Organic erectile dysfunction (ED) is more likely to develop in men with gallbladder stone disease, new data suggest.

The data are from a population-based study comparing 9362 men aged 20 years or older diagnosed with gallbladder stone disease and a control group 9362 men without gallbladder stone disease matched by age, index date of the diagnosis of gallbladder stone disease, and comorbidities. The organic ED rate was significantly higher in the stone disease group than controls (4.01 vs 2.69 per 1000 person-years). In adjusted analyses, men in the stone disease group had a significant 1.4-fold increased risk of organic ED compared with the control group, Chien-Hua Chen, MD, of Chang-Bing Show-Chwan Memorial Hospital, Lukang Town, Taiwan, and colleagues reported in the American Journal of Men’s Health.

The rate of psychogenic ED was similar between the stone disease and control groups (0.40 vs 0.28 per 1000 person-years). In adjusted analyses, the men with stone disease had a nonsignificant 37% increased risk of psychogenic ED.

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In addition, cholecystectomy appeared to be protective. Men who underwent cholecystectomy for their stone disease had a significant 42% decreased risk of organic ED than those who did not, in adjusted analyses. The cholecystectomy group had a risk of organic ED similar to that of the control group, whereas the stone disease patients who did not undergo cholecystectomy had a significant 1.7-fold increased risk organic ED compared with controls. Cholecystectomy had no association with the development of psychogenic ED.

Dr Chen and colleagues used data from the Taiwan National Health Insurance Research Database. The mean ages of the men with gallbladder stone disease and controls were 56.4 and 56.8 years. The mean follow-up duration for the groups was 6.44 and 6.39 years, respectively. In the stone disease cohort, the mean follow-up duration for the men who underwent cholecystectomy and those who did not was 6.58 and 6.37 years, respectively.

The study is the first population-based investigation to examine the association between gallbladder stone disease and subsequent development of ED, the authors noted. One of its strengths was that their statistical analyses included data from a national database with a 12-year observation period for the representative cohort of 1 million citizens covered by Taiwan’s National Health Insurance program. In addition, men enrolled in the study were sampled from a population of about 99% of Taiwanese residents to provide the generalizability of the findings in Taiwan.

Dr Chen’s team also point out study limitations. They noted, for example, they could have neglected potential confounding factors because the National Health Insurance Research Database did not provide detailed information on ED-related lifestyle and socioeconomic status. The database lacked data on educational background, exercise, and work load, as well as the height and weight of beneficiaries.


Chen CH, Lin CL, Kao CH. Erectile dysfunction in men with gallbladder stone disease: A nationwide population-based study. Am J Mens Health. 2019;13(2):1557988319839589