Search

Objective: To investigate the incidence of comorbid ED with lower urinary tract symptoms (LUTS) and its risk factors in BPH patients., Methods: Based on inclusion and exclusion criteria, we selected BPH patients visiting the outpatient department of the Second Xiangya Hospital of Central South University from January 2020 to January 2023. We collected the general and clinical data from the patients, including age, height, body weight, abdominal circumference, hip circumference, blood pressure, blood routine, liver function, kidney function, blood lipids and fasting blood glucose, obtained their IPSS, quality of life (QOL) scores, and IIEF-5 scores by questionnaire investigation, and performed data processing and analysis with the SPSS 22.0 software., Results: The incidence rate of comorbid ED with LUTS in the BPH patients rose with the increase of age, 36.46% in the 45－49-year group, 43.72% in the 50－54-year group, 53.66% in the 55－59-year group, 69.23% in the 60－64-year group, and 78.74% in the 65－70-year group. The lipid accumulation product (LAP), visceral adiposity index (VAI), triglycerides and glucose (TyG), hepatic steatosis index (HSI), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) were correlated positively with IPSS scores and negatively with IIEF-5 scores, while LDL-C and total cholesterol (TC) negatively with IPSS scores and positively with IIEF-5 scores., Conclusion: The incidence of comorbid ED with LUTS in BPH patients increases with age. The risk factors for this comorbidity include hypertension, dyslipidemia, diabetes, BMI, and lifestyle, and the risk of the condition can be effectively assessed by LAP, VAI, TYG, HSI, BMI, WHtR, WHR, TG and HDL-C.

Objective: To analyze the influential factors of erectile dysfunction (ED) in patients with localized prostate cancer (LPC) after radical surgery., Methods: The clinical data of 150 male patients diagnosed with LPC and normal erectile function (EF) before surgery admitted to the Department of Urology of the Eastern Theatre General Hospital from January 2021 to January 2023 were retrospectively analyzed. The EF status of the patients 6 months after surgery was assessed using the International Erectile Function Index -5(IIEF-5). Age, Gleason score, PSA level, TNM stage, preoperative International prostatic symptom score (IPSS), preoperative prostate volume, smoking index, alcohol consumption index, educational level, comorbidities, operation mode, and psychosexual state were used as influencing factors to analyze their effects on postoperative ED., Results: Of the 150 patients, 88 had ED and 62 had normal EF. Univariate analysis showed that age, preoperative IPSS, preoperative prostate volume, comorbidities and sexual and psychological status were significantly correlated with postoperative ED. Further multivariate logistic regression analysis showed that age, preoperative prostate volume, comorbidities and sexual and psychological status were independent factors influencing the occurrence of ED after RP in LPC patients., Conclusion: The recovery of sexual function of patients with localized prostate cancer after radical surgery is generally poor, and the incidence of ED is high. Its independent influencing factors include age, preoperative prostate volume, comorbidities and sexual psychological state, etc. Correct intervention of different influencing factors is required in clinical work. In order to provide a better diagnosis and treatment scheme for LPC patients undergoing radical treatment, reduce the incidence of postoperative ED and improve the quality of life of patients after surgery.

Objective：The purpose of this study was to explore the causal relationship between nonalcoholic fatty liver disease (NAFLD) and the risk of erectile dysfunction (ED) by using two-sample Mendelian randomization (MR) analysis., Methods: Single nucleotide polymorphisms (SNPs) were screened as instrumental variables (IVs) using the public genome-wide association study summary data set (GWAS). Univariate MR, bidirectional MR and multivariate MR methods were used to analyze the causal relationship between NAFLD and ED., Results: IVW results showed that NAFLD was not associated with ED (OR=0.991 2, 95%CI: 0.955 2－1.0286, P=0.640 6). The results of reverse MR showed that there was no correlation between ED and NAFLD (OR=1.181 5, 95%CI: 0.820 8－1.7007, P=0.369 5). Multivariate MR results showed that there was still no causal relationship between the two diseases after adjusting for confounding factors., Conclusion: The results showed that there was no causal relationship between NAFLD and the risk of ED.

Objective: To investigate the correlation of frailty with ED in Chinese elderly men., Methods: This community-based study was conducted with a sample of 258 Chinese men aged 60 to 83 years old in Fuyang City, Anhui Province. All the participants completed a standard questionnaire on demographics, lifestyle, underlying diseases and medical and sexual histories. They also scored on the Chinese version of Tilburg Frailty Indicator (TFI) and International Index of Erectile Function-5 (IIEF-5)., Results: The incidence rates of ED and frailty in the elderly men were 85.27% and 75.58%, respectively. The ED patients, compared with the non-ED males, had a significantly older age (［71.25 ± 5.83］ vs ［66.92 ± 5.44］ yr, P < 0.01) and higher body mass index (［24.37 ± 3.31］ vs ［23.35 ± 2.97］ kg/m 2, P < 0.05), incidence of diabetes mellitus (38.0% vs 19.2%, P < 0.05) and TFI scores (8.61 ± 4.29 vs 5.95 ± 4.36, P < 0.05), but lower education and frequency of irregular intercourse (less than once a week) (all P<0.05). Multivariate analysis indicated that diabetes (OR：3.292，95% CI：1.236－8.768), irregular intercourse (OR：2.425，95% CI：1.114－5.279), and scores of frailty (OR：4.502，95% CI：1.905－10.640) were regarded as independent risk factors for ED (all P < 0.05)., Conclusion: There is a strong correlation between ED and frailty in elderly men. Sexual health care for elderly ED patients should be more focused on the multidimensional assessment and treatment of senile frailty.

Objective: To investigate the prevalence of ED and the associated factors in infertile males., Methods: We continuously selected 896 infertile males present at Peking Union Medical College Hospital, Dongzhimen Hospital and the Sixth Medical Center of PLA General Hospital and evaluated the erectile function of the patients using a self-designed questionnaire and IIEF-5. We analyzed the ED-associated factors by multivariate analysis., Results: Based on the results of questionnaire investigation, there were 416 cases of ED in the 896 infertile males (46.43%), including 23 (2.56%) severe, 38 (4.24%) moderate, 109 (12.17%) mild-moderate and 246 (27.46%) mild cases. Multivariate analysis indicated that the prevalence rate of ED was correlated positively with obesity, hypertension and diabetes, and negatively with husband-wife affection and the frequency of sexual intercourse., Conclusions: The prevalence rate of ED is high in infertile males, mostly mild, and correlated with husband-wife affection, the frequency of sexual intercourse and some diseases.

