Current Management Patterns of Erectile Dysfunction
Current Management Patterns of Erectile Dysfunction
Justin Parker, MD
Assistant Professor of Urology University of South Florida James A. Haley VA Medical Center
Disclosure
Consultant for Coloplast but have no conflicts regarding this presentation.
Incidence of ED
Worldwide prevalence is high
? 10% (Spain) to 22% (US)
Massachusetts Male Aging Study
? Prevalence of ED 52% in males 40-70 years old in Boston area
? 17.2% minimal ED ? 25.2% moderate ED ? 9.6% complete ED
26 new cases per 1000 per year 19% prevalence in European study of 30-80 year
olds
Evolution of ED Treatment
Prior to 1974- ED was largely treated by psychiatrists and psychologists
1974- New Era of ED treatment
? Miami: Small-Carrion prosthesis ? Houston: Scott and Timm first inflatable prosthesis
1983- Self demonstration of ICI use by Brindley 1998- FDA approval of Viagra
Evolution of ED Treatment
Broderick- 1999
? Changing Practice Patterns in Erectile Dysfunction: A Diagnostic Algorithm for the New Millenium
Now
? Multiple PDE5 inhibitors- sildenafil, vardenafil, tadalafil, avanafil, udenafil (not approved in US), generic formulations.
? Wide availability of ICI- for profit injection clinics ? Evolution of implant surgery- device modifications, infection
resistant coatings, no touch techniques, etc. ? Clinic availability of vascular testing ? Emerging restorative therapies
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