Department of Urology, Third Xiangya Hospital of Central South
University, Changsha 410013, Hunan Province, China
Objective: To assess the pathophysiological composition and age structure of erectile dysfunction (ED) in men visiting
outpatient clinics in China.
Methods: We studied 3327 consecutive ED outpatients (median
age 39 years) during 2006 and 2010 in the five training hospitals
in China. Every patient was independently evaluated by an
experienced urologist/andrologist based on comprehensive
diagnostic procedures. The simplified International Index of
Erectile Function (IIEF-5) was used to assess the severity of ED.
Results: Most patients (95.0%) were younger than 60 years,
and none was older than 70 years. Psychogenic patients were
younger (36.53 years) and had greater percentage (56.1%) than
any other patients. Vasculogenic factors were the major etiology
of organic ED (20.1%). There was a significant difference in age
composition between the patients with psychogenic ED and
organic ED (P=0.000). Diabetes, hypertension, coronary artery
disease, and hyperlipidaemia played significant roles in affecting
the severity of ED in a statistical model including age. The IIEF
scores decreased with age (rs=–0.199, P=0.000). Moreover,
the percentage of severe and moderate cases increased with age
(P=0.003, P=0.002, respectively), yet the constituent ratio of
patients sharply declined from 30.3% to 4.5% with age.
Conclusions: More men visit outpatient clinics due to
psychological ED rather than organic causes. The age composition
of Chinese ED patients who seek medical help is relatively young
due to inadequate sex education. Most elderly ED patients are
reluctant to go to hospital just for the loss of erectile function.