S1537 Prevalence and Associated Risk Factors of Erectile Dysfunction Among Patients With Inflammatory Bowel Disease: An Updated Meta-Analysis

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. Conclusion: ED is a prevalent and multifactorial complication of IBD, likely mediated by inflammation, psychological burden, and surgical disruption of pelvic autonomic nerves. 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, 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.