Erectile dysfunction

Purpose: An overview of the latest concepts advanced with regard to the epidemiology, pathophysiology, and management of male ED is provided. Materials and Methods: Published literature and current paradigms promoted by consensus bodies in the field with regard to the management of ED were reviewed. Results: ED is a neurovascular phenomenon modulated by hormonal, local biochemical, and biomechanical/structural factors of the penis. Once viewed primarily as a psychological issue, ED is now understood to represent predominantly organic etiologies. It has a significant association with cardiovascular disease and could serve as a harbinger of subsequent cardiovascular events. Goal directed assessment and management implies a focus on patient (and partner) preferences regarding various treatment options. These options range from oral pharmacological agents to surgery and may be pursued according to a stepwise management approach. Psychosocial interventions also may serve as useful therapeutic adjuncts. Conclusions: ED is a highly manageable disorder in most patients. The patient and his partner have integral roles in the decision making process, since preferences regarding the importance of sexual activity, and the risks and benefits of treatment will vary greatly among individuals.