Evaluation of the Patient With Erectile Dysfunction

Abstract

Evaluation of the male with erectile dysfunction (ED) has evolved over the past two decades. Although a complex array of diagnostic studies are available and may be employed in the appropriate subject, for the great majority of men these invasive, expensive, and on occasion painful studies are not necessary. Clearly, most men have a physiological etiology to their dysfunction and in fact, most of these men have a vascular cause. It seems that the fundamentals of medicine provide the most useful information, including a thorough medical history and physical exam as well as blood testing of serum glucose, lipids, and, when a hypogonadal etiology is suspected, semen testosterone. There are several circumstances in which a more detailed analysis is in order, including patients who fail first-line therapy with oral pharmacotherapy and those with primary or traumatic ED. This chapter provides an up-to-date review of the diagnostic approach to the man with ED.