It is the most important sexual dysfunction among men. Erectile dysfunction (ED) is described as inadequate erection or unability to maintain erection during sexual intercourse. Even a healty man may not succeed the same quality of erection during each sexual intercourse. Further investigations are needed for a better clinical overview of the disease. Especially 50% of men over the age of 40 suffer from ED.
A sexual stimulation is needed for normal erection. When spongious vascular tissues relax, arterial blood flows into cavernous bodies. This will block venous outflow from penis while erection is maintained. Nerves around penis are important for erectile function. Any abnormality on these steps may end up with erectile dysfunction.
With aging, hypertension, diabetes, atherosclerosis, dyslipidemia, depression, tissue or organ injuries, neurological diseases, hormonal abnormalities, alcohol, tobacco and drug addiction may be the cause of ED.
A detailed history and physical examination are clinically important. Comorbid diseases and drug history need to be evaluated. Some blood tests are also mandatory. For selected cases, further tests such as penile doppler ultrasonography and nocturnal tumescence may be needed.
Comorbid diseases need to be contained. Additionally, erection pills may be prescribed. As a second step, intrapenile injections or vacuum devices are also available. For those who fail to respond to any of these treatment modalities, penile prothesis may be surgically implanted.