Background: Erectile dysfunction (ED) has been associated with both systemic inflammation and generalized vascular disease. Monocyte count (MNC) represents a sensitive marker of inflammatory activity in atherosclerosis. We examined the possible associations between MNC, penile vascular damage and early atherosclerosis.

Methods: 145 consecutive ED patients were divided into three groups according to pharmacologically stimulated peak systolic velocity (PSV) values of cavernous arteries: Group A (venous occlusive disease), group B (mild arterial insufficiency) and group C (severe arterial insufficiency, PSV<25 cm/s). PSV shows the greatest flow velocity detectable in an artery throughout the systole. Ultrasound-determined intima media thickness (IMT) of carotid arteries and carotid-femoral pulse wave velocity (PWV) as an index of aortic stiffness were used to assess subclinical atherosclerosis.

Results: Patients with severe arterial insufficiency (n=44) compared to subjects in group B (n=41) and A (n=60) had increased IMT (0.96 vs 0.93 vs 0.87 mm, P<0.05) and PWV (9.3 vs 8.9 vs 8.5 m/s, P<0.05). They also exhibited higher MNC, compared to those of groups A and B (0.47 vs 0.44 vs 0.39 × 10⁹/L, P<0.05), whereas there were no significant differences between the 3 groups as regards white cell counts. Furthermore, MNC remained significantly different between groups after adjustment for CRP, fibrinogen and risk factors, (P<0.05). MNC correlated with IMT (r=0.23, P<0.05), PWV (r=0.27, P<0.01) and PSV (r=−0.26, P<0.01).

Conclusions: Our study shows that there is an augmentation in MNC throughout increasing penile vascular damage and subclinical atherosclerosis. These findings may reflect the potential role of MNC as a marker of early atherosclerosis in ED patients.