Erectile dysfunction is diagnosed if a patient cannot get an erection sufficient for penetration or maintain it until orgasm.

“if they answer no to either one of those questions they have Ed under any condition even if it happens just once or if it says well you know eight times out of nine I'm okay but one time out of nine I can't so that had then they had one episode of Ed so it's graded right but by definition if someone says I can and the number one cause of Ed typically is I can't maintain it so they're gonna that's the first sign they say Doc I can get it but I can't maintain their action they're telling you I have Venus leak which is the first sign of some kind of erectile dysfunction”