Findings highlight hyperuricemia as an important risk factor of erectile dysfunction (ED). In hyperuricemia cases, ED risk can be attenuated by urate-lowering therapy (ULT). According to results, hyperuricemia-related endothelial dysfunction could also underlie the pathogenesis of ED in these patients.

• This systemic review and meta-analysis was conducted to assess the link between hyperuricemia and ED by analyzing five cohort studies and six cross-sectional studies, comprising a total of 454,510 participants.

• A 1.59-fold higher risk of ED was observed in patients with hyperuricemia vs (pooled odds ratio, OR = 1.59, 95% CI [1.29, 1.97]) the non-hyperuricemia counterparts.

• In these hyperuricemia patients, ULT decreased ED risk by 27% (OR = 1.27, 95% CI [1.14, 1.41]).

• Post-subgroup analysis, the link between hyperuricemia and ED continued to be significant apart from the >60 years subgroup.