Erectile Dysfunction (ED)

Question 1

What key history would you obtain from a patient who complains of erectile dysfunction?

Answer 1

Duration
Severity
Nocturnal erection?
Libido
Stress
Depression
Trauma
Associated incontinence
Medications (and recent changes)
Past medical history (hypertension, diabetes, high cholesterol, known atherosclerotic vascular disease, prior prostate surgery)
Smoking
Alcohol
Drug use

Question 2

What key physical exams would you perform on a patient who complains of erectile dysfunction?

Answer 2

Vital signs
Cardiovascular exam
Genital and rectal exams

Question 3

47 yo M presents with impotence that started three months ago. He has hypertension and was started on atenolol four months ago. He also has diabetes and is on insulin. Differentials?

Answer 3

Drug-related ED
ED caused by hypertension
ED caused by DM
Psychogenic ED
Peyronie's disease

Question 4

47 yo M presents with impotence that started three months ago. He has hypertension and was started on atenolol four months ago. He also has diabetes and is on insulin. Differentials: drug-related ED, ED caused by hypertension, ED caused by DM, psychogenic ED, Peyronie’s disease. Workup?

Answer 4

Genital exam
Rectal exam
Glucose
CBC