BACKGROUND AND AIMS This retrospective cohort study evaluated the degree of pelvic inflow and internal pudendal artery (IPA) calcification in male smokers versus non-smokers. As erectile dysfunction (ED) is strongly associated with IPA vascular, we wanted to investigate radiologically if there was a statistically significant difference in the degree of IPA calcification in smokers and potentially be a contributing factor in the cause of ED.

METHODS CT studies of 100 men aged between 40 and 60 years of age were blindly reviewed and assigned a calcium score of their vascular calcification levels. We compared scores of 50 smokers versus 50 non-smokers. The Mann Whitney U test statistic was used to test for a statistical difference in calcification score between the smoking and non-smoking groups.

RESULTS Results show a statistically significant association between smoking and pelvic inflow and IPA calcification. The Mann Whitney U test demonstrated a statistically significant higher calcium score in the smoking group (mean = 4.8, SD 3.7), versus the non-smoking group, (mean = 1.8, SD 1.9) (U = 701.5, p < 0.05).

CONCLUSIONS This research is the first of its kind based on an extensive literature review. The association between vascular calcification and smoking is well established, in addition to the direct relationship of IPA calcification and ED. This unique study has demonstrated an increased rate of IPA calcification in smokers with a potential inferred association with ED. Findings represent a novel and useful deterrent for health authorities to include in anti-smoking campaigns.