Restoring erectile function

Vince is a 58-year-old man who has been attending the same general practice for a decade but who has not been seen for more than a year.

At his wife's insistence, Vince comes in for a 'health check'. He reports some weight gain and fatigue.

He is still smoking and doing little or no exercise. He has a family history of heart disease -- his father died of a heart attack at 65 but Vince reports no cardiac symptoms.

On examination, Vince weighs 92kg and his height is 178cm. His BMI is 29 and his blood pressure is 160/94. Both have increased compared to his last review.

His cardiovascular examination is otherwise normal. While asking about general health issues, Vince's GP explains that changes in the blood vessels in the penis can occur before changes in blood vessels in other organs such as the heart.

In this context, Vince is asked whether he has had any erectile problems.