Erectile dysfunction (ED), although recognized as a pathologic condition for thousands of years, was not clearly defined until 1992, thus overcoming one of many barriers to treatment. ED is defined as the inability to achieve or maintain erection of sufficient rigidity and duration to permit satisfactory sexual performance. Causes of ED are psychogenic, vasculogenic, neurogenic, endocrinologic, cavernosal smooth muscle dysfunction, iatrogenic, pharmacologic, or combination of these. Diagnosis and evaluation of ED can be as simple as a questionnaire or involve complex testing and imaging. Treatment of ED follows a stepwise progression from noninvasive strategies to surgical placement of penile prostheses.
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