Objective To quantify incidence of erectile dysfunction (ED) and the associated risk factors in men attending community clinics in a large population in Wales, UK. Subjects and methods Of 4060 men who were invited to attend 11 community clinics, primarily to check for prostate disease, 2025 (aged 55±70 years) attended. Of these, 2002 men answered a questionnaire about personal details, medical, family and sexual history, and detailed alcohol and smoking habits. All had their serum prostate-speci®c antigen (PSA) analysed and those referred for investigation of prostatic disease underwent serum testosterone analysis. Results Complete ED was reported by 265 men (13.2%), and was closely related to age (r=0.19, P<0.001) and medication (r=0.2, P<0.001). ED occurred in 6.9% of men aged 55±60 years, 12.5% aged 61±65and 22.2% of those aged 66±70. Patients taking diabetic medication had the highest relative risk for ED and 11.3% of men with ED were taking nitrates. The numbers of years of smoking had the third closest correlation with impotence (r=0.16, P<0.001). A low serum testosterone level was a poor predictor of ED and increasing serum PSA levels did not in¯uence the distribution of ED. Conclusion About 13% of these men aged 55±70 years had complete ED; if this value is extrapolated to the whole of the UK, this equates to almost half a million men being unable to achieve any erections. The estimate would be much greater if those with milder forms of ED are included.
This study counters the theory that a complete resection of the prostate is routinely achieved. The endoscopic appearances probably imply a complete resection of the adenoma but a considerable volume of the gland remains. This has important implications for the detection of prostate carcinoma at TURP and for the staging of the disease.
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