Objective: To review the evidence suggesting a significant association between gout and erectile dysfunction (ED) and evaluate possible underlying pathways that may explain this relationship. Methods: English medical literature was searched from January 1, 2010, to January 1, 2020, for randomized or quasi-randomized controlled trials, cross-sectional studies, case-cohort studies, or meta-analysis evaluating the relationship between gout and ED. Results: All nine gout studies included in the study found a significant association between gout and ED. ED pathophysiology in gout involves hyperuricemia, increased reactive oxygen species, decreased nitric oxide synthesis, and low-grade inflammation. Conclusion: The findings of this review suggest that the effect of urate-lowering therapy on the incidence of ED in gout patients should be studied. Additionally, we propose that all gout patients should be assessed for ED.
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