Effects of herbicides on erectile dysfunction and reproduction in Korean veterans exposed to "Agent Orange" in Vietnam

초록

INTRODUCTION AND OBJECTIVES: Weinvestigated pathogenesis of erectile dysfunction (ED) and reproduction in patients who exposed to defoliants during the Vietnam War. MATERIALS AND METHODS: Twenty-seven men with urologic symptoms who diagnosed as defoliants associated disease at department of Occupational and Environmental Medicine were included. The study included detailed history, physical examinations, blood test with lipid profile and hormones, penile duplex Doppler ultrasonogram, biothesiometry, and cavernous biopsy for Masson’s trichrome staining and NADPH-diaphorase staining. Total dioxins level was measured in two patients. RESULTS: Causes of ED were vasculogenic 20 cases (74.1%), neurogenic 18 cases (66.7%), and hormonal 6 cases (22.2%). Of all patients 15 patients (55.6%) have mixed cause, and remainder has single cause. Risk factors for ED, such as hypertension, peripheral neuropathy, diabetes mellitus, dyslipidemia and atherosclerosis were associated in 21 (77.8%), 18 (66.7%), 15 (55.6%), 13 (48.1%), and 9 patients (33.3%) respectively. ED patients with vasculogenic cause showed increased cavernous fibrosis (% collagen fiber: 71.6±20%), and in patients with neurogenic ED the number of NADPH diaphorase-positive nerve fibers was severely decreased Congenital anomalies of offspring, repetitive abortion, and male infertility with abnormal semen parameters were associated in 8 (29.6%), 4 (14.8%), and 3 patients (11.1%) respectively. Total dioxins levels measured in two patients were 61.4 g/g(fat), 32.8 pg/g(fat) respectively and significantly increased compared to background levels in combustion area (10pg/g(fat)). CONCLUSIONS: Defoliants are highly associated with vascular risk factors and resultant cavernous fibrosis contributes to ED.Furthermore defoliants has adverse effect on reproduction.