The Prevalence of Vascular Erectile Dysfunction in the United States: Insights from Khalil Masabni, MD

The Prevalence of Vascular Erectile Dysfunction in the United States: Insights from Khalil Masabni, MD

Erectile Dysfunction (ED) is a widespread condition affecting millions of men in the United States. While ED can result from various factors, a significant number of cases are linked to vascular issues. A recent study highlighted the prevalence of ED in the U.S. and suggested penile implants for patients with moderate to severe ED and suboptimal response to ED pills like Viagra and Cialis. However, Dr. Khalil Masabni believes that many of these cases are vascular in nature and can be effectively treated with less invasive methods like stent placement for ED and penile venous leak treatment, aiming to improve blood flow or blood retention in the penis, while avoiding the invasive and irreversible nature of penile implants.

Prevalence of ED in the United States

A study by Rojanasarot et al. using the Merative MarketScan Commercial Database and the Medicare Standard Analytical Files (SAF) found that 8.3% of insured men in the U.S. have been diagnosed with ED by a healthcare provider. This equates to approximately 10,302,540 men, including 8,882,548 aged 18-64 and 1,419,992 aged 65 and older. However, these figures likely underestimate the actual prevalence, as not all men with ED seek medical care or receive a formal diagnosis.

Estimating the True Prevalence of ED

To better estimate the true prevalence of ED, Rojanasarot et al. reviewed patient-reported data from the PubMed.gov database. The prevalence of ED reported by patients ranged from 3.0% to 70.2% across different age groups, with a median prevalence of 27.0%. Based on this median, it is estimated that up to 30,333,668 men in the U.S. may experience ED.

The Burden of Moderate to Severe ED and Suboptimal Response to Phosphodiesterase Type 5 Inhibitors

The study also highlighted that over 17.1% of men aged 18 and older (approximately 1,759,248 men) with diagnosed ED have moderate to severe symptoms and do not respond well to standard treatments like phosphodiesterase type 5 inhibitors (such as Viagra and Cialis). When considering self-reported data, this number could rise to as many as 13,436,363 men experiencing moderate to severe ED with suboptimal response to these medications.

Dr. Masabni’s Perspective on Vascular ED

While the study suggested that these patients might be candidates for penile implants, Dr. Khalil Masabni offers a different perspective. Drawing from his research and expertise, Dr. Masabni believes that more than 70% of patients who do not respond to vasoactive agents, such as phosphodiesterase type 5 inhibitors (such as Viagra and Cialis), likely have vascular ED. This type of ED is caused by problems with blood flow to the penis. By extrapolating this data, Dr. Masabni estimates that over 1,231,473 men with healthcare-diagnosed ED and more than 9,405,454 men with self-reported ED may have vascular ED. He advocates for treating these cases with endovascular techniques, which are minimally invasive procedures aimed at improving blood flow or blood retention in the penis, rather than resorting to penile implants.

The Need for Appropriate Diagnosis and Treatment

Understanding the prevalence of vascular ED is crucial for providing effective treatment. While traditional treatments for ED, such as phosphodiesterase type 5 inhibitors, are often effective, they are not suitable for everyone, particularly those with vascular ED. Endovascular treatments, including procedures like angioplasty or stenting, offer a promising alternative for many patients, potentially avoiding the need for penile implants.

Conclusion

The true prevalence of erectile dysfunction, particularly vascular ED, in the United States is likely higher than previously estimated. Accurate diagnosis and targeted treatment are essential for managing ED effectively. For men with vascular ED, endovascular techniques can provide a viable and less invasive treatment option, helping to restore normal function and improve quality of life. If you or someone you know is experiencing symptoms of ED, it is important to consult with a healthcare provider, like Dr. Khalil Masabni, to explore all available treatment options, including those that address underlying vascular issues.

1. Rojanasarot S, Williams AO, Edwards N, Khera M. Quantifying the number of US men with erectile dysfunction who are potential candidates for penile prosthesis implantation. Sex Med. 2023 Apr 17;11(2). doi: 10.1093/sexmed/qfad010. PMID: 37082721; PMCID: PMC10110759.