Abstract
Introduction and objectives
There is evidence of an association between erectile dysfunction and cardiovascular risk factors including diabetes, hypertension and smoking. Indeed erectile dysfunction is now thought to be a symptom of underlying cardiovascular disease. Strong emphasis is placed upon identifying such risk factors, and management strategies to address these have been shown to be effective in treating erectile dysfunction. The European Association of Urology (EAU) have published Guidelines on Male Sexual Dysfunction 2012 which advocate a detailed medical history and clinical examination in all patients presenting with erectile dysfunction. The aim of this multicentre audit was to assess how well patients presenting to erectile dysfunction services across the North West of England are assessed with a history and examination according to EAU guidelines.
Methods and materials
An independent data collection team examined the case notes of 239 new referrals presenting with erectile dysfunction to 16 centres across the North West of England. The audit departments at each centre were requested to identify the last 20 new referrals for erectile dysfunction retrospectively from the end of 2011. The documentation was then evaluated, and we report these results.
Results
Risk factor assessment, percentage documentation
Diabetes 99.6% Hypertension 41.8% Cardiovascular disease 22.2% Hyperlipidaemia 28.5% Smoking 89.1% Alcohol 83.3%
Assessment of erectile dysfunction, percentage documentation
Duration 95% Rigidity 90.4% Longevity 89.1% Spontaneous erections 91.6% Orgasm 39.3% Ejaculation 53.1% Intercourse 96.7% Libido 93.7% International Index for Erectile Function (IIEF) 32%
Examination, percentage documentation
Genitalia 85.4% Blood pressure 74.9% Secondary sexual characteristics 41% Body mass index (BMI)/obesity 77.4% Peripheral pulses 56.5%
Conclusion
The results from the North West of England Regional Audit on Erectile Dysfunction 2012 show that the documentation employed in the case notes has scope for improvement. The authors suggest that employing a specifically designed pro forma would improve the documentation and consequently the accuracy in assessment of these patients. Other recommendations include the development of designated andrology/erectile dysfunction clinics where urologists or specialist nurses with an interest in the subject matter can provide a more meaningful patient experience.
Keywords
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