genitourinary disorders
Erectile Dysfunction
Key Points
Vascular, neurologic, psychologic, and hormonal disorders and sometimes drug use can compromise achievement of satisfactory erections. Evaluate all men with ED for hormonal, neurologic, and vascular disorders and depression. Measuretestosteronelevels and consider other testing based on clinical findings. Treat underlying disorders and use an oral PDE5 inhibitor if necessary. If those measures are ineffective, consider intracavernosal or intraurethral prostaglandin E1 or use of a vacuum device; surgical implantation of a penile prosthesis is the final line of treatment. 