Management of impotence in a developing country.

Three hundred and seventy five impotent men attended our Andrology clinic between July 1988 and June 1993. Their ages ranged from 20-89 years. Associated factors were diabetes mellitus, testicular failure, trauma, venous leak and hyperprolactinaemia. We categorised them into subgroups of highly educated men with manual dexterity and financial ability but impairment of manual dexterity, financially able but illiterate men, and illiterate poor with or without manual dexterity. Penile prostheses were implanted in 15; 48 were treated with vasoactive substances; 4 with vacuum devices and two had ligation of venous leaks. However, 297 (79%) men did not get the treatment best suited for their problems and received only supplementary hormones and/or psychological reassurance. In the developing countries, the selection of the appropriate treatment modality for impotence is compounded by considerations of economic, social and educational factors.