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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