What should be included in the physical exam to evaluate erectile dysfunction (ED)?

Updated: Oct 14, 2020
  • Author: Edward David Kim, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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A physical examination is necessary for every patient, with particular emphasis on the genitourinary, vascular, and neurologic systems. A focused physical examination entails evaluation of the following:

  • Blood pressure

  • Peripheral pulses

  • Sensation

  • Status of the genitalia and prostate

  • Size and texture of the testes

  • Presence of the epididymis and vas deferens

  • Any penile abnormalities, such as hypospadias and Peyronie plaques

The physical examination may corroborate history findings or may reveal unsuspected physical findings, such as penile plaques, small testes, evidence of possible prostate cancer, prostate infections, or hypertension.

Several studies have found a strong correlation between hypertension and ED—not surprisingly, given that both are manifestations of a vascular disorder. In a large hypertension clinic, men who also demonstrated ED had a much higher prevalence of complications related to high blood pressure. It has been suggested that hypertensive patients with ED and poor cavernosal artery blood flow as measured during duplex ultrasonography studies should proceed to a full cardiac evaluation because of the high prevalence of associated problems.

A number of studies have shown a correlation between benign prostatic hyperplasia and ED. The cause of this correlation is not yet clear.

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