1. Guidelines should never replace clinical judgment. They should aid and inform decision-making
2. Avoid layering tests. Testing should be ordered when specific information is required to aid in risk stratification and clinic decision-making
3. Lab testing should be interpreted in the appropriate context – checking morning samples of testosterone, repeating testosterone levels to confirm borderline results, checking two values of hsCRP, not screening during an acute illness. Results taken out of context can be misleading
4. Do not underestimate the value of lifestyle modification as an intervention. Estimation of risk can drive changes in behavior and promote health and wellness (over the usual paradigm of disease and treatment)
References
1.
Hatzimouratidis K, Amar E, Eardley I et al (2010) Guidelines on male sexual dysfunction and premature ejaculation. Eur Urol 57:804–814PubMed
2.
Prins J, Blanker MH, Bohnen AM et al (2002) Prevalence of erectile dysfunction: a systematic review of population –based studies. Int J Impot Res 14:422–432PubMed
3.
Inman BA, St Sauver JL, Jacobson DJ et al (2009) A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc 84:108–113.KPubMedCentralPubMed
4.
Marma AK, Berry JD, Ning H et al (2010) Distribution of 10-year and lifetime predicted risks for cardiovascular disease in US adults findings from the National Health and Nutrition Examination Survey 2003 to 2006. Circ Cardiovasc Qual Outcome 3:8–14
5.
Dhaliwal SS, Welborn TA (2009) Central obesity and multivariable cardiovascular risk as assessed by the Framingham prediction scores. Am J Cardiol 103:1403–1407PubMed
6.
Stone NJ, Robinson J, Lichtenstein AH et al (2014) 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce astherosclerotic cardiovascular risk in adults. J Am Coll Cardiol 63:2935–59
7.
Nehra A, Jackson G, Miner M et al (2012) The Princeton III consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clin Proc 87(8):766–778PubMedCentralPubMed
8.
Miner M, Nehra A, Jackson G et al (2014) All men with vasculogenic ED require a cardiovascular workup. Am J Med 127(3):174–182PubMed
9.
Castelli WP, Abbott RD, McNamara PM (1983) Summary estimates of cholesterol used to predict coronary heart disease. Circulation 67(4):730–734PubMed
10.
Kassi E, Pervanidou P, Kaltsas G et al (2011) Metabolic syndrome: definitions and controversies. BMC Med 9:48–61PubMedCentralPubMed
11.
Alberti KG, Eckel RH, Grundy SM et al (2009) International Diabetes Task Force on Epidemiology and Prevention, National Heart, Lung and Blood Institute, American Heart Association, World Heart Federation, International Atherosclerosis Society, International Association for the Study of Obesity: harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120:1640–1645PubMed
12.
Aslan Y, Sezgin T, Tuncel A et al (2009) Is type 2 diabetes mellitus a cause of severe erectile dysfunction in patients with metabolic syndrome. Urology 74:561–565PubMed
13.
Saigal CS, Wessels H, Pace J et al; Urologic Diseases in America Project (2006) Predictors and prevalence of erectile dysfunction in a racially diverse population. Arch Intern Med 166:207–212
14.
Demir T (2006) Prevalence of erectile dysfunction in patients with metabolic syndrome. Int J Urol 13:385–388PubMed
15.
Bal K, Oder M, Sahin AS et al (2007) Prevalence of metabolic syndrome and its association with erectile dysfunction among urologic patients: metabolic backgrounds of erectile dysfunction. Urology 69:356–360PubMed
16.
El Sakka AI, Morsy AM (2004) Screening for ischemic heart disease in patients with erectile dysfunction: role of penile Doppler ultrasonography. Urology 64:346–350PubMed
17.
El-Sakka AI, Morsy AM, Fagih BI et al (2004) Coronary artery risk factors in patients with erectile dysfunction. J Urol 172:251–254PubMed
19.
Al Hunayan A, Al Mutar M, Kehind EO et al (2007) The prevalence and predictors of erectile dysfunction in men with newly diagnosed with type 2 diabetes mellitus. BJU Int 99:130–134PubMed
20.
Tomada N, Tomada I, Botelho F et al (2011) Are all metabolic syndrome components responsible for penile hemodynamics impairment in patients with erectile dysfunction? The role of body fat mass assessment. J Sex Med 8:831–839PubMed
21.
Kupelian V, Shabsig R, Araujo AB et al (2006) Erectile dysfunction as a predictor of the metabolic syndrome in aging men: results from the Massachusetts male aging study. J Urol 176:222–226PubMed
22.
Corona G, Mannucci E, Ricca V et al (2009) The age related decline of testosterone is associated with different specific symptoms and signs in patients with sexual dysfunction. Int J Androl 32:720–728PubMed
23.
Gorbachinsky I, Akpinar H, Assimos DG (2010) Metabolic syndrome and urologic diseases. Rev Urol 12:157–180
24.
Reilly CM, Zamorano P, Stopper VS et al (1997) Androgenic regulation of NO availability in rat penile erection. J Androl 18:110PubMed
25.
Shamloul R, Ghanem HM, Salem A et al (2004) Correlation between penile duplex findings and stress electrocardiography in men with erectile dysfunction. Int J Impot Res 16:235–237PubMed
26.
Chen CJ, Kuo TB, Tseng YJ et al (2009) Combined cardiac sympathetic excitation and vagal impairment in patients with no organic erectile dysfunction. Clin Neurophysiol 120:348–352PubMed
27.
Kirby RS, O’Leary MP, Carson C (2005) Efficacy of extended release doxazosin and doxazosin standard in patients with concomitant benign prostatic hyperplasia and sexual dysfunction. BJU Int 95:103–109PubMed
28.
De Rose AF, Carmignani G, Corbu C et al (2002) Observational multicentric trial performed with doxazosin: evaluation of sexual effects on patients with diagnosed benign prostatic hyperplasia. Urol Int 68:95–98PubMed
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