Hormonal Protocol • ICD-10 N52.9
Vasculogenic Erectile Dysfunction & Lower Urinary Tract BPH
Impaired cavernosal smooth-muscle nitric oxide/cGMP relaxation frequently co-occurring with prostatic stromal hyperplasia and bladder outlet obstruction.
Medically Reviewed by Dr. Julian Sterling, MD, FACS (NPI #1376841536)
Vasculogenic Erectile Dysfunction & Lower Urinary Tract BPH Optimal Biomarker & Diagnostic Fact Matrix
| Metric | Verified Benchmark | Source |
|---|---|---|
| ICD-10-CM Diagnostic Classification | N52.9 | WHO / CMS ICD-10-CM Clinical Modification |
| Biomarker: IIEF-5 Score | 22 – 25 | DotMD Preventive Optimal Target Range |
| Biomarker: Total PSA | < 1.5 ng/mL (age-adjusted) | DotMD Preventive Optimal Target Range |
| Biomarker: Fasting Glucose & ApoB | Rule out microvascular etiology | DotMD Preventive Optimal Target Range |
Pathophysiology & Clinical Presentation
Endothelial dysfunction blunts eNOS-derived nitric oxide activation of soluble guanylate cyclase while premature PDE5 hydrolysis degrades cGMP; concurrently, prostatic alpha-1A adrenergic tone narrows the prostatic urethra.
Hallmark Clinical Signs & Biomarker Triggers
- Inconsistent cavernosal rigidity or premature detumescence
- Weak urinary stream, nocturia, and incomplete bladder emptying
- Early sentinel marker of systemic microvascular dysfunction
Evidence-Based Medications & Cash Arbitrage for Vasculogenic Erectile Dysfunction & Lower Urinary Tract BPH
| Medication | Mechanism Class | Worth-It Score | Retail Avg | Lowest Cash |
|---|---|---|---|---|
| Tadalafil Cialis, Adcirca | Long-Half-Life Selective Phosphodiesterase-5 (PDE5) Inhibitor | 96.10% (64) | $165.00 | $5.90/mo |
| Nebivolol Hydrochloride Bystolic | Cardioselective Beta-1 Blocker & Endothelial eNOS Nitric Oxide Enhancer | 92.00% (24) | $148.00 | $9.40/mo |
| Sildenafil Citrate Viagra, Revatio | Rapid-Onset Cavernosal & Pulmonary PDE5 Inhibitor | 91.40% (52) | $138.00 | $5.40/mo |
| Dutasteride Avodart | Dual Type I, II & III 5-Alpha-Reductase Pan-Inhibitor | 90.20% (34) | $98.00 | $7.90/mo |
| Alfuzosin Hydrochloride Geomatrix ER Uroxatral | Ejaculation-Sparing Prostatic Alpha-1 Adrenergic Antagonist | 89.50% (19) | $92.00 | $8.70/mo |
| Vardenafil Hydrochloride Levitra, Staxyn | High-Affinity Imidazotriazinone PDE5 Inhibitor | 87.80% (18) | $188.00 | $12.40/mo |
| Finasteride Propecia (1 mg), Proscar (5 mg) | Competitive Type II & III 5-Alpha-Reductase Inhibitor | 86.90% (58) | $62.00 | $5.50/mo |
| Mirabegron Extended-Release Myrbetriq | Detrusor Smooth-Muscle Beta-3 Adrenoceptor Agonist | 86.70% (14) | $446.00 | $48.90/mo |
| Tamsulosin Hydrochloride Flomax | Uroselective Alpha-1A / Alpha-1D Adrenoceptor Antagonist | 83.50% (27) | $38.00 | $5.80/mo |
| Pentoxifylline Controlled-Release Trental | Hemorheologic Methylxanthine Erythrocyte Deformability & TNF-Alpha Inhibitor | 81.70% (14) | $56.00 | $9.40/mo |
| Bremelanotide (PT-141 Autoinjector) Vyleesi | Central Melanocortin MC4R / MC3R Sexual Excitation Agonist | 81.40% (16) | $890.00 | $165.00/mo |
INSTANT PRESCRIPTION & CASH ROUTING
DotMD Club Members get $29 flat-rate script renewals →
Verified Online Prescribers & Wholesale Pharmacies for Vasculogenic Erectile Dysfunction & Lower Urinary Tract BPH
Mark Cuban Cost Plus Drugs (Wholesale Pharmacy)
Requires an existing doctor prescription. Need a script? Pair with a $29 DotMD Club TeleMed consult.
$5.90/mo
Wholesale Cash Price
Ro Body & Metabolic Clinic (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~2 days
$
45.00
Consult / Starting Tier
Hone Health Hormone & At-Home Biomarker Lab (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~3 days
$
65.00
Consult / Starting Tier
Hims & Hers Direct Cash Pharmacy (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~2 days
• Rx included in monthly tier
$
49.00
All-In Monthly