CI: 2.15 – 7.95).

CONCLUSION: ED was reported in 80.8% cirrhotic patients, and most of them in CTP class C. Patients reporting ED had elevated INR, serum bilirubin, suppressed serum albumin, severe or resistant ascites and higher grades of hepatic encephalopathy.

Key words: Erectile Dysfunction (ED), Child Turcot Pugh (CTP), International Index for Erectile Function - 5 (IIEF-5), cirrhosis of liver.