Objective: To analyze vascular damage-related risk factors for ED in patients with type 2 diabetes mellitus (DM) and develop a nomogram for the prediction of the factors., Methods: A total of 181 patients with type 2 DM were included for sexual function assessment, and the clinical data on vascular damage were retrieved from the patients system. After preprocessing, the data were described by the number and percentage of different types of cases and subjected to statistical analysis with the R software. The Lasso regression model was used to optimize feature selection. On the premise of the sample size required for logistic regression analysis according to the number of events per variable, multivariable logistic regression analysis was performed on the selected variables and a nomogram was developed for diabetes-induced erectile dysfunction (DIED). Then, the performance of the nomogram was evaluated with respect to its calibration, discrimination and clinical utility using Harrell's concordance index (C-index), the calibration plot and decision curve analysis, as well as bootstrapping for internal validation., Results: ED was diagnosed in 90 (49.7%) of the 181 patients. The risk factors subjected to logistic regression analysis included the duration of DM (OR = 4.440, 95% CI: 1.594－13.105; OR = 7.667, 95% CI: 1.444－48.733), status of carotid intima-media thickness (c-IMT) (OR = 3.767, 95% CI: 1.194－12.691), diabetic retinopathy (DR) (OR = 5.382, 95% CI: 1.373－28.301), diabetic kidney disease (DKD) (OR = 4.959, 95% CI: 1.156－27.728), low-density lipoprotein cholesterol (LDL-C) (OR = 8.210, 95% CI: 2.027－43.507), red blood cell distribution width (RDW) (OR = 2.418, 95% CI: 1.021－5.826), and plasma fibrinogen (Fbg) (OR = 4.649, 95% CI: 2.001－11.339). The C-index of the DIED model was 0.911 (95% CI: 0.869－0.954). The curve representing the performance of the nomogram fit in well with that representing a perfect prediction by the calibration plot. Decision curve analysis indicated that the nomogram was clinically useful for predicting DIED in the type 2 DM patients at the possibility threshold of 6% to 93%., Conclusions: A nomogram was preliminarily developed for predicting the risk of DIED in type 2 DM patients with respect to the seven independent influencing factors, including the duration of DM, status of c-IMT, DR, DKD, LDL-C, RDW, and Fbg.

Objective: To analyze the basic characteristics and related factors of ED., Methods: Using the self-designed National Key Collaboration Platform for Impotence Disease Research, we enrolled 297 ED males at the urological clinic of the Second Hospital of Zhejiang University of Chinese Medicine from January 2015 to August 2018, and analyzed their basic characteristics, IIEF-5 scores, and erection hardness grades based on the Erectile Hardness Grading Scale., Results: The patients were aged 21－81 years, 41.4% at the age of 31－40 years, 81.5% with a disease course of less than 5 years, 56.9% with mild ED, and 44.8% with grade-3 erectile hardness. The IIEF-5 scores were significantly lower in the patients over 60 years old than in those aged 31－40 years (13.82±5.36 vs 8.50±4.99, P < 0.05), in those with a disease course of <5 years than in those with a disease course of >10 years (P < 0.05), and in those with a poor than in those with a loving relationship (P < 0.05), but showed no statistically significant difference among those with different marital status (P > 0.05)., Conclusions: The severity of ED is related to age, course of disease and mutual affection between the partners, but not to marital status.

Erectile dysfunction (ED) is a common male disease. Some related studies show that the prevalence of ED is nearly 52% in men aged 40 to 70 years and is increasing among younger males. Hypoxia is now considered to be an independent risk factor for ED and the mechanisms of hypoxia inducing ED are varied and complicated. Recently, an idea in penile rehabilitation has attracted much attention, which aims at improving erectile function by increasing oxygen supply to the cavernosum and reducing tissue fibrosis and apoptosis. The approaches to achieve non-sexual penile erection by increasing oxygen supply to the cavernosum, such as behavior therapy, medication, vacuum constriction device, and intracavernous injection, can simulate normal sexual erection and help patients with penile rehabilitation. This review focuses on the strategies for non-sexual penile erection in penile rehabilitation.

Objective: To investigate the relationship of erectile dysfunction (ED) with psychological factors in male patients with infertility., Methods: We conducted a questionnaire investigation among 252 male patients with infertility, which involved the general condition, results of semen routine examination, sexual life, and scores in IIEF-5, self-reported 9-item patient health questionnaire (PHQ-9) and 7-item generalized anxiety disorder scale (GAD-7). We analyzed the prevalence of ED, depression, and anxiety and their correlations among the patients in comparison with 100 fertile male controls., Results: In 245 of the infertility patients, the most common symptoms of depression and anxiety were "feeling tired or no vitality" and "easily getting worried or impatient", 20.4% of them with depression disorder and 42.9% with anxiety disorder. The PHQ-9 and GAD-7 scores were significantly higher in the infertile males than in the normal fertile controls (P <0.05), and so was the incidence of ED (28.6% vs 12.4%, P <0.05), while the IIEF-5 scores were markedly lower in the former than in the latter group (P <0.01), and so were sex frequency and sexual satisfaction (P <0.05). The PHQ-9 and GAD-7 scores were remarkably higher in the infertility patients with ED than in those without (P <0.01). Logistic regression analysis showed that the level of libido and results of semen routine examination were the risk factors for depression disorder, while age, education level, disease course and experience of assisted reproduction were those for anxiety disorder., Conclusions: Male infertility patients have a poorer mental health and a higher incidence of ED than normal fertile men, and there is some interaction between psychological status and ED prevalence.

Objective: To investigate the prevalence of erectile dysfunction (ED) in men with pre-diabetes., Methods: This study included 500 men with impaired fasting glycaemia (IFG), 500 with impaired glucose tolerance (IGT), and another 500 with normal blood glucose (NBG), all from Lanzhou. We conducted a questionnaire investigation among the subjects using the International Index of Erectile Dysfunction 5 (IIEF-5)., Results: The prevalence rates of ED in the IFG, IGT, and NBG groups were 14.8%, 29.2%, and 33.2%, respectively. After controlling for age, nationality, occupation, education, income, obesity, and blood pressure, the incidence rate was markedly higher in the IFG and IGT than in the NBG group (29.2% and 33.2% vs 14.8%, P <0.05), but showed no statistically significant difference between the IFG and IGT groups (P >0.05)., Conclusions: The prevalence of ED is higher in men with pre-diabetes than in those with normal blood glucose in Lanzhou.

