title: Love and sex after 60: how to evaluate and treat the impotent older man. A roundtable discussion: Part 2.
abstract: In the medical evaluation of older men with erectile dysfunction, obtain a detailed history to determine whether the dysfunction is organic or psychogenic. Determine if there are underlying pathologic processes--most notably vascular diseases--or other factors responsible for the dysfunction, such as medications or nerve or arterial damage from surgery. Lifestyle changes in mid-life (regular exercise, a low-fat diet, and smoking cessation) increase a man's chances of remaining potent as he grows older. Treatments for impotence include injection therapy, vacuum devices, and implants. Each therapy has advantages and disadvantages, and the informed patient plays an important role in choosing the therapy that is right for him.
authors.affiliation: Henry L. Schwartz Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York.
authors.forename: R N
authors.initials: RN
authors.lastname: Butler
authors.forename: M I
authors.initials: MI
authors.lastname: Lewis
authors.forename: E
authors.initials: E
authors.lastname: Hoffman
authors.forename: E D
authors.initials: ED
authors.lastname: Whitehead
mesh_terms: D000368:Aged / Q000523:psychology*; D000527:Alprostadil / Q000627:therapeutic use; D007172:Erectile Dysfunction / Q000209:etiology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010208:Papaverine / Q000009:adverse effects / Q000627:therapeutic use; D015917:Penile Prosthesis; D010646:Phentolamine / Q000009:adverse effects / Q000627:therapeutic use; D011468:Prostatectomy / Q000009:adverse effects; D014618:Vacuum
chemical_list: D010208:Papaverine; D000527:Alprostadil; D010646:Phentolamine