Distribution of psychogenic and vascular impotence in a tertiary health-care center's cohort: A retrospective study using penile Doppler imaging.

PURPOSE: In this study, we retrospectively reviewed the penile color Doppler ultrasound (PCDU) scans of the patients who had admitted to our clinic with erectile dysfunction and aimed to evaluate the contribution of penile Doppler scan results to the clinical decisions.

MATERIAL-METHOD: The data of patients admitted to our outpatient clinic with complaints of erectile dysfunction (IIEF-5 score<22 or IIEF-EF score<26) between January 2005 and January 2018 were retrospectively evaluated. Patients whose testosterone level is lower than 280ng/ml or who had undergone radical prostatectomy were excluded from the analysis.

RESULTS: Three thousand ninety patients were included in the study. The mean age of our patients was 55.05±13.05 years. In total, 2139 (69%) patients had normal PCDU findings, 351 (11%) patients had arterial insufficiency, 531 (17%) patients had venous insufficiency, and 69 (2%) patients had arterial insufficiency with concurrent venous leakage. When the patients were divided into 2 groups ≤40 years (Group 1) old and >40 years (Group 2) old; normal PCDU findings were found in 432 patients (84%) of the Group 1 patients and normal PCDU findings in 1707 (66%) patients of the Group 2 patients (p<0.0001). There were arterial insufficiency findings in 24 (4.7%) and 327 (12.7%) patients of the Group 1 and 2, respectively (p=0.002).

CONCLUSION: The etiology is psychogenic in the majority of patients who present with ED complaints to the urology clinic. With age, the prevalence of psychogenic ED is decreasing but still more than organic.