8 3 Vol. 8 No National Journal of Andrology J un : ED : A : (2002)

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1 Vol. 8 No National Journal of Andrology J un. 2002,,,, (, ) : : ( ),, : 301 : %,85 %,78. 7 %,89. 7 % (45. 5 %) (12. 6 %) (12. 0 %) %,32. 6 %,9510 % %, 7. 2 % %60. 5 %( P < 0. 01) :, (42. 2 %), (20. 9 %), (17. 3 %), (15. 6 %), (13. 6 %) :, : ; ; ; : R698 ; R19213 : A : (2002) PhysiciansKnowledge and Attitude to Erectile Dysfunction Kai ZHAN G, Zhan2J u HE, Zhong2Cheng XIN, Jie J IN, Ying2Lu GUO ( Depart ment of U rology, the Fi rst Hospital of Peking U niversity, Instit ute of U rology, Peking U niversity, Beijing , China) Abstract : Objectives : The physicians knowledge and attitude to erectile dysfunction ( ) is very important to the diagnosis and management of this disease. We investigated the physicians and practitioners knowledge of, attitude to, and if they actively find the underlying patients. Methods : Three hundreds and one physicians and practitioners in Beijing completed a question2 naire. The subjects included urologists, cardiologists, endocrinologists, suregeons, orthopaedicians and community practitioners. Results : The definition of was well known by most subjects (83. 4 %). Many agreed that was a common condition in the ag2 ing men ( %), and it was an important health problem ( %) and it was the local signs of certain systemic diseases (89. 7 %). The most common risk factors of enumerated by the physicians were diabetes (45. 5 %), hypertension (12. 6 %) and coronary artery diseases (12. 0 %) % physicians met the patients who initiated questions about % physicians would discuss with the patients if the patients initiate questions about % non2urological physicians would refer the patients to urologists or andrologists % of all the physicians never asked their patients about erectile function, this proportions in the subgroups of urologists, non2urological physicians and community practitioners were 7. 2 %, %and % respectively ( P < 0. 01). The most common reasons for the physicians not to initiate the inquiries about was the patients would not have if they didn t complain about it(42. 2 %), there was no patients in my specialty (20. 9 %), diagnosis and treatment of : ; : : (19682),,,,,

2 was not my business (17. 3 %), have no time (15. 6 %), feel embarrassed (13. 6 %). Conclusions : Most physicians regarded as an important health problem and a common condition in aging men, but they didn t take an active attitude to in their clini2 cal practice. Natl J Androl, 2002, 8 ( 3) : Key words : Erectile dysfunction ; Physicians attitude ; Investigation ; Beijing (erectile dysfunction, ),, [1,2 ], [3, ], 2,,, 1, 5 : , 304 ( %), 301 (99 %), 83, 39, 29, 33, 31, 86, Table 1. Demography of the investigated physicians Items Options Urologists ( n = 83) Cardiologists ( n = 39) Endocrinologists ( n = 29) Surgeons ( n = 33) Orthopaedicians ( n = 31) Practitioners ( n = 86) Gender Male Length of servise (years) Female < > Enducation College Graduates Position Residents Standing physicians Professores Table 2. Physicians knowledge of [ n( %) ] Urologists Non2urological Options ( n = 83) physicians( n = 132) practitioners( n = 86) P Know the definition of 80 (96. 4) 103 (78. 0) 68 (79. 7) 251 (83. 4) < Regard as a common condition of aging men 77 (92. 8) 111 (84. 1) 68 (79. 7) 256 (85. 0) > 0. 1 Regard as an important health problem 68 (81. 9) 102 (77. 3) 67 (77. 9) 237 (78. 7) > 0. 1 Regard as consequence of smoking 68 (81. 9) 84 (63. 6) 54 (62. 8) 206 (68. 4) < Regard as local signs of certain systemic diseases 76 (91. 6) 120 (90. 9) 74 (86. 0) 270 (89. 7) > 0. 1 Regard as a disease could be cured 77 (92. 8) 117 (88. 6) 76 (88. 4) 270 (89. 1) > (45. 5 %)

