A 58-Year-Old Construction Worker Can’t Maintain an Erection

Edward D. Kim, MD

Disclosures

May 21, 2020

Physical Examination and Workup 

The examination reveals a virilized male with normal-sized testes. The prostate is moderately enlarged but without evidence of induration or nodules. The penis is normal but is becoming buried in suprapubic fat. No gynecomastia or lower-extremity edema is present. The abdomen is obese but is soft, flat, and nontender.

The patient has a body mass index (BMI) of 32 kg/m2, a blood pressure of 145/90 mm Hg, and a heart rate of 80 beats/min. Pedal pulses are present.

Lipid levels are borderline high. The serum total testosterone level is 345 ng/dL (normal range, 300-950 ng/dL). Basic metabolic profile findings are normal. A previous prostate-specific antigen result was 2.1 ng/mL. The hematocrit was 45%. A brief neurologic examination does not reveal any focal sensory or motor deficits.

The patient's erectile function (EF) domain score, as derived from the International Index of Erectile Function (IIEF) questionnaire, is 19.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....