Delay in Seeking Medical Help in Patients with New-Onset Erectile Dysfunction Remained High Over and Despite the PDE5 Era—An Ecological Study

Abstract

Introduction It is common knowledge among researchers that erectile dysfunction (ED) is an important sentinel marker of cardiovascular and overall men’s health. Aim Determine whether the delay of time between ED onset and seeking medical help (DSH), considered as a proxy of awareness of the importance of ED for overall men’s health, has shortened during the phosphodiesterase type 5 inhibitors (PDE5) era. Methods Complete data from 619 patients seeking first medical help for new-onset ED as their primary disorder between July 2000 and July 2010 were analyzed (i.e., DSH, ED severity as defined by the International Index of Erectile Function-erectile function [IIEF-EF] domain score, patient’s awareness of any PDE5, and Charlson Comorbidity Index [CCI]). Analysis of variance tested DSH throughout the 10-year time frame. Cox regression models tested the association between predictors and DSH. Main Outcome Measures Assess if DSH has shortened throughout PDE5 era. Evaluate potential predictors of DSH. Results Overall, mean DSH was 30.2 months (median 12.0; range 5–300 months). DSH shortened throughout the analyzed 10-year period (F = 1.918; P = 0.047), with a significant drop only from year 2009 (DSH up to year 2008 vs. from year 2009: 31.0 months [12.0] vs. 7.5 months [6.0], respectively; P < 0.001). Age, CCI, educational status, and ED severity did not significantly change over time. As a whole, 560 patients (90.5%) were aware of PDE5 at the time of their first office visit. PDE5 awareness emerged as an univarible and multivariable predictor of a shortened DSH. Conversely, DSH was not clearly associated with age, CCI, educational status, or ED severity. Conclusion Delay in seeking medical help in new-onset ED patients remained high over the PDE5 era, with a significant drop only from the year 2009. PDE5 awareness emerged as an independent predictor of shortening of this delay.

Help-seeking behavior for erectile dysfunction: a clinic-based survey in China

“…Only approximately half of our men had a high household income, so some financial barriers might deter them from seeking and obtaining the desired medical attention. The mean time between noticing ED and taking the first treatment was 4.3 months, which was shorter than in the Salonia et al 9. study, which had a mean time of 30.2 months (median 12.0; range 5–300 months).…”

Prevalence, correlates, attitude and treatment seeking of erectile dysfunction among type 2 diabetic Chinese men attending primary care outpatient clinics

“…Numerous researches revealed that men with ED find it difficult to report their conditions to doctors,1516 although all men from a cross-national survey agreed that ED was a source of great dismal for themselves and their partners, and nearly all disagreed that they were too old for sex 17. To begin with, more than half of those who were screened ED positive did not in fact think that they had ED 18.…”

Prediction model for penile prosthesis implantation for erectile dysfunction management

“…A significant time delay often exists between the onset of ED symptoms and both presenting to a clinician to discuss the symptoms and instituting treatment. Salonia et al 22 reported on 619 patients seeking medical help for new-onset ED in the PDE5i era, where the mean delay prior to presentation was 30.2 months (median 12.0; range 5-300). This delay seems surprising given the likely waning of the taboo associated with openly discussing ED, as well as the explosion of direct-to-consumer advertising for ED treatments in both electronic and print media 25 .…”

“…Notably, this approach does not contradict any ED management guidelines, as no urological society mandates a trial of non-surgical ED therapies prior to proceeding with PPI. This decision may facilitate earlier restoration of erectile function with a treatment option that affords high satisfaction 22 .…”

“…The time period between onset of ED symptoms and PP implantation (PPI) is variable, and may cover an extended time period 22,23 . During this time, the patient may experience diminished quality of life, including role limitation due to physical and emotional problems, negative perceptions of health, and relationship hardship.…”