Meta-Analysis of Prevalence of Erectile Dysfunction in Mainland China: Evidence Based on Epidemiological Surveys

INTRODUCTION The epidemiologic characteristics of erectile dysfunction (ED) in mainland China remain incompletely understood. AIM To evaluate the overall prevalence and determine the severity of ED in mainland China. METHODS An extensive database search was performed of PubMed, Embase, the Chinese National Knowledge Infrastructure (CNKI) database, the WanFang database, the Chinese Biological Medical Literature (CBM) database, and the Chongqing VIP using the following terms: erectile dysfunction, prevalence, epidemiology, epidemiological, and China. Study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Data were pooled for the random-effects model. Sensitivity analyses were conducted to assess potential bias. MAIN OUTCOME MEASURES All survey studies reporting on the prevalence of ED in mainland China were included. Data extraction was performed independently by two of the authors, and conflicts were resolved by another author. RESULTS Of 2,155 retrieved articles, 25 were included in this meta-analysis with a total of 48,254 participants. The pooled prevalence of ED in men was 49.69% (95% CI = 39.29-60.10). The occurrence rates of ED in age groups younger than 30, 30 to 39, 40 to 49, 50 to 59, 60 to 69, and at least 70 years were 20.86%, 25.30%, 40.48%, 60.12%, 79.10%, and 93.72%, respectively. The severity-specific prevalences of mild, moderate, and severe ED were 32.54%, 9.86%, and 13.97%, respectively. Moreover, the prevalences reported by different diagnostic methods were 14.19% for self-reports, 44.60% for the Chinese Index of Erectile Function, and 49.91% for the International Index of Erectile Function-5. The prevalence map based on a geographic information system showed an unequal geographic distribution. CONCLUSION ED is highly prevalent in mainland China, and its prevalence increases with age. More high-quality surveys on ED with larger samples throughout mainland China are needed to confirm these findings.