An Evidence-Based Perspective to Commonly Performed Erectile Dysfunction Investigations
- 1 July 2008
- journal article
- review article
- Published by Oxford University Press (OUP) in The Journal of Sexual Medicine
- Vol. 5 (7), 1582-1589
- https://doi.org/10.1111/j.1743-6109.2007.00665.x
Abstract
Currently there is no universally accepted gold standard diagnostic test to differentiate psychogenic from physical erectile dysfunction (ED). Instead, sexual health specialists rely on a detailed history, a focused physical examination, and specialized diagnostic tests, to decide if the etiology of the ED is mainly psychogenic or organically caused. Aim. In this review we point out the status of evidence-based principles in the area of diagnosis in Sexual Medicine. We review the concepts of evidence-based medicine (EBM) in the area of medical diagnostic tests. We highlight four of the well-known diagnostic tests (penile duplex, pharmacoarteriography, pharmacocavernosometry/cavernosography [PHCAS/PHCAG], and nocturnal penile tumescence [NPT monitoring]) for ED evaluation within an evidence-based perspective. Assessment of diagnostic tests for ED using principles of EBM. Several good diagnostic tests are useful in the evaluation of men with ED. However, modern evidence-based concepts-mainly the likelihood ratio-have not yet been applied to these tests to obtain their maximum clinical benefits. While penile duplex/color Doppler has good evidence of supporting its use in the diagnosis of arteriogenic ED, data supporting its diagnosis of a physical disorder associated with cavernous venous occlusion dysfunction are lacking. PHCAS/PHCAG's main drawback is an unknown positive predictive value and a possibility of frequent false-positive results. NPT has many advantages when differentiating psychogenic from organic ED, however, several questions related to its physiological mechanisms do exist. Ghanem H, and Shamloul R. An evidence-based perspective to commonly performed erectile dysfunction investigations.Keywords
This publication has 38 references indexed in Scilit:
- Erectile Dysfunction: Monitoring Response to Treatment in Clinical Practice—Recommendations of an International Study PanelThe Journal of Sexual Medicine, 2007
- Development and Validation of the Quality of Erection QuestionnaireThe Journal of Sexual Medicine, 2007
- Comparison of the International Index of Erectile Function erectile domain scores and nocturnal penile tumescence and rigidity measurements: does one predict the other?BJU International, 2006
- Peak Systolic Velocities May Be Falsely Low in Young Patients with Erectile DysfunctionThe Journal of Sexual Medicine, 2006
- Sleep-related erections: Clinical perspectives and neural mechanismsSleep Medicine Reviews, 2005
- Summary of the Recommendations on Sexual Dysfunctions in MenThe Journal of Sexual Medicine, 2004
- Clinical Evaluation and Management Strategy for Sexual Dysfunction in Men and WomenThe Journal of Sexual Medicine, 2004
- Correlation between penile duplex findings and stress electrocardiography in men with erectile dysfunctionInternational Journal of Impotence Research, 2004
- Correlation of penile duplex ultrasonography, PBI, DICC and angiography in the diagnosis of impotenceInternational Journal of Impotence Research, 1998
- Comparison of Rigiscan and Sleep Laboratory Nocturnal Penile Tumescence in the Diagnosis of Organic ImpotenceJournal of Urology, 1995