Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a progressive history of erectile dysfunction characterized by inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Symptoms are consistent with organic vascular etiology, including gradual onset, absence of morning erections, and correlation with cardiovascular risk factors (HTN, DM, dyslipidemia, smoking). No psychogenic triggers reported. IIEF-5 score: [Insert Score].
Clinical Examination Findings
Genitourinary exam: Normal penile anatomy, no Peyronieโs plaques or curvature. Testicular volume within normal limits. Peripheral vascular exam: Diminished or absent pedal pulses noted. Cardiovascular exam: Regular rate and rhythm, no murmurs. Neurological exam: Intact sensation in the perineal and penile distribution.
Treatment Protocol
Initiate PDE5 inhibitor therapy (e.g., Sildenafil/Tadalafil) as first-line treatment. Advise on cardiovascular risk factor modification (smoking cessation, glycemic control, lipid management). Schedule penile Doppler ultrasound to assess peak systolic velocity (PSV) and end-diastolic velocity (EDV). Consider vacuum erection device or intracavernosal injection therapy if refractory.