Clinical and laboratory profile of men with erectile dysfunction in a tertiary care referral Andrological center

Abstract

Introduction

The incidence of erectile dysfunction (ED) is rising, even among men in their reproductive age group. The main objective of this study is to analyze the profile of ED and address the concerns in treating them.

Methods

A prospective observational study was conducted in the Andrology unit of a tertiary care center in South India over two years in men seeking treatment for ED. Demographics, clinical history and physical examination findings, erection hardness score (EHS) and intravaginal or masturbatory ejaculation latency time ejaculation latency time were noted. Blood investigations mainly included glycosylated hemoglobin or fasting blood sugar, lipid profile, serum testosterone and estradiol. Erectile function was assessed by office sildenafil test (OST) and intracavernosal injections when necessary.

Results

Out of 1012 patients, majority (N=851, 84.1%) were married; 161 (16.7%) were premarital; 44 (4.3%) patients had unconsummated marriage. The median (IQR) stretched penile length was 9 (2.5) cm. Low testosterone (<3 ng/dl) was found in 108 (10.7%) patients and elevated estradiol (estradiol > 50 pg/ml) was seen in 190 (18.8%) men; 231 (22.8%) had prediabetes and 222 (21.9%) were diabetics or newly detected diabetics. The improvement in erection hardness was better in non-diabetic men. The concerns in premarital men included short phallus, thin semen, semenuria and anxiety regarding erection.

Conclusions

ED may be an early indicator of heart disease. A standardized algorithmic approach, use of objective tools and office assessment of erectile function will improve the overall outcomes in management of ED.