Routine cardiac assessment is not necessary for all patients with erectile dysfunction

Abstract

Erectile dysfunction (ED) is defined as the persistent inability to achieve and/or maintain an erection sufficient for satisfactory sexual performance. The combined prevalence of minimal, moderate and complete ED was reported as high as 52% from the Massachusetts Male Aging Study.1 At age 40, there is an about a 40% prevalence rate, increasing to almost 70% in men at age 70.1 In Canada, a similar overall prevalence of ED was reported (49.4%).2 In addition, ED been shown to have a negative impact on a patient’s quality of life, sexual relationships and overall well-being.3 The etiology of ED fits in one of 3 categories: organic, psychogenic or, most commonly, a combination of both. Phophodiesterase-5 (PDE) inhibitors revolutionized ED treatment and is the first-line treatment. These agents have been shown to be effective with good safety profiles in a comorbid population of men with ED, including patients with vascular disease, coronary artery disease (CAD), hypertension and diabetes.4–6 Treatment options for patients not responding to oral drugs (or contraindicated) include intracavernous injections, intraurethral alprostadil, vacuum-constriction devices and penile prosthesis.7