The prevalence and influence of significant psychiatric abnormalities in men undergoing comprehensive management of organic erectile dysfunction

Psychiatric factors are etiologically important in a proportion of patients with erectile dysfunction, We determined the prevalence of psychopathology and the impact it has on current erectile dysfunction (ED) assessment and management. A group of 120 consecutive men with ED presenting to the Human Sexuality Cl inic for the first time was prospectively investigated. All patients partic ipated in a standardized evaluative protocol, including history, physical e xam, assessment by a psychiatrist (using DSM-IV(TM) criteria), selective ho rmonal screen, and diagnostic intracavernosal injection. Follow-up appointm ents were to discuss diagnostic findings and, eventually, treatment choices . The prevalence of significant psychiatric pathology, excluding interview st ress, was 33%, Only 16 of 40 cases were recognized and highlighted in the i nitial assessments by urological staff. There was no significant difference in the modalities of treatment choices between patients with psychiatric p roblems and those without, 10% of the patients had multiple organic risk fa ctors, normal ICI, and significant psychiatric pathology. Psychopathology or emotional factors play a significant role in the etiolog y of ED and they are difficult to identify in a non-directed assessment. Ev en in the face of significant vascular risk factors, psychological abnormal ities may be the primary etiology. Treating the 'phallodynamically challeng ed' individual without adequately addressing the possible presence of psych opathology, will account for treatment failures and have the potential for leaving untreated serious emotional problems.