Objective: To systematically analyze the correlation between psoriasis and erectile dysfunction (ED)., Methods: We searched the Cochrane Library, EMbase, PubMed, OVID, Medline, VIP, WanFang, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical Literature Database (CBM via SinoMed) for the published literature about the relationship between psoriasis and ED up to June 2016. According to inclusion and exclusion criteria, two researchers respectively extracted the relevant data and made a meta-analysis on the correlation of psoriasis with ED and IIEF-5 scores using the Review Manager 5.3 software., Results: A total of 6 studies were included in this analysis. The analysis with the fixed-effects model revealed a significant correlation between psoriasis and ED (OR = 1.92, 95% CI: 1.53－2.40, P <0.01), and that on 3 of the studies with the random-effects model showed that the IIEF-5 scores were significantly lower in psoriasis patients than in non-psoriasis males (MD = －3.11, 95% CI: －4.85－－1.37, P <0.01)., Conclusions: There is a certain correlation between psoriasis and ED. Psoriasis patients may have a higher incidence of ED though it is to be further confirmed by more higher-quality studies.

Objective: To investigate the penile erectile function of hospitalized male patients with cardiovascular diseases, the incidence of erectile dysfunction (ED) in this cohort, and the relationship of ED with cardiovascular diseases and its risk factors., Methods: Using a self-designed questionnaire, we conducted an investigation among the hospitalized patients in the Department of Cardiovascular Diseases of the First and Second Affiliated Hospitals of Xi'an Jiaotong University. We measured their body height, body mass index (BMI), waist circumference, hip circumference, and blood pressure, obtained their personal data, past history, metabolic indexes, and erectile function scores by IIEF-5, and analyzed the risk factors of ED using univariate and multivariate logistic regression and OR analyses., Results: Totally, 225 valid questionnaires were included in this investigation, which showed a 66.7% incidence of ED, 15.8% mild, 27.0% mild to moderate, 17.6% moderate, and 6.3% severe. The incident rates of ED in the 18-35 yr, 36-49 yr, 50-65 yr, and > 65 yr age groups were 13.6%, 39.1%, 89.2%, and 91.2%, respectively. Univariate logistic regression analysis manifested that the risk factors of ED in the patients with cardiovascular diseases included age (OR = 3.122, 95% CI 2.040-4.779), smoking (OR = 1.768, 95% CI 1.209-2.584), BMI (OR = 1.261, 95% CI 1.114-1.427), total cholesterol (OR = 1.77, 95% CI 1.339-2.340), TC/HDL (OR =1.715, 95% CI 1.349-2.181), hypertension (OR = 1.717, 95% CI 1.110-2.658), and coronary heart disease (OR = 2.235, 95% CI 1.169-4.275), while multivariate logistic regression analysis showed the risk factors to be age (OR = 4.99, 95% CI 2.264-10.998), financial condition, (OR = 2.804, 95% CI 1.127-6.976), smoking (OR = 2.109, 95% CI 1.179-3.772), BMI (OR = 1.414, 95% CI 1.136-1.760), and TC/HDL (OR = 2.001, 95% CI 1.016-3.943)., Conclusion: The incidence of ED is high in hospitalized patients with cardiovascular diseases and rises with the increase of age. Age, smoking, financial condition, BMI, and TC/HDL are the risk factors of both ED and cardiovascular diseases, and financial condition is closely associated with ED.

Objective: To evaluate the erectile and ejaculatory function of sacral tumor patients after sacral nerve root resection and investigate the relationship of erectile and ejaculatory dysfunction (EED) with the level of sacral nerve injury., Methods: This retrospective study included 47 male patients aged 16 to 63 (32.6 +/- 6.8) years treated by sacral tumor resection between January 2008 and August 2013. According to the levels of the sacral nerve roots spared in surgery, the patients were divided into four groups: bilateral S1-S3 (n=16), unilateral S1-S3 (n=21), unilateral S1-S2 (n=6), and unilateral S1 (n=4). The patients were followed up for 12 to 41 (27.2 +/- 10.9) months by questionnaire investigation, clinic review, and telephone calls about their erectile and ejaculatory function at 3, 6 and 12 months after surgery and in August 2013., Results: In the bilateral S1-S3 group, the incidence rates of EED were 31.25% (5/16), 25% (4/16), and 12.5% (2/16) at 3, 6, and 12 months respectively after surgery, with recovery of erectile and ejaculatory function in August 2013. The incidence rates of EED in the unilateral S1-S3 group were 85.71% (18/21), 71.43% (15/21), 52.38% (11/21), and 42.86% (9/21) at 3, 6 and 12 months and in August 2013, respectively; those in the unilateral S1-S2 group were 100% (6/6), 83.33% (5/6), 83.33% (5/6), and 66.67% (4/6) at the four time points; and those in the unilateral S1 group were all 100% (4/4). No statistically significant differences were found in the incidence rate of EED among the patients of different ages or tumor types (P > 0.05)., Conclusion: The incidence of postoperative EED in male patients treated by sacral tumor resection is closely related to the mode of operation. Sparing the S3 nerve root at least unilaterally in sacral tumor resection is essential for protecting the erectile and ejaculatory function of the patient.

Objective: To investigate the incidence of erectile dysfunction (ED) in men with lower urinary tract symptoms (LUTS) and the correlation between LUTS and ED., Methods: We enrolled 1 000 men aged 40 - 80 years with regular sex partners, evaluated their erectile function using IIEF-5, and investigated LUTS among them by International Prostate Symptom Score (IPSS). We studied the relationship between ED and LUTS by univariate conditional Logistic regression analysis., Results: LUTS were found in 42.81% of the men investigated (426/995), and ED in 76.18% of the subjects (758/995) and 82.16% of those with LUTS (350/426). Logistic regression analysis revealed a significant relation of ED with aging and LUTS (P < 0.01)., Conclusion: The The incidence of ED is high in men with LUTS and increases with aging and the severity of LUTS.

