The interplay between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, erectile dysfunction, and Peyronie’s disease: A meta-analysis of observational studies


Submitted: January 17, 2023
Accepted: February 16, 2023
Published: March 15, 2023
Abstract Views: 736
PDF: 330
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Authors

  • Cennikon Pakpahan Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya; Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya; Andrology Outpatient Clinic, General Academic Dr. Soetomo Hospital, Surabaya, Indonesia. https://orcid.org/0000-0003-0157-1131
  • Ilhamsyah Ilhamsyah Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya; Andrology Outpatient Clinic, General Academic Dr. Soetomo Hospital, Surabaya, Indonesia. https://orcid.org/0000-0002-7659-6467
  • Supardi Supardi Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya; Andrology Outpatient Clinic, General Academic Dr. Soetomo Hospital, Surabaya, Indonesia.
  • Pety Narulita Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya; Andrology Outpatient Clinic, General Academic Dr. Soetomo Hospital, Surabaya, Indonesia.
  • Agustinus Agustinus Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya; Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya; Andrology Outpatient Clinic, General Academic Dr. Soetomo Hospital, Surabaya, Indonesia.
  • Darmadi Darmadi Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. https://orcid.org/0000-0001-5281-168X

Introduction: This study aims to investigate the relationship between Neutrophil- Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR) with Erectile Dysfunction (ED) and Peyronie's disease (PD).

Methods: We conducted a meta-analysis of the observational study by searching for the appropriate keywords in eight databases. The risk of publication bias of the included studies was assessed by Egger's test and Kendall's t. The data extraction was carried out for each study and analysed using Revman 5.0.

Results: There were eleven eligible studies out of the 411 studies retrieved. Eight studies were conducted on cases of erectile dysfunction, and three studies on Peyronie's disease. There was a significant relationship between NLR, PLR and ED (SMD: 0.59, 95% CI: 0.33-0.85 and SMD: 0.64, 95% CI: 0.13-1.16, respectively). The same was also found for PD. The active phase of PD tended to have higher NLR (SMD: 0.68, 95% CI: 0.43-0.92) and PLR (SMD: 0.27, 95% CI: 0.06-0.49) compared to the chronic phase. No publication bias was found in both ED and PD studies.

Conclusions: NLR and PLR indicate an ongoing inflammatory process in both ED and PD. These findings can be used as markers of treatment and prognosis of both diseases in sexual health care.


Sivritepe R, Uçak Basat S, Baygul A, Küçük EV. The effect of inter-leukin-6 level at the time of hospitalisation on erectile functions in hospitalised patients with COVID-19. Andrologia. 2022; 54:e14285. DOI: https://doi.org/10.1111/and.14285

Erdogan A, Keskin E, Sambel M. Red blood cell distribution width values in erectile dysfunction. Rev Int Androl [Internet]. 2022; 20:24-30. DOI: https://doi.org/10.1016/j.androl.2020.05.007

Karabakan M, Bozkurt A. Relationship Between Erectile Dysfunction, the Neutrophil-to-Lymphocyte Ratio, and the Platelet- to-Lymphocyte Ratio. J Acad Res Med. 2019; 9:27-31. DOI: https://doi.org/10.5152/jarem.2019.2138

Zhang Y, Feng X, Wu X, et al. A systematic review and meta-analysis of the relationship between erectile dysfunction and the neu- trophil-to-lymphocyte and platelet-to-lymphocyte ratios. Andrologia. 2022; 54:1-13. DOI: https://doi.org/10.1111/and.14337

Liao Z, Tang Y, Li X, Li D. The Relationship Between Hematologic Parameters and Erectile Dysfunction. Sex Med [Internet]. 2021; 9:100401. DOI: https://doi.org/10.1016/j.esxm.2021.100401

Sambel M, Kilic M, Demirbas M, et al. Relationship between erectile dysfunction and the neutrophil to lymphocyte and platelet to lym- phocyte ratios. Int J Impot Res. 2018; 30:27-35. DOI: https://doi.org/10.1038/s41443-017-0007-1

