ED 15. A multicenter pathophysiological investigation of erectile dysfunction among outpatients in China

Objective: To assess the pathophysiological composition and age structure of erectile dysfunction (ED) in men visiting outpatient clinics in China.

Methods: We studied 3327 consecutive ED outpatients (median age 39 years) during 2006 and 2010 in the five training hospitals in China. Every patient was independently evaluated by an experienced urologist/andrologist based on comprehensive diagnostic procedures. The simplified International Index of Erectile Function (IIEF-5) was used to assess the severity of ED.

Results: Most patients (95.0%) were younger than 60 years, and none was older than 70 years. Psychogenic patients were younger (36.53 years) and had greater percentage (56.1%) than any other patients. Vasculogenic factors were the major etiology of organic ED (20.1%). There was a significant difference in age composition between the patients with psychogenic ED and organic ED (P=0.000). Diabetes, hypertension, coronary artery disease, and hyperlipidaemia played significant roles in affecting the severity of ED in a statistical model including age. The IIEF scores decreased with age (rs=–0.199, P=0.000). Moreover, the percentage of severe and moderate cases increased with age (P=0.003, P=0.002, respectively), yet the constituent ratio of patients sharply declined from 30.3% to 4.5% with age.

Conclusions: More men visit outpatient clinics due to psychological ED rather than organic causes. The age composition of Chinese ED patients who seek medical help is relatively young due to inadequate sex education. Most elderly ED patients are reluctant to go to hospital just for the loss of erectile function.