How, why and when should urologists evaluate male sexual function?

Area of Science:

• Urology
• Andrology
• Sexual Medicine

Background:

• Male sexual dysfunction (MSD), encompassing erectile dysfunction (ED), premature ejaculation, decreased libido, and impaired orgasm, is a prevalent urological complaint.
• Despite its high incidence and impact on quality of life, MSD is frequently underdiagnosed and undertreated in clinical settings.

Purpose of the Study:

• To identify specific clinical scenarios where urologists should proactively assess male sexual function.
• To emphasize the potential of erectile dysfunction as an early indicator of systemic vascular and metabolic diseases.

Main Methods:

• Review of clinical guidelines and relevant scientific literature.
• Analysis of the association between male sexual dysfunction and common urological conditions.
• Exploration of erectile dysfunction as a marker for underlying comorbidities.

Main Results:

• Systematic evaluation of male sexual functioning is indicated in men with pelvic trauma, malignancies, lower urinary tract symptoms (LUTS) from benign prostatic hyperplasia (BPH), neurological disorders, and infertility.
• Erectile dysfunction (ED) may serve as a preclinical marker for endothelial dysfunction, potentially indicating undiagnosed diabetes, hypertension, dyslipidemia, coronary artery disease, and depression.

Conclusions:

• Urologists should integrate systematic screening for male sexual dysfunction into the management of patients with specific urological conditions.
• Recognizing ED as a potential marker for systemic disease can facilitate early diagnosis and intervention for serious health issues.