Erectile Dysfunction Disease Summary

Overview

Erectile dysfunction (ED) is the inability to attain and maintain an erection sufficient for satisfactory sexual performance as stated in the Introduction section.   

The prevalence of erectile dysfunction increases with age as sexual activity decreases, with as many as 150 million people affected by it. Other details in its prevalence are discussed in the Epidemiology section.

The Pathophysiology section discusses the processes that may be involved in erectile dysfunction.

The Risk Factors section states how erectile dysfunction has common risk factors with cardiovascular disease. Mentioned in this section as well are the different comorbidities and risks associated with erectile dysfunction. 

Erectile Dysfunction_Disease Summary

History and Physical Examination

The Clinical Presentation section discusses how erectile dysfunction can be an early manifestation of coronary artery and peripheral vascular disease. This section also discusses the other features of erectile dysfunction such as early detumescence, nocturnal penile, inability to maintain erection, etc.

The History section mentions the pertinent details in the history and the psychometric questionnaires that can be used in assessing patients. While the Physical Examination section emphasizes the importance of focusing on genitourinary, cardiovascular, and neurological systems.

Diagnosis

As stated in the Laboratory Tests and Ancillaries section, testing must be tailored to the patient’s complaints and risk factors. Some of the lab tests that can be done include fasting glucose, lipid profile, and even a testosterone assay to evaluate the hypothalamic-pituitary-gonadal axis

Management

The Evaluation section discusses risk stratification based on the different cardiovascular disease risk factors.

The goals of therapy are mentioned in the Principles of Therapy section. This section also emphasizes the importance of correcting any existing medical risk factors such as regulating glucose control, optimizing antihypertensive medication, treating hyperlipidemia, and reducing or stopping alcohol intake.

The Pharmacological Therapy section provides details of the various treatment options for erectile dysfunction like phosphodiesterase-5 (PDE5) inhibitors, intracavernosal injection therapy, and intraurethral therapy.

The Nonpharmacological section states the importance of patient and partner education, lifestyle modification, treating psychosocial factors, counseling and education, discontinuing offending medications, and other modalities like vacuum constriction devices and low-intensity shockwave therapy.

The Surgery section provides details on the different surgical options for erectile dysfunction.

As mentioned in the Monitoring section, patients receiving PDE5 inhibitors must have regular follow-up of efficacy, side effects, and any relevant change in their health status, especially cardiovascular health. Discussed here as well are the possible reasons for failure of response to PDE5 inhibitors and what one can do in such cases.