3 3 183 (12. 6 %) (12. 0 %) Table 3. Percentage of the physicians who initiated the inquiries about erectile function of the patients( %) (31. 3 %) (24. 1 %) (20. 5 %) TURP (13. 3 %) ; ( %) ( %) (23. 1 %) ; (93. 1 %) (81. 8 %) ; Compared with non2urological physicians and community practi2 (90. 3 %) ; ( %) ( %) (17. 4 %) (18. 6 %) , (45. 5 %), 4, % %39. 5 % ( P < 0. 01) 2. 7,32. 6 %, (42. 2 %),, (20. 9 %), % %24. 4 % (17. 3 %), ( P < 0. 01) (15. 6 %), %75. 6 %, (13. 6 %) 9510 % Urologists Non2urological physicians pratitioners Never Seldom Sometimes tioners, 3 : P < Table 4. Percentage of urologists who initiated inquires about of the patients exposed to risk factors[ n( %) ] Percentage of urologists who initiated inquires Radical prostatectomy Radical cystotectomy Urethral injury or operation TURP about ( n = 83) ( n = 79) ( n = 76) ( n = 77) ( n = 77) Never 3 (3. 6) 4 (4. 8) 4 (4. 8) 5 (6) Seldom 9 (10. 8) 10 (12) 7 (8. 4) 7 (8. 4) Sometimes 6 (7. 2) 9 (10. 8) 7 (8. 4) 8 (9. 6) Half of the time 3 (3. 6) 5 (6) 2 (2. 4) 7 (8. 4) Most times 33 (39. 8) 27 (32. 5) 27 (32. 5) 29 (34. 9) Every time 25 (30. 1) 21 (25. 3) 30 (36. 1) 21 (25. 3) Table 5. Percentage of non2urological physicians who initiated inquires about of the patients exposed to risk factors Percentage of physicians who initiated Cardiologists Endocrinologists Surgeons Orthopaedicians inquiries about Coronary artery disease ( n = 10) Hypertension ( n = 9) Diabetes ( n = 26) Rectum surgery ( n = 26) Spinal injury ( n = 27) Never Seldom Somtimes Half of the time Most times Every time

4 Table 6. Reasons that physicians didn t initiate the inquiries about of the patients[ n( %) ] Reasons Urologists Non2urological physicians practitioners ( n = 83) ( n = 132) ( n = 86) Patients have not initiative 51 (61. 4) 40 (30. 3) 36 (41. 9) 127 (42. 2) No patient in my specialty 1 (1. 2) 32 (24. 2) 30 (34. 9) 63 (20. 9) Not my business for diagnosis and treatment of 8 (9. 6) 27 (20. 5) 17 (19. 8) 52 (17. 3) Had no time 14 (16. 9) 23 (17. 4) 10 (11. 6) 47 (15. 6) Felt embarrassed 5 (6. 0) 25 (18. 9) 11 (12. 8) 41 (13. 6) Never think of 0 28 (21. 2) 7 (8. 1) 35 (11. 6) 3, % %39. 5 % (MMAS),4070,32. 6 % 52 %, 10 % [4 ], %,85. 0 %,78. 7 %, 9510 %,,,, ( ),, (45. 5 %) (12. 6 %) (12. 0 %) MMAS,, 71 %, 39 % 25 % 28 %,,, %, ( %) ( %) ( %) 7. 2 % % % ( P < % 0. 01), % % ( %), (24. 1 %) (20. 5 %) TURP, (13. 3 %) % TURP,45. 5 % %75. 6 % [5 ] Laumann [6,7 ],1/ 10,74 % 9010 %,,89. 7 %, %,, 80 %, %,,,,,

5 ( ) 3 185,,, 10,,9 ;9,,8, ;26,,18, :, ( %), (20. 9 %), (17. 3 %), (15. 6 %), (13. 6 %) [ 2 ],,,,,28 (21. 2 %), 15,12,, ;,,, [ 1 ]. [ M ]. :, ,. [J ].,2001,7 (3) : [ 3 ] Perttula E. Physician attitudes and behavior regarding erectile dysfunc2 tion in at risk patients from a rural community[j ]. Postgrad Med J, 1999,75(880) :8385. [ 4 ] Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study[j ]. J Urol,1994,151(1) :5461. [5 ] Sadovshy R, Miller T, Moskowitz M, et al. Three2year update of sildenafil citrate (VIAGRA) efficacy and safety[j ]. Intl J Clin Pract,2001,55 (2) : [6 ] Laumann EO, Paik A, Rosen RC, et al. Sexual dysfunction in the United States : prevalence and predictors[j ]. JAMA,1999, 281 (6) : [ 7 ] Levine LA, Kloner RA. Importance of asking questions about erectile dysfunction [J ]. Am J Cardiol, 2000, 86 (11) : A Carmona E, Weerachatyanukul W, Xu H, et al. Binding of arylsulfatase A to mouse sperm inhibits gamete interaction and in2 duces the acrosome reaction. Biol Reprod,2002,66(6) : , (,SGG) 2, SGG ( A,AS2A), AS2A SGG( 1 400) AS2A SGG 2, AS2A SGG Percoll AS2A 1 h, 2,63 nmol/ L AS2A 2, 63 nmol/ L AS2A 1 h, (63 nmol/ L ) ( 32 %,15 %), 2 h 53 %, AS2A SGG, SGG, SGGIgG/ IgM,630 nmol/ L, 630 nmol/ L AS2A 75 %,AS2A ( ; )