Is routine endocrine testing of impotent men necessary?

Endocrine screening of impotent men is performed in an effort to identify a treatable cause of impotence. However, the prevalence of endocrinopathy in this patient population is low. We determined whether any historical or physical findings obtained during the initial office visit would identify a subgroup of patients at risk for endocrinopathy to decrease the cost of endocrine screening. The results of routine endocrine screening of 330 consecutive impotent patients formed the basis of this study. A total of 7 patients (2.1%) had endocrinopathy. Testicular atrophy was observed in 5 of these 7 patients and 6 reported decreased libido. All of the patients with endocrinopathy had either decreased libido or bilateral testicular atrophy. Our results indicate that the cost of impotence evaluation can be decreased by screening only those patients with clinical signs of hypogonadism, that is either decreased libido or bilateral testicular atrophy.