[A discussion of the differential diagnosis of the impaired erection]

In light of the fact that internationally accepted diagnostic criteria for erectile disorder are hardly considered in prevalence studies, the Berlin Male Study (BMS) was designed to collect data both on the frequency of dysfunctional erections experienced (DSM-IV criterion A) and the concomitance of related distress (DSM-IV criterion B). As a result, the age-adjusted total prevalence for erectile disorder (17.8%) was markedly lower than in other studies with comparable samples (40-79 years of age). Likewise, the age-dependent increase in prevalence was by far less prominent than commonly reported in the literature. These findings strongly suggest the necessity to clearly differentiate between erectile disorder, indicating that the patient is experiencing some degree of distress associated with his dysfunctional erection, and erectile dysfunction, indicating that the respective individual is not too concerned about his dysfunctional erection (with respect to erectile function, there is no reason to refer to the latter as a patient). The authors suggest that the internationally used abbreviation "ED" be differentiated into "EDy" when referring to erectile dysfunction and "EDi" when referring to erectile disorder. This extended perspective on differential diagnosis would not only make future studies (more) comparable, it would also do justice to clinical experience.