History - Erectile dysfunction

From CambridgeNotes

History of Presenting Complaint

Psychogenic Organic
Onset sudden/life event gradual
Quality early collapse no tumescence
Variability specific situations all the time
Waking/night erections good quality/ “better” altered
Ejaculation premature/ inability normal
Libido normal/↓
  • Pain or deformity
  • Symptoms of depression: early morning waking, mood

Past Medical History

  • Cardiovascular, neurological, endocrine including diabetes mellitus
  • Operations, radiotherapy, trauma to pelvis or scrotum
  • Psychological problems

Drug and Allergy: (see below)

Personal and Social History

  • Smoking, alcohol, recreational or body building drugs
  • Problems or changes in relationship, major life events

ICE

  • "Why are you presenting now?"
  • "What do you think is the cause?"
  • "What have you tried?"
  • "Does your partner know? What is partner’s attitude?"
  • "What do you hope to gain?"

Differential Diagnosis

  • Organic (66%): Vascular (including hypertension) > diabetes > surgical > drugs (antihypertensives, TCA, SSRI, MAOi, benzodiazipines, cimetidine)
  • Psychological (27%); Mixed (7%)

References

  1. (EDA guidelines 2000)
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