The association between chronic periodontitis and vasculogenic erectile dysfunction: a systematic review and meta-analysis.

AIM: The purpose of this systematic review and meta-analysis was to explore the association between erectile dysfunction (ED) and chronic periodontitis (CP) in observational studies. MATERIALS AND METHODS: A literature search of PubMed, EMBASE and Cochrane up to and including May 22, 2015, was conducted by two independent reviewers. Statistical analysis was performed using Review Manager 5.3, and the results are expressed as odds ratios (ORs) together with 95% confidence intervals (CIs), as determined using a random effects model. Subgroup analysis was performed by age. RESULTS: Of the 250 potentially eligible articles, four studies, involving 38,111 cases and 174,807 controls, were included. Based on random effects meta-analysis, a significant association between CP and ED was identified (OR = 3.07, 95% CI: 1.87-5.05, p < 0.001). Sensitivity analysis was performed due to the presence of statistically extensive heterogeneity (I(2) = 98%). CONCLUSIONS: The results of this systematic review revealed a positive association between CP and ED; however, because the presence and extent of statistical heterogeneity limits the conclusiveness of our findings, larger and better-controlled studies of socially homogeneous populations as well as pathophysiological studies are required to confirm the relationship between CP and ED and to explore the biological mechanisms involved.