Foresta Carlo, Argiolas Antonio, Bassi PierFrancesco, Bettocchi Carlo, Fabbri Andrea, Gentile Vincenzo, Ghirlanda Giovanni, Isidori Aldo, Jannini Emmanuele, Ledda Andrea, Maggi Mario, Rosano Giuseppe M C, Spera Giovanni, Caretta Nicola
Centro di Crioconservazione dei Gameti Maschili, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi di Padova.
Ann Ital Med Int. 2003 Oct-Dec;18(4):204-18.
Erectile dysfunction (ED), defined as the inability to achieve and/or maintain an erection sufficiently long for a satisfactory sexual performance or intercourse, is an important and common medical problem. ED is not a life-threatening disorder, but it influences the daily routine, social interactions, well-being and quality of life of the patient. Recent epidemiological data have shown a high prevalence and incidence of ED. The Massachusetts Male Aging Study found that 52% of men between the ages of 40 and 70 years reported ED with 9.6% having mild, 22.2% moderate and 17.2% complete or severe ED. In a large Italian cross-sectional study the overall prevalence of self-reported ED was 12.8% and the frequency of ED increases with age. ED may signal serious underlying and potentially life-threatening diseases, such as diabetes, hypertension, cardiovascular disease, peripheral vascular disease and other neurological and endocrine disorders. Also well documented is the role of some drug groups, certain types of surgery, injuries and the role of risk factors related to lifestyle such as smoking, alcohol consumption and inappropriate dietary habits accompanied by an abnormal serum level of cholesterol. The current availability of effective and safe oral drugs for ED in conjunction with the tremendous media interest in the condition, have resulted in an increasing number of men seeking help for ED. As a consequence, many physicians without background knowledge and clinical experience in the diagnosis of ED are involved in making decisions concerning the evaluation of such patients. The result of this is that some males with ED may undergo little or no evaluation before treatment is initiated and, in such circumstances, the disease causing the symptom (ED) may remain untreated. Baseline diagnostic evaluation for ED can identify the underlying pathological condition or the risk factors associated with ED in 80% of patients. This article reports a sequential approach for the diagnosis of ED that may diagnose reversible causes of ED and also unmask medical conditions that manifest with ED as the first symptom.
勃起功能障碍（ED）被定义为无法勃起和/或维持足够长的勃起时间以获得满意的性行为或性交，是一个重要且常见的医学问题。ED并非危及生命的疾病，但它会影响患者的日常生活、社交互动、幸福感和生活质量。最近的流行病学数据显示ED的患病率和发病率都很高。马萨诸塞州男性老龄化研究发现，40至70岁的男性中有52%报告患有ED，其中9.6%为轻度，22.2%为中度，17.2%为完全或重度ED。在一项大型意大利横断面研究中，自我报告的ED总体患病率为12.8%，且ED的发生率随年龄增长而增加。ED可能预示着严重的潜在疾病，甚至可能危及生命，如糖尿病、高血压、心血管疾病、外周血管疾病以及其他神经和内分泌疾病。一些药物组、某些类型的手术、损伤以及与生活方式相关的风险因素（如吸烟、饮酒和不良饮食习惯，伴有异常的血清胆固醇水平）所起的作用也有充分记录。目前有有效且安全的口服药物治疗ED，再加上媒体对该病症的极大关注，导致越来越多的男性寻求ED方面的帮助。因此，许多没有ED诊断背景知识和临床经验的医生参与到对这类患者的评估决策中。结果是，一些患有ED的男性在开始治疗前可能很少或根本没有接受评估，在这种情况下，导致症状（ED）的疾病可能得不到治疗。对ED进行基线诊断评估可在80%的患者中识别出潜在的病理状况或与ED相关的风险因素。本文报告了一种用于诊断ED的序贯方法，该方法可能诊断出ED的可逆病因，还能揭示以ED为首发症状的疾病状况。
