Ronpichai ChokesuwattanaskulCharat ThongprayoonPavida PachariyanonKonika SharmaPatompong UngprasertTarun BathiniWisit CheungpasitpornTexas Tech University Health Sciences Center at LubbockChulalongkorn UniversityKing Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn UniversityFaculty of Medicine, Siriraj Hospital, Mahidol UniversityUniversity of Mississippi Medical CenterBassett Medical Center2019-08-232019-08-232018-08-01International Journal of Urology. Vol.25, No.8 (2018), 752-75714422042091981722-s2.0-85050509758https://repository.li.mahidol.ac.th/handle/123456789/46490© 2018 The Japanese Urological Association Objective: To investigate the pooled incidence or the prevalence of erectile dysfunction, and to assess the risk of erectile dysfunction in patients with atrial fibrillation. Methods: A systematic review was carried out in the MEDLINE, EMBASE and Cochrane databases from inception through January 2018 to identify: (i) studies that reported the incidence and/or prevalence of erectile dysfunction in atrial fibrillation patients; or (ii) studies that assessed the association between atrial fibrillation and erectile dysfunction. Pooled odds ratios and 95% confidence intervals were calculated using a random effects model. Results: Five observational studies (27 841 patients) were enrolled. The pooled estimated prevalence of erectile dysfunction in atrial fibrillation patients was 57% (95% confidence interval 50–64, I2 = 0). A study showed an incidence of newly diagnosed erectile dysfunction in atrial fibrillation patients of 0.96% during the mean follow-up duration of 4.67 ± 3.20 years. There was a significant association of atrial fibrillation with an increased risk of erectile dysfunction, with a pooled odds ratio of 1.79 (95% confidence interval 1.44–2.23, I2 = 0%). The data on the risk of atrial fibrillation development in patients with erectile dysfunction were limited. A study showed the comparable risk of atrial fibrillation in patients with erectile dysfunction (odds ratio 1.03, 95% confidence interval 0.67–1.5), when compared with those without erectile dysfunction. Conclusions: The present study suggests a significant association between erectile dysfunction and atrial fibrillation. The overall estimated prevalence of erectile dysfunction among atrial fibrillation patients is 57%. However, despite limited data, the current evidence suggests a low incidence of new erectile dysfunction in atrial fibrillation patients.Mahidol UniversityMedicineArticleSCOPUS10.1111/iju.13725