Objective: To evaluate the impact of the factors of perceived male infertility on men's penile erectile function., Methods: Using the 5-item version of the International Index of Erectile Function (IIEF-5), we investigated the penile erectile function among 245 infertile men (infertility group) and another 52 males having physical checkup for planned conception (checkup group), the former further divided into four subgroups according to the factors of infertility: male factor, female factor, bilateral factor, and unknown factor. We compared the total and item scores of IIEF-5 among different groups., Results: Mild or mild-moderate ED was found in 50.61% of the infertile men, with a total IIEF-5 score of 21.24 +/- 2.58. The total and item scores of IIEF-5 were markedly higher in the male factor than in the female factor subgroup (P < 0.01), but with no significant difference between the male factor subgroup and the bilateral and unknown factor subgroups (P > 0.05), except the score on confidence. The scores were significantly lower in the bilateral and unknown factor subgroups than in the female factor subgroup (P < 0.05), with no remarkable difference between the former two. In the infertility group, the total and item scores of IIEF-5 were markedly higher in those with education above high school than in those with high school or lower education (P < 0.01), but not correlated with age and infertility duration. After adjustment for education background, the total IIEF-5 score and the scores on confidence and satisfaction were significantly lower in the infertility than in the checkup group (P < 0.05), and 15.38% of the men in the latter group had mild ED, dramatically lower than in the former (P < 0.01)., Conclusion: Perceived infertility may cause ED in males, and a higher incidence rate is associated with lower education background of the men.

Objective: To investigate the treatment effect on penile erectile function after lumbar discectomy in different age groups of men., Methods: We included in this study 90 male patients with intervertebral disc herniation treated by lumbar discectomy, who were divided into three age groups of equal number: groups A (< 45 yr), B (45 - 55 yr) and C ( > 55 yr). We obtained the IIEF-5 scores of the patients preoperatively and at 12 months after surgery., Results: The IIEF-5 scores at 12 months after surgery were 21.3 +/- 3.3, 16.8 +/- 1.3 and 14.1 +/- 1.0 in groups A, B and C, respectively, significantly higher than 10.4 +/- 2.6, 10.7 +/- 2.8 and 11.2 +/- 1.9 preoperatively (P < 0.05). Group A showed better improved erectile function than B and C ([51.17 +/- 6.25 ]% vs [36.31 +/- 4.28]% and [22.71 +/- 5.68]%, P < 0.05)., Conclusion: Penile erectile function of the male patient is one of the major factors in evaluating lumbar discectomy for intervertebral disc herniation. Early decompression surgery according to different etiological factors is very important for erectile function recovery in the young and middle-aged male patients.

Objective: To investigate the epidemiology of late-onset hypogonadism (LOH) in old and middle-aged males in the rural area of Southern China., Methods: Using the age-stratified sampling method, we conducted a questionnaire investigation on androgen deficiency in aging males (ADAM), aging male symptoms (AMS) and IIEF-5 among 996 males aged 40 -80 years in a rural community of Jiashan county, Zhejiang Province from April to October 2012. We also determined the concentrations of serum total testosterone (TT), serum sex hormone binding globulin (SHBG) and serum albumin (ALB), detected the levels of free testosterone (cFT) and bio-available testosterone (Bio-T) by Vermeulen formula, and measured the volumes of the prostate and testis by ultrasonography., Results: The mean age of the males was 56.22 +/- 8.82 years. The positive rates of LOH were 62.86% and 23.05% based on ADAM and AMS, respectively, and the incidence of erectile dysfunction (ED) was 68.83%. There were significant differences among different age groups in the levels of luteinizing hormone (LH), SHBG, cFT and Bio-T, but not in TT concentration., Conclusion: Ours was the first survey on the epidemiology of LOH among old and middle-aged males in the rural area of China. The incidence of LOH in the rural community of Zhejiang Province was lower than that in the urban areas reported in other studies, but the positive rate of ED showed no significant difference.

Objective: To investigate and compare the prevalence of erectile dysfunction, hyposexuality and ejaculation disorder among middle-aged and older males in the urban and suburban areas of Beijing., Methods: Using the random sampling method, we selected 1 656 men aged > or = 50 years from 15 communities in Beijing. We recorded their scores on the International Index of Erectile Function-5 (IIEF-5) and Brief Male Sexual Function Inventory for Urology (O'Leary 1995), and analyzed the obtained data using SPSS 17.0., Results: Totally, 1 644 of the subjects were qualified for the study, 1 244 from the urban area and the other 400 from the suburbs. The median scores on IIEF-5, sexual desire and ejaculation were 5, 2 and 4 in the urban males as compared with 13, 2 and 5 in the suburban men, with statistically significant differences between the two groups (P < 0.01). The IIEF-5 score was significantly correlated with age, diabetes, cardio-cerebrovascular diseases, drinking and administration of 5alpha-reductase inhibitor in both the urban and suburban groups (P < 0.01)., Conclusion: The sexual function of the middle-aged and older males is better in the suburbs than in the urban area of Beijing. The main reasons might be the lower incidences of diabetes and cardio-cerebrovascular diseases, moderate drinking and less use of 5alpha-reductase inhibitor among the suburban men.

Objective: To explore the clinical features and related factors of sexual dysfunctions in male patients with pituitary adenomas., Methods: The questionnaires of sexual functions were collected from 86 male patients with pituitary adenomas. We examined the clinical features of sexual dysfunctions and analyzed the correlations between sexual behaviors and age, tumor type, invasiveness, tumor size, serum levels of prolactin (PRL) and testosterone., Results: The incidence of sexual dysfunctions was 80.2% (69/86). Sexual dysfunctions were found in 84.6% (66/78) of the patients with functioning pituitary adenomas and 37.5% (3/8) of those with non-functioning pituitary adenoma respectively. In the PRL group, the incidence of erectile dysfunctions was 92.1% (35/38) and it was higher than those in the FSH (follicle-stimulating hormone) and GH (growth hormone) groups (P < 0.05). In the FSH group, the incidence of reduced sexual desire was 78.3% (18/23). In the GH group, the incidence of erectile dysfunctions was 70.6% (12/17) and the incidence of reduced sexual desire or ejaculation dysfunction was lower than that of the PRL/FSH group (P < 0.05)., Conclusion: The incidence of sexual dysfunctions is quite high in males with pituitary adenomas, especially for those with functioning pituitary adenomas. The clinical features of sexual dysfunctions vary in different types of functioning pituitary adenoma. The incidence of erectile dysfunctions is the highest in the PRL group. Pathological type of pituitary tumors is a major risk factor of sexual dysfunctions.

