Issue link: https://viewer.e-digitaledition.com/i/1091761
BY HILLARY EAMES " If the patient requires any treatment for [ED], we're always in touch with each provider about what these patients need. We like to keep referrers in the loop and aware of what's going on." — HESHAM MOSTAFA, MD, UROLOGIST AT THE TOLEDO CLINIC ERECTILE DYSFUNCTION (ED) is the most common sexual health problem men report to their providers, according to the Urology Care Foundation. While it is common for men to experience some level of ED from time to time, persistent ED or ED that gets progressively worse may be a sign of an underlying health problem. Hesham Mostafa, MD, urologist at The Toledo Clinic, explains that, on many occasions, ED is a sign of a more serious condition. He often recommends further testing for other issues for patients who present with concerns about ED. "Sometimes, patients don't even know they have cardiovascular disease or diabetes," Dr. Mostafa says. "We'll often refer those patients to a cardiologist or primary care provider, and they'll learn they have an underlying health issue they didn't know about." Severa l factors t hat a f fect t he endocr i ne, ner vous or ca rdiova scu la r system may cause ED, according to t he Nationa l Institute of Diabetes a nd Digestive a nd Kidney Diseases. About 40 percent of ED causes are vascular, such as atherosclerosis and hypertension. Similar to heart disease, diabetes may cause damage to the nerves and blood vessels that allow an erection to develop. Treatment for prostate cancer can also cause ED and urinary incontinence (see "Treating Male Incontinence" for more information.) CHECKING FOR COMORBIDITIES Whatever the cause, Dr. Mostafa works with the patient's referring physician to ensure the patient receives the proper treatment — not just for ED, but any underlying health conditions as well. "I administer basic blood work to make sure there are no obvious abnormalities," Dr. Mostafa says. "If something is abnormal, I contact the physician to tell him or her it may be an underlying cause, because if they address the cause, the patient's ED may improve." Similar to Dr. Mostafa, Daniel Murtagh Jr., MD, MSDS, urologist at The Toledo Clinic, finds that many of his patients with ED have other comorbidities. "I especia lly [ta lk to] referring physicia ns in the a rea, such a s ca rd iolog i s t s a nd fa m i ly pra c t ice phy sicia n s, [about how] ca rdiova scu la r disea se ca n cause erecti le dysfunction," Dr. Murtagh says. "If a patient is being treated for erectile dysfunction, they should a lso be screened for cardiovascular disease." 0 4❱❱❱❱❱ C O V E R S T O R Y One Facet of High-level Urologic Care and Treatment at The Toledo Clinic Eradicating ED: AFFECTING MORE THAN 30 MILLION MEN IN THE UNITED STATES, ERECTILE DYSFUNCTION IS TRE ATABLE, EITHER A S ITS OWN CONDITION OR A S A SYMPTOM OF UNDERLYING COMORBIDITIES. 0 4