Erectile dysfunction.
OBJECTIVE
An overview of the latest concepts advanced with regard to the epidemiology, pathophysiology, and management of male ED is provided.


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.
Burnett
Arthur L
AL
Johns Hopkins University, Baltimore, Maryland 21287, USA. aburnett@jhmi.edu
D000328:Adult; D000367:Age Factors; D000368:Aged; D000728:Androgens / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000379:methods; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015917:Penile Prosthesis; D018570:Risk Assessment; D012720:Severity of Illness Index; D012731:Sex Counseling / Q000379:methods; D016896:Treatment Outcome
D000728:Androgens