Objective: To investigate the prevalence of erectile dysfunction (ED) in men with high-normal blood pressure (HNBP)., Methods: This study included 120 men with HNBP and another 120 with normal blood pressure (NBP) as controls. We analyzed the scores of the two groups on the International Index of Erectile Dysfunction 5 (IIEF-5)., Results: The ED prevalence in the men with HNBP was 25.8%. After controlling for age, nationality, occupation, education, income, smoking, alcohol consumption, exercise, obesity, fatty liver, blood lipids, blood glucose, and blood uric acid, the incidence of ED was 25.8% in the HNBP group, significantly higher than 14.2% in the NBP group (P<0.05)., Conclusion: The prevalence of ED is higher in men with HNBP than in those with NBP.

Objective: To survey the incidence of lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in males aged ≥ 50 years and explore the correlation between LUTS and ED., Methods: A cross-sectional study was performed at Beijing communities in 1644 males aged over 50 years. The International Index of Erectile Function-5 (IIEF-5) and International Prostate Symptom Score (IPSS) were recorded. Pearson's χ(2) test and Spearman correlation coefficients were used to analyze the results of IPSS, LUTS and their correlations with ED., Results: The mean age was 64.5 years old (range: 50-93), the mean value of IPSS(9.9 ± 8.2), the prevalence of mild, moderate and severe LUTS 49.2% (809/1644), 36.4% (599/1644) and 14.4% (236/1644) respectively. The mean value of IIEF was (9.4 ± 8.6), the total incidence of ED 90.5% (1487/1644) and the incidence of ED of mild, moderate and severe LUTS 85.7% (694/809), 93.7% (561/599) and 97.9% (231/236) respectively. The total IIEF-5 score was found significantly correlated with the total IPSS score (r = -0.335, P < 0.01), the obstructive symptoms (r = -0.276, P < 0.01)and irritative symptoms (r = -0.326, P < 0.01). The severity of LUTS was correlated with the severity of ED (r = 0.304, P < 0.01). Correlations also existed between age and total IPSS score(r = 0.388, P < 0.01), LUTS severity (r = 0.457, P < 0.01), total IIEF score (r = -0.533, P < 0.01) or ED severity (r = 0.529, P < 0.01)., Conclusion: The incidence of LUTS or ED in aging males increases with age. The severity of ED is positively correlated with the severity of LUTS. Irritative and obstructive symptoms influence the occurrence of ED in aging males.

Objective: To investigate the prevalence of hyposexuality, erectile dysfunction (ED) and defective ejaculation (DE) in the old and middle-aged males in Pingliang area., Methods: This investigation included 1 539 men aged > or = 50 years from 6 urban districts and 20 villages in the suburbs of Pingliang City, Gansu Province. We recorded and analyzed their scores on IIEF-5 and Brief Male Sexual Function Inventory for Urology (O'Leary 1995)., Results: A total of 1 230 subjects met the investigation criteria. They averaged 62.5 +/- 9.6 years of age (range 50-89 years), and were divided into four age groups: 50-59, 60-69, 70-79 and > or = 80 years. The mean scores on IIEF-5 were 0-25 (9.4 +/- 8.6), sexual desire 0-8 (2.3 +/- 2.1), and ejaculation 0-8 (3.6 +/- 3.0). Hyposexuality, ED and DE were defined as sexual desire score < or = 2, IIEF-5 score = 0-21, and ejaculation score < or = 2, respectively. Based on these criteria, the incidence rates of hyposexuality, ED and DE were 57.96%, 92.27% and 36.91%, respectively, with statistically significant differences among different age groups (P < 0.01)., Conclusion: The prevalence of ED, hyposexuality and DE, particularly the incidence of ED, is positively correlated with the increase of age in the old and middle-aged males in Pingliang area.

Objective: To assess the mean age of sexual activity termination, the prevalence of erectile dysfunction (ED), and their related factors in the old male population in Beijing., Methods: We included in this study 764 males aged over 60 years old received in the health examination clinic and investigated the prevalence of ED and the related factors using the sexual health assessment resource (SHARE) and IIEF-5 questionnaires., Results: The average age of sexual activity termination (no sexual intercourse in over 2 years) was 68.4 +/- 5.2 years among the subjects. The prevalence of ED was 89.4% , of which the rates of mild, moderate and severe ED and non-sexuality were 6.7, 18.6, 28.4 and 35.7% , respectively. Those who had no sexual intercourse for over 2 years because of severe ED accounted for 26.8% among the 60-64 years old males and more than 50% in the >70 yr group. The main risk factors for ED-induced sexual activity termination included age, diabetes, cardiovascular and cerebrovascular diseases, obesity, and low urinary tract symptoms (LUTS)., Conclusion: ED is a common problem as well as the main risk factor for sexual activity termination, and age and general health status are significantly associated with the prevalence of ED among aging males.

Objective: To investigate the prevalence and characteristics of sexual dysfunction in patients with chronic prostatitis (CP) in the high altitude area., Methods: A total of 637 CP patients randomly recruited from different urologic clinics were divided into 4 groups according to their living altitudes. The subjects were scored on the National Institute of the Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Index of Erectile Function-5 (IIEF-5), the Chinese Index of Sexual Function for Premature Ejaculation (C-ISFPE) and the questionnaire on ejaculatory difficulties from the University of Washington Symptom Score., Results: In the 637 CP patients, the overall incidences of premature ejaculation (PE), erectile dysfunction (ED) and difficult ejaculation (DE) were 28.4%, 17.6% and 23.9%, respectively, 9.9% with PE, ED and DE simultaneously. With the increase of the living altitude, the scores on IIEF-5 (P = 0.032) and C-ISFPE (P = 0. 047) were obviously decreased, and the incidences of PE (P = 0.047), ED (P = 0.046) and DE (P = 0.019) markedly elevated. Those with PE or ED experienced worse symptoms at a higher altitude (r = 0.249 or 0.267, P < 0.05). The differences were all statistically significant., Conclusion: The prevalence and severity of sexual dysfunction are positively correlated with the living altitude among CP patients.

