Clinical features and treatment options for Chinese patients with severe primary erectile dysfunction

To investigate clinical features of Chinese patients with severe primary erectile dysfunction (S-PED) and to identify the ideal treatment options for this population.

Patients with PED were screened for enrollment in our study. Sexual history, marital status, and erectile function were evaluated by inquiry including International Index of Erectile Function-5. Individuals with severe PED (defined as refractory to management with phosphodiesterase type 5 inhibitor [PDE5i]) underwent serum hormone analysis, penile color duplex Doppler ultrasound, neuroelectromyogram, and cavernosography as appropriate. Long-term treatment results were determined.

Among 220 PED patients, 72 (32.7%) suffered from severe PED (PDE5i nonresponse). Mean age was 31.5 +/- 4.5 years and mean duration of attempts at sexual activity was 2.4 +/- 3.2 years, Sixty-eight men (94.5%) had organic etiologies for erectile dysfunction, including arteriogenic (n = 13), venogenic (n = 35), endocrinologic (n = 6), neurologic (n = 9), and cavernosal fibrosis (n = 5). Sixteen men (22.2%) had been divorced. Mean erectile function and quality-of-life were significantly improved (P <.001) in the 25 men (34.7%) who were treated by penile prosthesis implantation, at a mean follow-up of 5.6 years. Satisfaction with penile prosthesis for patients and partner was 93.4% and 92.3%, respectively.

Severe PED has a major impact on young couple's life quality. Venous leak is the most common cause of severe PED. Penile prosthesis implantation is safe and effective for severe PED.