Vasculogenic erectile dysfunction in teenagers: a 5-year multi-institutional experience.
OBJECTIVE
To report the experience of three highly specialized centres in the vascular evaluation of erectile dysfunction (ED) in teenagers, as there is little information on this topic, and although clinical guidelines support the use of vascular studies in selected cases, our experience is that vascular evaluation aimed at diagnosing organic ED is uncommon in teenagers, and most are designated as having psychogenic ED.


METHODS
In a retrospective multi-institutional analysis of three ED databases (1998-2003) we assessed males aged < or =19 years presenting with ED. The review of these databases focused on demographic characteristics, risk factors for ED, erectile function, results of vascular evaluation, and the causes of ED.


RESULTS
In all, 40 males aged 14-19 years were identified. The mean (range) duration of ED at presentation was 22.6 (4-84) months. The major risk factors for ED were antecedent perineal trauma (37%) and penile trauma or surgery (15%). The mean (sd) International Index of Erectile Function 'erectile function' domain score was 15 (4). Information obtained by history taking was not predictive of the cause of ED. Vascular studies were performed in 62% of the patients and 48% of these patients were found to have an underlying vascular pathology; 42% of the latter group were found to be possible candidates for surgical intervention and another 16% needed further angiographic evaluation.


CONCLUSIONS
ED in teenagers should not be routinely categorized as psychogenic without an adequate vascular evaluation, as a significant percentage have abnormal erectile haemodynamics consistent with vasculogenic ED.
Tal
Raanan
R
Department of Urology, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, NY, USA.
Voelzke
Bryan B
BB
Land
Spencer
S
Motarjem
Pejman
P
Munarriz
Ricardo
R
Goldstein
Irwin
I
Mulhall
John P
JP
D000293:Adolescent; D000328:Adult; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D018783:Impotence, Vasculogenic / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D010410:Penile Erection / Q000502:physiology*; D010413:Penis / Q000098:blood supply / Q000293:injuries; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult