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Referral criteria from primary care - erectile dysfunction (ED)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Urgent admission to hospital

  • if there is priapism (the patient should be advised to if he has an erection lasting longer than 4 hours).

Referral to secondary care is done in

  • penile abnormality (phimosis, Peyronie’s disease, post-priapism, penile cancer)
  • endocrinopathy (primary or secondary hypogonadism)
  • severe mental distress
  • first line pharmacotherapy ineffective
  • psychogenic erectile dysfunction refractory to first line drugs
  • specialised diagnostic tests needed (for example, penile Doppler studies, nocturnal penile tumescence)
  • intermediate or high risk cardiovascular disease
  • contraindication to phosphodiesterase-5 inhibitors
  • lifelong history of erectile dysfunction (1)


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