[Management of erectile dysfunction in daily practice--PISTES study].

Introduction: Despite the improved knowledge on erectile dysfunction and its prevalence over recent years, no pharmaco-epidemiology study on the management of erectile dysfunction in daily practice has been performed. This absence of data is all the more regrettable in view of the real revolution in the management of this disorder, leading an increasing number of patients to consult.

Objectives: To determine and analyse the presenting complaints, aetiological diagnoses, and modalities of management of patients with erectile dysfunction.

Method: PISTES pharmaco-epidemiological, prospective and transverse study of a representative national sample of 411 private or hospital urologists and sexologists between April and June 2002.

Results: The majority of patients (56.7%) expressed discomfort talking about this subject. Patients with mixed predominant psychogenic ED and mixed predominant organic ED represented 67.1% of the population, confirming the multifactorial aetiology. The management varies according to the aetiology. Complementary investigations are essentially hormone assays (89.6%), well ahead of provoked erection tests (21.9%). Patients are reviewed within 2 months and 65% resumed a satisfactory sexual activity. The main causes of failure are inefficacy (83.7%) and the high cost of treatment preventing purchase (56%).

Conclusion: This study shows an effective management of erectile dysfunction, but which is still faced with difficulties of access to care for psychological or economic reasons. These difficulties concern the patient, his partner and the practitioner Although information on erectile dysfunction has been greatly improved, it does not sufficiently encourage effective therapeutic management.