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LACK OF DIAGNOSTIC TOOLS TO PROVE ERECTILE DYSFUNCTION: CONSEQUENCES FOR REIMBURSEMENT?

2000; Lippincott Williams & Wilkins; Volume: 163; Issue: 1 Linguagem: Inglês

10.1016/s0022-5347(05)67980-3

1527-3792

Kurt Lehmann, R. Eichlisberger, Thomas C. Gasser,

Urinary Bladder and Prostate Research

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jan 2000LACK OF DIAGNOSTIC TOOLS TO PROVE ERECTILE DYSFUNCTION: CONSEQUENCES FOR REIMBURSEMENT? KURT LEHMANN, REMY EICHLISBERGER, and THOMAS C. GASSER KURT LEHMANNKURT LEHMANN , REMY EICHLISBERGERREMY EICHLISBERGER , and THOMAS C. GASSERTHOMAS C. GASSER View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67980-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Oral medications for treatment of erectile dysfunction may drastically increase health care expenses. Therefore, reimbursement for treatment will be limited in many countries. Proof of erectile dysfunction on an individual basis may be required. We determine whether erectile dysfunction can be proved by pharmacostimulation tests. Materials and Methods: We prospectively evaluated 77 consecutive patients with a median age of 54 years (range 25 to 75) who presented with previously untreated erectile dysfunction. Assessment included patient reported semiquantitative data on sexual erections (rigidity, ability for vaginal intromission, duration), standard clinical and laboratory tests, and intracavernous injection test and color duplex sonography with 10 μg. intracavernous prostaglandin E1. Data were compared on the basis of the most important complaint, namely whether vaginal intromission was impossible, feasible only with manual assistance or possible but not long enough for satisfactory sexual performance. Results: Of the 77 patients 36 (47%) were unable to perform vaginal intromission, 28 (37%) needed manual help and 13 (17%) had erections sufficient for penetration but were not satisfied with sexual performance. Patient reports were reliable as shown by the significant correlation of items (r = 0.77) and significant discriminating power among categories for penetration (analysis of variance p <0.001). In contrast, clinical response to intracavernous pharmacostimulation and flow parameters assessed by color duplex sonography could not discriminate among the groups. Conclusions: Erectile dysfunction could not be defined by pharmacostimulated erections but relevant erectile dysfunction was honestly reported. New and reliable tests for clinical assessment are required to support the application for reimbursement of treatment expenses for erectile dysfunction. References 1 : Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol1994; 151: 54. Link, Google Scholar 2 : Impotence. JAMA1993; 270: 83. Google Scholar 3 : Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction. N Engl J Med1996; 334: 873. 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Crossref, Medline, Google Scholar From the Urologic Division, Kantonsspital Baden, Baden, Reha-Klinik Zurzach, Zurzach and the University Hospital, Basel, Switzerland© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byRhoden E, Teloken C, Sogari P and Souto C (2018) The Relationship Of Serum Testosterone To Erectile Function In Normal Aging MenJournal of Urology, VOL. 167, NO. 4, (1745-1748), Online publication date: 1-Apr-2002. Volume 163Issue 1January 2000Page: 91-94 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsimpotenceinsurance, health, reimbursementpenile erectiondiagnostic techniques, urologicalMetricsAuthor Information KURT LEHMANN More articles by this author REMY EICHLISBERGER More articles by this author THOMAS C. GASSER More articles by this author Expand All Advertisement PDF downloadLoading ...