Investigations
1st investigations to order
International Index of Erectile Dysfunction
Test
Addresses all domains of male sexual dysfunction (ED, orgasmic function, sexual desire, ejaculation, intercourse, and overall satisfaction).
Composed of 15 questions.
Questions 3 and 4 address the ability to obtain an erection sufficient for intromission and completion of intercourse, respectively, and have been used in assessing therapeutic endpoints during treatment.[53][54]
Result
abnormal
Sexual Health Inventory for Men
fasting blood glucose
Test
Ordered as part of screening blood-work in non-diabetic patients.
Consider standard interventions for diabetes mellitus.
Result
>125 mg/dL in diabetes mellitus
lipid profile
Test
Consider standard interventions for lipid lowering.
Result
abnormal in hypercholesterolaemia
Investigations to consider
haemoglobin A1c in diabetic men
Test
Used in known diabetic men with ED as an indicator of the quality of glycaemic control.
Consider standard interventions for improved glycaemic control with elevated values.
Result
<6.5% indicates optimal glucose control
testosterone (morning)
Test
Ordered in cases of suspected hypogonadism, which may be characterised by decreased libido or signs of androgen deprivation.
Serum testosterone should be a morning sample.
Bioavailable and/or free testosterone are more sensitive and can be tested.[60]
Result
low in hypogonadism
follicle-stimulating hormone and luteinising hormone
Test
Low = hypogonadotrophic hypogonadism; normal = eugonadotrophic hypogonadism; elevated = hypergonadotrophic hypogonadism.[61]
Result
varies
thyroid-stimulating hormone
Test
Elevated thyroid-stimulating hormone relative to the assay's normal values is the most sensitive indicator of hypothyroidism.[62]
Result
elevated in hypothyroidism
prolactin
Test
In hypogonadotrophic hypogonadism, to rule out prolactinoma.
Result
elevated in hypogonadotrophic hypogonadism
Doppler ultrasonography
Test
In cases of pelvic, perineal, or genital trauma. Before penile prosthesis insertion.
Result
normal
pelvic/penile angiography
Test
May identify an arteriovenous fistula or facilitate operative planning before penile revascularisation.
Result
normal
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