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The International Index of Erectile Function\u20105 (IIEF\u20105) is a well\u2010validated survey to determine the presence and severity of erectile dysfunction in men. We assessed (i) the prevalence and severity of erectile dysfunction, and (ii) risk factors for erectile dysfunction in patients with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective study, erectile dysfunction was defined as: absent (&gt;21 IIEF\u20105\u2010points), mild (12\u201021) and severe (5\u201011). Patients with overt hepatic encephalopathy, active alcohol abuse, extrahepatic malignancy, previous urologic surgery, previous liver transplantation and severe cardiac conditions were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among n\u00a0=\u00a0151 screened patients, n\u00a0=\u00a041 met exclusion criteria and n\u00a0=\u00a030 were sexually inactive. Thus, a final number of n\u00a0=\u00a080 male patients with cirrhosis were included. Patient characteristics: age: 53\u00a0\u00b1\u00a09\u00a0years; model for end\u2010stage liver disease score (MELD): 12.7\u00a0\u00b1\u00a03.9; Child\u2010Pugh score (CPS) A: 30 (37.5%), B: 35 (43.8%), C: 15 (18.7%); alcohol: 38 (47.5%), viral: 25 (31.3%), alcohol\/viral: 7 (8.8%) and others: 10 (12.5%). The presence of erectile dysfunction was found in 51 (63.8%) patients with 44 (55%) and 7 (8.8%) suffering from mild\u2010to\u2010moderate and moderate\u2010to\u2010severe erectile dysfunction. Mean MELD and hepatic venous pressure gradient (HVPG) were significantly higher in patients with erectile dysfunction (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.021; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.028). Child\u2010Pugh score C, MELD, creatinine, age, arterial hypertension, diabetes, low libido, low testosterone and high HVPG were associated with the presence of erectile dysfunction. Interestingly, beta\u2010blocker therapy was not associated with an increased risk. In multivariate models, arterial hypertension (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 6.36 [1.16\u201034.85]; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.033), diabetes (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 7.40 [1.31\u201041.75]; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.023), MELD (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 1.19 [1.03\u20101.36]; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.015) and increasing HVPG (n\u00a0=\u00a048; <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 1.11 [1.002\u20101.23]; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.045) were independent risk factors for the presence of erectile dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>About two\u2010thirds of male patients with cirrhosis show erectile dysfunction. Severity of liver dysfunction, portal hypertension, arterial hypertension and diabetes were identified as risk factors for erectile dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13704","type":"journal-article","created":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T04:46:45Z","timestamp":1516855605000},"page":"1427-1436","source":"Crossref","is-referenced-by-count":36,"title":["Erectile dysfunction in cirrhosis is impacted by liver dysfunction, portal hypertension, diabetes and arterial hypertension"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1813-5769","authenticated-orcid":false,"given":"Rafael","family":"Paternostro","sequence":"first","affiliation":[{"name":"Vienna Hepatic Hemodynamic Lab Divison of Gastroenterology and Hepatology Department of Internal Medicine III Medical University of Vienna  Vienna Austria"},{"name":"Divison of Gastroenterology and Hepatology Department of Internal Medicine III Medical University of 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