What is the basis for treatment selection in erectile dysfunction (ED)?

Updated: Oct 14, 2020
  • Author: Edward David Kim, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

After all the information regarding the patient’s status has been gathered, the various options for management of erectile dysfunction (ED) can be discussed. It is best to include the patient’s partner in this discussion. [1] One of the most difficult aspects of treatment is teaching men that sex entails more than simply achieving an erection.

The task of the physician is to identify which treatment would be most appropriate and most likely to have long-term success. To do that, the physician must take the time to understand the patient’s problem and be knowledgeable about the available options. Enough options are available that every man who wants to be sexually active can be, regardless of the etiology of the problem. These include the following:

  • Sexual counseling if no organic causes can be found for the dysfunction
  • Oral medications - Typically, phosphodiesterase type 5 (PDE5) inhibitors
  • External vacuum devices
  • Invasive therapy (eg, revascularization, penile implant)

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