Urologic/clinical treatment of erectile dysfunction

Abstract

The treatment of erectile dysfunction (ED) employs a step-wise algorithm to achieve an optimal response. Treatment is progressive, with the initial use of oral pharmacotherapy, and becomes more invasive if initial therapies fail. Vacuum erection devices (VEDs) and intraurethral or intracavernosal vasoactive agents comprise second-line treatments. Comorbid conditions, such as hormonal deficiencies and cardiovascular disease, should be identified and managed concurrently using lifestyle modification or medical therapies. For refractory ED, penile prosthetic surgery is available for appropriate patients, resulting in high satisfaction rates. Addressing psychosocial factors contributing to ED can maximize treatment efficacy.