Objective: To investigate the epidemiological changes of erectile dysfunction (ED) patients in the past five years., Methods: In 2003 and 2008, we conducted two questionnaire investigations on the epidemiological changes of ED outpatients in 11 Chinese cities in such aspects as age, disease course, ED severity, smoking and drinking habits, accompanying hypertension, diabetes and coronary heart disease (CHD), and sexual intercourse satisfaction., Results: According to the valid copies of the questionnaire collected (808 in 2003 and 858 in 2008), the age pattern of the ED patients hardly changed in the past five years, over 60% aged 30 - 50 years. Compared with the results obtained in 2003, the second investigation showed obvious increases in the following numbers of the ED patients: by 13% in those with longer disease courses (5 - 10 yr), from 24.1 to 42.9% in those with moderate ED, from 20.4 to 29.9% in those with severe ED, by at least 10% in those with smoking and drinking habits, from 11.5 to 16.2% in those with hypertension, from 9.4 to 13.5% in those with diabetes, and from 57.6 to 73.3% in those without sexual satisfaction, while the number of those with CHD did not change significantly., Conclusion: Increased unhealthy living habits and erectile function impairing diseases have added to the incidence and severity of ED. There is still much work to be done in the prevention and early treatment of ED.

Objective: To investigate the incidence of lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in men aged > or = 50 years and to achieve the correlation between LUTS (obstructive symptoms and stimulant symptoms) and ED., Methods: We investigated 245 men aged > or = 50 years and with regular sex mates using International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5), designed diagnostic interrogation and medical examination, and statistically analyzed the results of IPSS, IIEF-5, LUTS and their correlation with erectile function., Results: The incidence of ED was 81.9% (140/171) among the men with LUTS, 73.1% (38/52), 82.1% (46/56) and 88.9% (56/63) respectively in the 50-59, 60-69 and > or = 70 age groups, with significant differences in IPSS, IIEF-5 (P < 0.01) and the severity of ED (P < 0.01) among different age groups. ED incidence was found significantly correlated with the severity of LUTS (r = 0.52, P < 0.01), 71.3% (57/80), 89.6% (60/67) and 95.8% (23/24) respectively in the groups of mild, moderate and severe LUTS. The mean scores on obstructive and stimulant symptoms were (3.1 +/- 3.6) and (6.8 +/- 4.9), and their correlation coefficients with IIEF-5 were r = -0.41 (P < 0.01) and r = -0.59 (P < 0.01), respectively., Conclusion: The incidence of ED is high in men with LUTS and positively correlated with the severity of LUTS. Stimulant symptoms have greater influence than obstructive symptoms on the sexual life of old and middle-aged males.

Objective: To investigate the influence of chronic prostatitis on premature ejaculation (PE) and erectile dysfunction (ED) and the correlation of chronic prostatitis with PE and ED., Methods: We adopted NIH-CPSI, CISFPE and IIEF-5, interviewed 623 patients with chronic prostatitis, and recorded their scores on the above systems., Results: The incidence of PE was 39.0% and the rates of the mild, moderate and severe types were 26.2%, 12.0% and 0.8%, respectively. It developed mostly among the younger patients, accounting for 42.9% (103/240), 37.0% (95/257) and 35.7% (45/126) in the 18-30, 30-40 and 40-57 yr age groups, respectively. The incidence of ED was 16.9% and the rates of the mild, moderate and severe types were 14.9%, 1.0% and 1.0%, respectively. It occurred mostly among the older patients, accounting for 13.8% (33/240), 11.3% (29/257) and 34.1% (43/126) in the 18-30, 30-40 and 40-57 yr age groups, respectively. Analyses revealed no significant correlation among the scores on NIH-CPSI, CISFPE and IIEF-5., Conclusion: There is a high incidence of PE and ED among patients with chronic prostatitis, but without significant correlation between the severity of chronic prostatitis and that of PE and ED.

Objective: To study the impacts of kidney transplantation on erectile function and analyse its contributing factors., Methods: In order to evaluate the severity of erectile dysfunction (ED), a total of 250 married male kidney transplant recipients (KTR) with functioning graft were assessed with the International Index of Erectile Function (IIEF) questionnaire. Data of clinical characteristics, medical and sexual history and laboratory examination were collected. Univariate and multivariate logistic regression analyses were carried out to determine which have independent impacts on erectile function., Results: The investigation was accomplished in 84.8% of the KTRs. There was no significant difference in ED incidence before and after renal transplantation (53.8% vs. 44.3%, P > 0.05). According to the IIEF score, erectile function improved in 43.9% of the KTRs, remained unchanged in 42.9%, and deteriorated in 13.2%, as compared with pre-transplantation. Logistic regression analysis showed that significant and independent influencing factors in erectile function were age, hemoglobin level, presence of DM and/or peripheral neuropathy and iterative transplantations, and their relative risks were 3.01, 2.01, 3.15, 3.89 and 2.67, respectively., Conclusion: ED is highly prevalent among KTRs and its pathogenesis is multifactorial. Age, presence of DM and/or peripheral neuropathy, hemoglobin level and iterative transplantations were chief contributing factors in erectile function.

The quality of sexual life is important for renal transplantation recipients. With the increase of survival rate of renal transplantation, the quality of the male recipients' sexual life, especially their erectile function, has been generally remarked. The prevalence of ED is 35.8%-78.3% in male allograft renal transplantation recipients. And it can be caused by various factors, such as age, dialysis time, modus operandi, hemoglobin level, deprementia, immunosuppressant, and diabetes. We give an overview of the therapeutic options for ED in this special population. Sildenafil is effective and safe. If the oral drug fails, we can choose intracavernosal injection and penile prosthesis implantation. Nevertheless, three-piece prostheses should be avoided.

Objective: To evaluate the effect of Long-term exposure to low intensity microwave radiation on male reproductivity., Methods: A total of 289 married male radar operators were included in the radar group and 148 married men unexposed to microwave radiation were enrolled as controls. Questionnaires were used and the intensity of microwave radiation in different working areas was detected., Results: The rate of sexual dysfunction was 43.6% in the radar group and 24.4% in the control group (P < 0.01). The natural pregnancy rate was 53.6% within 1 year of marriage and 46.4% after 1 year of marriage in the radar group, as compared with 81.1% and 18.9% in the control group (P < 0.01)., Conclusion: Long-term exposure to low intensity microwave radiation evidently increased the sexual dysfunction rate and decreased natural pregnancy rate in men.

Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are highly prevalent in aging men and both of the conditions have a significant impact on the quality of life. In the past few years, various epidemiological trials were conducted to assess the association between LUTS and ED. These studies showed that LUTS, particularly the voiding symptoms, nocturia and the others caused by LUTS, independently increased the incidence of ED. There are some factors involved in the link between LUTS and ED: (1) rho-kinase expression/activity increased; (2) nitric oxide release decreased and corpus cavernosum smooth muscle contraction strengthened due to endothelin-1; (3) the composition of myosin isoform altered; (4) sympathetic hyperactivity and innervation of the corpus cavernosum smooth muscles decreased. These findings concerning the relationship between LUTS and ED have offered some new insights into the evaluation and treatment of patients with these conditions. The present paper briefly reviews the recent studies of the association between LUTS and ED.

Objective: The aims of Asian Men's Attitudes to Life Events and Sexuality (Asian MALES)-China study were to identify the prevalence of erectile dysfunction (ED) and related health concerns in the general male population in China, and to examine the attitudes and behaviors of men in relation to these health issues., Methods: A total of 2055 men aged 20-75 years were included in Phase-I MALES study using a standardized questionnaire, and another 225 recruited from the sub-sample of Phase-I MALES participants with reported ED and some ED patients from other sources were involved in Phase-II Asian MALES- China study, with the prevalence of ED and men's associated attitudes as the main measure., Results: The overall rate of ED in the Asian MALES-China sample was 5.9%. The rate of self-reported ED rose with age increase. A higher rate of ED was reported in men with co-morbid medical conditions and risk factors, including cardiovascular disease, hypertension, dyslipidemia, and depression, and so were the rates of these co-morbid conditions in ED patients. Data from Phase-II Asian MALES-China indicated that among men with reported ED, only 17% would seek treatment., Conclusion: The rate of ED is high in Chinese men and it is associated with co-morbid conditions. For Chinese men, it is necessary to know more about ED and to seek safe and effective treatment of its symptoms.

Objective: To investigate the characteristics of erectile dysfunction (ED) in old males with lacunar infarction., Methods: A total of 38 old patients ages from 60 to 70 years were involved. The questionnaire of international index of erectile function 5 (IIEF -5) was used to determine the status and severity of ED. According to the focus of infarction on MRI, the patients were divided into two groups, Group I with lacunar infarction and minor neurological deficits, and Group II with none. The total IIEF-5 scores were compared between the two groups and repeatedly evaluated six months after discharge., Results: According to the total scores of IIEF-5, the prevalence of ED in Group II (95%) was higher, and the incidence of severe ED was significantly increased (60.0% vs. 44.4%, P < 0.05) as compared with Group II. In both the two groups, severe ED was more often seen in diabetic patients. At six months after discharge, the total scores of IIEF-5 were significantly increased (11.2 +/- 3.2 vs. 15.6 +/- 2.2, P < 0.05)., Conclusion: ED is significantly increased in old males with lacunar infarction, and it is more severe in diabetic patients. Post-stroke rehabilitation care helps to improve ED.

Hyperlipidemia is one of the risk factors leading to erectile dysfunction (ED), a common disorder in men, especially in old men. Epidemiological studies have found that the decrease in high density lipoprotein (HDL) and elevation of total cholesterol/high density lipoprotein (TC/HDL) are correlated with ED. Studies have also shown that arterial stenosis and occlusion caused by hyperlipidemia could be attributed to the advanced-stage mechanism of ED induced by hyperlipidemia. Hyperlipidemia may damage man's erectile function at an early stage by affecting the endothelial cells and smooth muscles of the penis and the peripheral nerves for penile erection. Apart from dietary therapy and drug therapy aiming at hyperlipidemia, the traditional Chinese medicine therapy and gene therapy are two promising approaches to the treatment of ED caused by hyperlipidemia.

Erectile dysfunction is common complication of diabetes mellitus. The incidence of diabetes mellitus induced erectile dysfunction (DMED) is 20% - 75%. DMED appears to be due to vascular-neuropathic and corpus cavernosum smooth muscular damage. To control blood glucose, blood pressure and blood lipids is the basis of DMED therapy. In 50% of the patients with DMED, the phosphodiesterase 5 inhibitors is effective, while intracavernous pharmacotherapy is effective for more than 90%. Penile prosthesis implantation continues to be the treatment of choice in case of other therapy failure.

Objective: To investigate the knowledge of and attitude to sexual dysfunction in aged men, and to discuss the status and needs of male healthcare., Methods: Two thousand seven hundred and twenty-eight men (40-70 years old) were surveyed on sexual dysfunction using the randomized questionnaire in Xicheng District, Beijing., Results: The prevalence of erectile dysfunction (ED) was 41.2%, and only 12.1% ED patients were to see the doctor. 52.4% aged men thought the sexual life was important or very important during the life, and 55.6% thought ED would exert negative impact on the quality of life and the partner relationship. Although 27.4% knew that ED was a kind of disease, 49.0% thought ED was a nature rule. Compare to the 41.2% ED prevalence, only 9.7% male were dissatisfied with their sexual life, and later ratio was 14.1% among the partner., Conclusion: In China, the status of the knowledge of and attitude to sexual dysfunction in aged men was unsatisfactory to some extent. There is a lot of work to do especially in sexual healthcare education and improvement on diagnostic and treatment of sexual dysfunction.

Objective: To investigate the correlative factors affecting the IIEF-5 scores of the patient with type 2 diabetic mellitus (T2DM)., Methods: A total of 149 T2DM patients were investigated for the relationships between their IIEF-5 score and such factors as age, body mass index (BMI), fasting plasma glucose (FPG), 2hPG, insulin (INS), GHbA1c, C-peptide, nitric oxide (NO), testosterone (T), estradiol (E2), the ratio of testosterone to estradiol (T/E), erythrocyte aldose reductase (AR), drinking, smoking, concomitant diseases, complications and medication., Results: The scores of the groups of smoking, complication, medication and concomitant disease were significantly lower than those of the controls. There was significant negative correlation between IIEF-5 scores and age, BMI, FPG, 2hPG, INS, GHbA1c and AR (P < 0.05), and significant positive correlation between IIEF-5 scores and NO (P < 0.05). But there was no correlation between drinking, T, E2 and T/E2 (P > 0.05)., Conclusion: Many factors may affect the IIEF-5 scores of T2DM patients.

