Delay in Seeking Medical Help in Patients with New-Onset Erectile Dysfunction Remained High Over and Despite the PDE5 Era—An Ecological Study


  • Funding: None.

Andrea Salonia, MD, Department of Urology, University Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milan, Italy. Tel: +39-02-2643-7286; Fax +39-02-2643-7298; E-mail:


Introduction.  It is common knowledge among researchers that erectile dysfunction (ED) is an important sentinel marker of cardiovascular and overall men's health.

Aim.  Determine whether the delay of time between ED onset and seeking medical help (DSH), considered as a proxy of awareness of the importance of ED for overall men's health, has shortened during the phosphodiesterase type 5 inhibitors (PDE5) era.

Methods.  Complete data from 619 patients seeking first medical help for new-onset ED as their primary disorder between July 2000 and July 2010 were analyzed (i.e., DSH, ED severity as defined by the International Index of Erectile Function-erectile function [IIEF-EF] domain score, patient's awareness of any PDE5, and Charlson Comorbidity Index [CCI]). Analysis of variance tested DSH throughout the 10-year time frame. Cox regression models tested the association between predictors and DSH.

Main Outcome Measures.  Assess if DSH has shortened throughout PDE5 era. Evaluate potential predictors of DSH.

Results.  Overall, mean DSH was 30.2 months (median 12.0; range 5–300 months). DSH shortened throughout the analyzed 10-year period (F = 1.918; P = 0.047), with a significant drop only from year 2009 (DSH up to year 2008 vs. from year 2009: 31.0 months [12.0] vs. 7.5 months [6.0], respectively; P < 0.001). Age, CCI, educational status, and ED severity did not significantly change over time. As a whole, 560 patients (90.5%) were aware of PDE5 at the time of their first office visit. PDE5 awareness emerged as an univarible and multivariable predictor of a shortened DSH. Conversely, DSH was not clearly associated with age, CCI, educational status, or ED severity.

Conclusions.  Delay in seeking medical help in new-onset ED patients remained high over the PDE5 era, with a significant drop only from the year 2009. PDE5 awareness emerged as an independent predictor of shortening of this delay. Salonia A, Ferrari M, Saccà A, Pellucchi F, Castagna G, Clementi MC, Matloob R, Briganti A, Rigatti P, and Montorsi F. Delay in seeking medical help in patients with new-onset erectile dysfunction remained high over and despite the PDE5 era—An ecological study. J Sex Med 2012;9:3239–3246.