title: Multicenter pathophysiologic investigation of erectile dysfunction in clinic outpatients in China.
abstract: OBJECTIVE
  To assess the pathophysiologic 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) from 2006 to 2010 in the 5 training hospitals in China. Every patient was independently evaluated by an experienced urologist/andrologist using comprehensive diagnostic procedures. The simplified International Index of Erectile Function was used to assess the severity of ED.
  
  
  RESULTS
  Most patients (95.0%) were <60 years old, and none were >70 years old. The psychogenic patients were younger and had greater percentage than any other patients. Vasculogenic factors were a major etiology of organic ED. A significant difference was found in the age distribution between the patients with psychogenic ED and those with organic ED (P = .000). Diabetes, hypertension, coronary artery disease, and hyperlipidemia played significant roles in affecting the severity of ED in a statistical model, including age. The International Index of Erectile Function scores decreased with age (rs = -0.199, P = .000). Moreover, the percentage of severe and moderate cases increased with age (P = .003 and P = .002, respectively). However, the constituent ratio of patients sharply declined from 30.3% to 4.5% with age.
  
  
  CONCLUSIONS
  The number of men visiting outpatient clinics with psychological ED is greater than the number with organic causes in China. The age of the Chinese patients with ED who seek medical help is young and this is mainly because of inadequate sex education to young men and because most older patients are reluctant to visit the hospital just for the loss of erectile function.
authors.affiliation: Department of Urology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
authors.forename: Dongjie
authors.initials: D
authors.lastname: Li
authors.forename: Xianzhen
authors.initials: X
authors.lastname: Jiang
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Zhang
authors.forename: Lu
authors.initials: L
authors.lastname: Yi
authors.forename: Xiangsheng
authors.initials: X
authors.lastname: Zhu
authors.forename: Xiangyang
authors.initials: X
authors.lastname: Zeng
authors.forename: Xiaoliang
authors.initials: X
authors.lastname: Guo
authors.forename: Yuxin
authors.initials: Y
authors.lastname: Tang
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002681:China / Q000453:epidemiology; D003469:Culture; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D018783:Impotence, Vasculogenic / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D012736:Sex Education; D055815:Young Adult