Heart disease and erectile dysfunction: Management at a nurse-led clinic

Background: Erectile dysfunction has an estimated prevalence of 10% in all sexually active men. Aetiological features include neurovascular disease and psychological distress. The authors’ clinical impression was that men with hear t disease were not offered any intervention for erectile dysfunction at all whereas men with prostate disease were.

Aim: To per form a retrospective analysis of men who had sought treatment for erectile dysfunction at the east London nurse-led sexual dysfunction clinic in the last 22 months.

Methods: A retrospective comparative analysis was made of the time it took different groups of men to seek treatment. The authors identified 96 patients who met the inclusion criteria for a diagnosis of erectile dysfunction. A search of all clinical notes of men seen in the erectile dysfunction clinic was conducted by hand.

Main outcome measure: Demographic and clinical data were collected from the clinical notes. The source of referrer, previous treatment and reasons for delay in seeking treatment were identified. The data were compared with men presenting to the same clinic but with a history of prostate cancer treatment only.

Results: The mean age of men attending the clinic for advice was 62.2 years and 61% of patients with cardiac disease and 5% with prostatic disease had not tried any treatment for erectile dysfunction. After referral and assessment only 12% declined active therapy for erectile dysfunction.

Conclusions: On average men who attend the clinic for advice had not had successful sexual activity for about 41.7 months. The reasons cited for delay in seeking help were embarrassment and because the subject was not brought up by health professionals. The authors believe that the subject of erectile dysfunction should be broached with patients, and referral pathways should be developed to facilitate an improvement in sexual function.