Practices and knowledge of general practitioners on erectile dysfunction: A practice survey

Introduction: Erectile dysfunction (ED) is a common and underestimated sexual disorder. This sexual concern, which should raise the suspicion of an underlying coronary artery disease, is rarely broached by general practitioners (GPs). The aim of this work was to establish an inventory of the practices and knowledge of general practitioners when faced with a case of ED. Methods: This survey is a descriptive cross-sectional epidemiological study targeting GPs' practice. Answers were collected through a self-questionnaire, "KIKI SAIT?", online that explored: demographic data, level of practice and theoretical knowledge regarding ED. Results: One hundred and seventy-seven GPs took part in this study. Regarding their practice, 80.2% of doctors expected the patient to bring up the subject. Few clinicians managed ED according to recommendations of the French Association of Urology. More than 30% referred the patient to a urologist, cardiologist or endocrinologist. In total, 57.6% of practitioners prescribed a phosphodiesterase 5 inhibitor (PDE5I) as first-line treatment. Regarding their knowledge, 67.8% of doctors considered their level of knowledge about PDE5I to be poor, 96.6% about intracavernosal injections, 88.7% about vacuum devices and 91% about penis rings. The main obstacle retained was the lack of medical knowledge (71.2%). Clinicians who rarely consulted for ED were less confident in explaining possible treatments (25/63 versus 18/113, P < 0.001). Conclusion: Strengthening initial training and providing a practical algorithm for the management of ED could be useful to help general practitioners detect ED, which could be a sentinel of coronary heart disease.