Erectile dysfunction under age 40: etiology and role of contributing factors

The aim of this study was to evaluate the etiology of erectile dysfunction (ED) in patients under the age of 40 years. Eighty one patients were included in this study. All patients underwent a multidisciplinary diagnostic approach by color Doppler ultrasonography, dynamic pharmacocavernosometry (optional), selective pudendal pharmaco-arteriography (optional) and nocturnal penile tumescence monitoring by a Rigi-Scan (optional). Mean age of the population was 32 years. Psychogenic impotence was diagnosed in 50% of the patients and organic impotence was diagnosed in 45%. After the 3rd decade of life, a vasculogenic etiology was the most common cause of impotence. Smoking and hypertension played a major role as chronic contributing factors in the overall study population. Primary impotence was diagnosed in 11 patients who were unmarried. The rate of organic causes was 45% in this group (all vasculogenic in nature). Erectile dysfunction in younger patients and in patients with primary impotence is due mainly to organic causes, usually vascular in origin.