AUA 2018: Erectile Dysfunction in the Adult Entertainment Industry Similar to that of the General Adult Male Population

Truckee, CA ( -- New studies show promise in understanding more about erectile dysfunction - Erectile dysfunction (ED) affects 30 million men in the United States. Three new studies evaluating the prevalence of ED in certain populations, as well as ED treatments and their availability to patients, are being presented at the 113th Annual Scientific Meeting of the American Urological Association (AUA) in San Francisco, CA. The study will be presented to the media during a special press conference on Saturday, May 19 at 10:30 a.m. (PT) at the Moscone Convention Center. The session will be moderated by Tobias S. Köhler, MD, MPH, FACS, AUA spokesperson, men’s health specialist and urologist with the Mayo Clinic in Rochester, MN.

Study Details 
Publication #: MP74-18 

Erectile Dysfunction Among Male Adult Entertainers: A Survey: Erectile dysfunction has not yet been evaluated among male adult entertainers, which is why researchers from Miami, Florida were determined to evaluate the prevalence of ED and use of erectile aids among men working in the adult entertainment industry. 

A 40-question online survey was distributed to male adult entertainers via email through collaboration with the Free Speech Coalition (FSC), the North American Trade Association of the Adult Industry. Surveys were sent by the FSC to those within the Performer Availability Screening Services (PASS) database who met the criteria of having biological penises and having experience as adult entertainers. The survey acquired baseline characteristics, use, and frequency of various erectile aids, anabolic steroids, and assessed erectile function using the International Index of Erectile Function (IIEF) survey. 

Researchers examined the surveys of 62 respondents who the met inclusion criteria of working within the adult entertainment industry. Results showed:

  • Seventy-three percent of respondents stated they used erectile aids. ED pills were the most common form of aid at 58 percent; however, 13 percent used a combination of pills and injections, 1.6 percent used injections only, and none of the respondents stated they had penile implants. The anabolic steroid use was noted to be 16 percent.
  • Of the 45 men who used erectile aids, 42 percent used them for work only while nearly 58 percent used them for both work and personal reasons.
  • Overall, 42 percent of men had erectile dysfunction based on the IIEF survey, leading researchers to conclude the prevalence of ED among male adult entertainers seems to be similar to the general population, except for entertainers under the age of 30.
Study Details 
Publication #: PD18-03

Doomed to Impotence: Analysis of Erectile Dysfunction and Inflatable Penile Prosthesis (IPP) Insurance Coverage from Verification Benefits Databases: A large number of men who are interested in ED treatments, specifically inflatable penile prosthesis (IPP) for refractory ED, are prostate cancer survivors; however, unlike the near-universal coverage for breast reconstruction after mastectomy afforded by the Women′s Health and Cancer Rights Act of 1998, coverage for ED treatment after prostate cancer therapy is not a federally protected right. Given the large number of insurers in the United States and the lack of readily available coverage information, it is difficult to know how many men have coverage for ED treatments nationally, which is why researchers from Houston, TX set out to assess the true coverage rate for ED. 

Using de-identified data from two IPP manufacturers’ insurance verification benefits databases, researchers analyzed nearly 4,600 cases submitted under 374 primary insurers. Results showed:

  • Of the total cases, 82.6 percent had coverage benefits for ED treatment and approximately 15 percent had an IPP exclusion.
  • Nearly 39 percent of the total cases were submitted under the top U.S. insurers, representing 38.7 percent of the U.S. health insurance market share.
  • ED coverage varies by state. For example, in Texas, Blue Cross Blue Shield (BCBS) beneficiaries are less likely to have IPP coverage (56 percent have IPP exclusions) than BCBS beneficiaries in North Carolina (2.3 percent have exclusions). 
Researchers concluded while it is difficult to determine the true coverage rate for ED treatment (and specifically for IPPs) for all men in the US, an appreciable number of men, including many prostate cancer survivors, do not have insurance coverage for ED therapy and have exclusions for IPPs. 

Study Details 
Publication #: PD18-06

Sexual Satisfaction of Men with Erectile Dysfunction Treated with Penile Prosthesis Versus Medical Treatment Modalities: Are We Waiting Too Long to Implant? Standard treatment for ED often begins with oral medications and progresses to surgical therapy with a penile prosthesis as a final treatment option. Researchers surveyed 55 men currently undergoing ED treatment via a Self Esteem and Relationship (SEAR) questionnaire with a scale 1-5 (1 is never and 5 always) to better understand their satisfaction with treatment methods. Results showed: 

  • Eight percent of the participants used oral medications, more than 15 percent had a prosthesis and only 4 percent used intracorporeal injections (ICI).
  • All SEAR scores were significantly better for men with a prosthesis, and most notably, these patients scored their satisfaction with sexual performance significantly higher.
  • One hundred percent of men with prosthesis gave a score of 5 regarding their confidence in sexual performance versus only 16 percent of men who took oral medication or ICI. 
Researchers concluded patients treated with a penile prosthesis for ED appear to be significantly more satisfied than patients on an oral medication or ICI regimen. This suggests that prosthesis may be offered sooner in the treatment plan for ED, but more research is needed to determine which specific patient populations would benefit from earlier prosthesis placement.
“These studies show promise in understanding more about erectile dysfunction and optimal treatment options,” said Dr. Köhler. “The insights gained from these studies, such as the increased quality of life in men with a prosthesis, can help improve patient diagnostic protocols and treatment.”
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