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Erectile dysfunction

Version: January 2017
Legacy ID: 48

Rationale

Erectile dysfunction is present when an erection of sufficient rigidity for sexual intercourse cannot be acquired or sustained more than 75% of the time. It has a major impact on relationships.

Causal Conditions

(list not exhaustive)

  1. Neurologic (e.g., diabetes mellitus)
  2. Cardiovascular
  3. Pharmacologic (e.g., alcohol)
  4. Hormonal (e.g., testosterone deficiency)
  5. Psychological or emotional (e.g., performance anxiety)
  6. Chronic systemic disease (e.g., kidney injury)

Key Objectives

Given a patient with erectile dysfunction, the candidate will diagnose the cause, severity, and complications, and will initiate an appropriate management plan.

Enabling Objectives

Given a patient with erectile dysfunction, the candidate will

  1. list and interpret critical clinical findings, including
    1. an appropriate history and physical examination, in particular to
      1. determine if there is an organic or psychological cause;
      2. identify reversible causes (e.g., medications);
  2. list and interpret critical investigations, including
    1. laboratory investigations (e.g., testosterone, blood glucose, thyroid hormone);
  3. construct an effective initial management plan, including
    1. determine the therapy based on the underlying cause;
    2. treat associated medical conditions;
    3. suggest lifestyle changes (e.g., weight loss);
    4. describe the indications and contraindications for inhibitors of phosphodiesterase type V and other drugs and devices;
    5. determine if the patient needs to be referred for specialized care;
    6. counsel and educate the patient (and/or partner, as appropriate).