Garcia Rojo E, García Gómez B, Santos-Pérez de la Blanca R, et al. Role of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in Peyronie's disease: a new diagnostic approach to predict the stage of the disease? Asian J Androl. 2021; 23:325-329. DOI: https://doi.org/10.4103/aja.aja_74_20

Langston JP, Carson CC 3rd. Peyronie disease: plication or grafting. The Urologic Clinics of North America. 2011; 38:207-216. DOI: https://doi.org/10.1016/j.ucl.2011.03.001

Greenberg JW, Kim J, Pincus J, et al. Are neutrophil-lymphocyte and platelet-lymphocyte ratios useful for determining active phase of Peyronie’s disease? Journal of Clinical Urology. 2022; 0(0). doi:10.1177/20514158221094636 DOI: https://doi.org/10.1177/20514158221094636

Özbir S, Degirmentepe RB, Atalay HA, et al. The role of inflammatory parameters (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-eosinophil ratio) in patients with Peyronie’s disease. Andrology. 2020; 8:348-52. DOI: https://doi.org/10.1111/andr.12702

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. DOI: https://doi.org/10.1136/bmj.n71

Wells GA, O’Connell D, Peterson J, et al. Newcastle-Ottawa quality assessment scale. Ottawa Hosp Res Institute,. 2014; (3):2-4.

Demirci A, Ozgur BC. The effect of using tadalafil 5 mg/day on neutrophil-lymphocyte and platelet-lymphocyte ratios in mild-medi- um and severe erectile dysfunction patients; and comparison of clinical response. Andrologia. 2019; 51:1-7. DOI: https://doi.org/10.1111/and.13347

Demirci A, Ozgur BC, Tuncer SÇ. Comparison of hormone profile and systemic inflammation in patients presenting with sexual dysfunction: Which is important? Rev Int Androl. 2021; 19:242-8. DOI: https://doi.org/10.1016/j.androl.2020.04.002

Akbas A, Gulpinar MT, Sancak EB, et al. The relationship between platelet-lymphocyte ratio and severity of erectile dysfunction. Kaohsiung J Med Sci. 2016; 32:91-5. DOI: https://doi.org/10.1016/j.kjms.2015.11.002

Aslan A, Kaya Y, Cirakoglu A, et al. Neutrophil-Lymphocyte Ratio Could Be a Marker for Erectile Dysfunction. Urol J. 2019; 16:216-220.

De Rose AF, Mantica G, Bocca B, et al. Supporting the role of penile trauma and micro-trauma in the etiology of Peyronie's disease. Prospective observational study using the electronic microscope to examine two types of plaques. Aging Male. 2020; 23:740-745. DOI: https://doi.org/10.1080/13685538.2019.1586870

Nishida Y, Hosomi S, Yamagami H, et al. Neutrophil-to-Lymphocyte Ratio for Predicting Loss of Response to Infliximab in Ulcerative Colitis. PLoS One. 2017; 12:e0169845. DOI: https://doi.org/10.1371/journal.pone.0169845

Zhang JH, Ferrante A, Arrigo AP, Dayer JM. Neutrophil stimu- lation and priming by direct contact with activated human T lymphocytes. J Immunol. 1992; 148:177-81. DOI: https://doi.org/10.4049/jimmunol.148.1.177

Devine CJJ, Somers KD, Jordan SG, Schlossberg SM. Proposal: trauma as the cause of the Peyronie’s lesion. J Urol. 1997; 157:285-90. DOI: https://doi.org/10.1016/S0022-5347(01)65361-8

El-Sakka AI, Salabas E, Dinçer M, Kadioglu A. The pathophysiology of Peyronie’s disease. Arab J Urol. 2013; 11:272-7. DOI: https://doi.org/10.1016/j.aju.2013.06.006

Pakpahan, C., Ilhamsyah, I., Supardi, S., Narulita, P., Agustinus, A., & Darmadi, D. (2023). The interplay between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, erectile dysfunction, and Peyronie’s disease: A meta-analysis of observational studies. Archivio Italiano Di Urologia E Andrologia, 95(1). https://doi.org/10.4081/aiua.2023.11162

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