A 30 yr old male presents to the OPD with Erectile dysfunction. Basic screening evaluation is unremarkable. Which of the following should be the next step in the evaluation/management of this patient?
Specialised investigations such as Penile Doppler Ultrasound, Dynamic Infusion Cavernosography and Neurological testing are rarely necessary in the evaluation of Erectile Dysfunction. These investigations are indicated in selected complicated cases and are not indicated for the initial evaluation of Erectile Dysfunction. So the most appropriate next step in management in this patient would be a trial of oral phosphodiesterase type 5 inhibitor sildenafil. Evaluation of a patient with sexual dysfunction involves taking thorough history and performing physical examination. Basic laboratory investigations done includes estimation of CBC, lipid profiles, serum prolactin and testosterone. Additional diagnostic testing is rarely necessary in the evaluation of erectile dysfunction. Specialized test involves (1) studies of nocturnal penile tumescence and rigidity, (2) vascular testing (in-office injection of vasoactive substances, penile Doppler ultrasound, penile angiography, dynamic infusion cavernosography/cavernosometry), (3) neurologic testing (biothesiometry-graded vibratory perception, somatosensory evoked potentials), and (4) psychological diagnostic tests. Ref: Harrison's Internal Medicine, 18th Edition, Chapter 48
Cavernosometry
Neurological testing
Oral Sildenafil citrate trial
Penile ultrasound doppler study