Delay in seeking medical help in patients with new-onset erectile dysfunction remained high over and despite the PDE5 era--an ecological study

J Sex Med. 2012 Dec;9(12):3239-46. doi: 10.1111/j.1743-6109.2012.02953.x. Epub 2012 Oct 11.

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.

Conclusions: 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.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Comorbidity
  • Educational Status
  • Erectile Dysfunction / drug therapy*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Phosphodiesterase 5 Inhibitors / therapeutic use
  • Regression Analysis
  • Severity of Illness Index
  • Time-to-Treatment*
  • Young Adult

Substances

  • Phosphodiesterase 5 Inhibitors