Diagnosis & Assessment
Clinical examination
A detailed medical and psychological history of patients and partners must always be the first step in the evaluation of ED 1,2 Although it may not often be possible to involve the partner on the first visit, an effort should be made to involve the partner during the second visit. The medical history will reveal many common disorders that are associated with ED.
Pathophysiology of ED may be vasculogenic, neurogenic, hormonal, anatomical, drug -induced or psychogenic in nature.
In several clinical studies two objective clinical measurements for ED were used. With the Rigiscan method the erection (tumescence and rigidity) is measured, while the Stopwatch method yields data on duration of erection.
RigiScan
The RigiScan instrument measures penile tumescence and rigidity continuously. It has two loops, one to be placed around the base of the penis and the other towards the tip, that tighten every fifteen or thirty seconds. The recording unit can be strapped around the waist or thigh.
Stopwatch method
The patient is given a standard stopwatch and measures the time from an erection perceived hard enough for penetration (start stopwatch) until withdrawal from the partner’s vagina (stop stopwatch) leading to successful intercourse. The time is noted in a diary and helps to identify problems with maintenance of an erection.
References:
1. Davis-Joseph B, Tiefer L, Melman A. Accuracy of the initial history and physical examination to establish the etiology of erectile dysfunction. Urology 1995;45:498-502. http:/anti-infectives/Paris-Event/Live-Webcast.cfmwww.ncbi.nlm.nih.gov/entrez/query
2. Hatzichristou D, Hatzimouratidis K, Bekas M, Apostolidis A, Tzortzis V, Yannakoyorgos K. Diagnostic steps in the evaluation of patients with erectile dysfunction. J Urol 2002;168:615-620. http:/anti-infectives/Paris-Event/Live-Webcast.cfmwww.ncbi.nlm.nih.gov/entrez/query