Objective: To evaluate the degree of sexual dysfunction in an unselected population of men with benign prostatic hyperplasia (BPH) accompanied by lower urinary tract symptoms (LUTS), and to assess the correlation between sexual dysfunction and urinary symptoms and age., Methods: A total of 88 men with symptomatic BPH were investigated using the International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), Brief Sexual Function Inventory (BSFI), and the measurement of urinary flow rate, the total prostatic volume and serum testosterone. Regression analysis was used to determine the correlation among the variables., Results: The mean age of the patients was (67.90 +/- 7.59) years, the mean IPSS score was (18.4 +/- 7. 79), and the mean IIEF-5 was (8.50 +/- 8.98). There were 76 cases of erectile dysfunction (86.36%). Among the BSFI scores, the mean sexual drive score was (1.92 +/- 2.21), the mean erectile function score was (4.18 +/- 4.96), the mean ejaculation score was (2.55 +/- 3.57), the mean problem assessment score was (10.44 +/- 3.57), and the mean overall satisfaction score was (1.90 +/- 1.37). Among the 88 cases, 65 (72.86%) had poor sexual drive, 70 (79.55%) erectile dysfunction, and 60 (68.18%) poor ejaculation. There was statistically significant correlation between age and sexual symptom scores for erection (gamma = -0.552, P = 0.000), IIEF-5 scores (gamma = - 0.567, P = 0.000), and IPSS (gamma = 0.213, P = 0.047) as well as between IPSS and sexual symptom scores for erection and overall satisfaction (gamma = -0.332, P = 0.002 and gamma = -0.302, P = 0.005). IIEF-5 scores were significantly correlated with sexual symptom scores for each of the three categories (sexual drive, erection and ejaculation) (P < 0.05). Serum testosterone did not correlate to age, IIEF-5 scores and sexual function (P > 0.05), nor did peak urinary flow rate and total prostatic volume to IPSS, IIEF-5 scores and sexual function (P > 0.05)., Conclusion: Results of this study suggest that age and LUTS are risk factors of sexual function, and sexual dysfunction is closely related to the severity of LUTS.

Objective: To understand the state of health of the middle-aged and old males in Jiangsu Province., Methods: A total number of 3 551 middle-aged and old males aged 46 approximately 69 years were randomly selected from 13 counties of Jiangsu Province. All of them received physical examinations, including laboratory tests of liver and kidney function, sugar and cholesterols, radioimmunoassay of testosterone and free testosterone levels in the serum, and B-ultrasonic examination of the prostate volume and remaining urine. They also underwent inquiries according to the International Index of Erectile Function (IIEF-5) and the questionnaire for PADAM (partial androgen deficiency of the aging male)., Results: The prostate volume differed significantly (P < 0.05), while the testosterone level showed no significant difference in different age groups (P > 0.05). The level of the free testosterone in the serum descended with the increase of age. The incidence of ED and PADAM was also correlated with the increase of age., Conclusion: In the old and middle-aged population of males, with the increase of age, sexual function decreases, the prostate volume enlarges, and the incidence of ED and PADAM obviously increases (P < 0.001).

Objective: To achieve the correlation between abnormal serum lipid and male erectile dysfunction (ED)., Methods: Randomly selected were 200 male patients abnormal at least in one of the four laboratory items: total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL). Their erectile function was evaluated by IIEF-5, and the correlation was studied between abnormal serum lipid and ED., Results: The incidence of ED was 47% in these patients. Age, coronary heart disease (CHD), high serum glucose, benign prostatic hyperplasia (BPH), drug, hypertension were negatively, while HDL was positively correlated with erectile function. Age, CHD, BPH and TC/HDL ratio were risk factors of ED, while HDL was a preventive one., Conclusion: Hyperlipidemia is an important factor of ED. HDL and TC/HDL ratio are good predictors of ED.

Objectives: To probe into the pathogenesis, prevention and treatment way of diabetic erectile dysfunction (DED)., Methods: The age, course, blood pressure, history of drink and smoke, relationship with DED were investigated in 126 DED patients of 320 diabetes mellitus., Results: The prevalence of DED in male diabetic patients was 39.4% (126/320). It was found by the analysis of Logistic regression that the values of OR rise to 1.8467, 1.2614, 1.4508, 1.3212, 1.2065, 5.3464 (P < 0.01), along with adding of 5 years in course, 10 years in ages, 2% in HbA1C, 4 kPa in systolic blood pressure, positive history of smoking and drinking respectively., Conclusions: Drinking is the most dangerous factor among all risk factors for occurrence of DED. It is very important to control blood pressure well, and to give up tobacco and drink in preventing occurrence of DED.

Male sexual function requires an intricate interplay between the man and his environment. Cognitive integration and physiological response to sexual stimulation is dependent on complex neurologic functions that may be impaired by central or peripheral neurologic disorders. This article reviews the normal neuroanatomy of sexual functioning in men, and the epidemiology, pathophysiology and management of sexual dysfunction in spinal cord injury, cerebrovascular accident, multiple sclerosis and Parkinson's disease.

Objectives: The physicians knowledge and attitude to erectile dysfunction (ED) is very important to the diagnosis and management of this disease. We investigated the physicians and practitioners knowledge of ED, attitude to ED, and if they actively find the underlying ED patients., Methods: Three hundreds and one physicians and practitioners in Beijing completed a questionnaire. The subjects included urologists, cardiologists, endocrinologists, surgeons, orthopaedicians and community practitioners., Results: The definition of ED was well known by most subjects (83.4%). Many agreed that ED was a common condition in the aging men (85.0%), and it was an important health problem (78.7%) and it was the local signs of certain systemic diseases (89.7%). The most common risk factors of ED enumerated by the physicians were diabetes (45.5%), hypertension (12.6%) and coronary artery diseases (12.0%). 45.5% physicians met the patients who initiated questions about ED. 32.6% physicians would discuss ED with the patients if the patients initiate questions about ED. 95.0% non-urological physicians would refer the ED patients to urologists or andrologists. 43.5% of all the physicians never asked their patients about erectile function, this proportions in the subgroups of urologists, non-urological physicians and community practitioners were 7.2%, 55.3% and 60.5% respectively (P < 0.01). The most common reasons for the physicians not to initiate the inquiries about ED was "the patients would not have ED if they didnt complain about it" (42.2%), "there was no ED patients in my specialty" (20.9%), "diagnosis and treatment of ED was not my business" (17.3%), "have no time" (15.6%), "feel embarrassed" (13.6%)., Conclusions: Most physicians regarded ED as an important health problem and a common condition in aging men, but they didnt take an active attitude to ED in their clinical practice.