Burnett Arthur L
Johns Hopkins University, Baltimore, Maryland 21287, USA.
J Urol. 2006 Mar;175(3 Pt 2):S25-31. doi: 10.1016/S0022-5347(05)00309-5.
An overview of the latest concepts advanced with regard to the epidemiology, pathophysiology, and management of male ED is provided.
Published literature and current paradigms promoted by consensus bodies in the field with regard to the management of ED were reviewed.
ED is a neurovascular phenomenon modulated by hormonal, local biochemical, and biomechanical/structural factors of the penis. Once viewed primarily as a psychological issue, ED is now understood to represent predominantly organic etiologies. It has a significant association with cardiovascular disease and could serve as a harbinger of subsequent cardiovascular events. Goal directed assessment and management implies a focus on patient (and partner) preferences regarding various treatment options. These options range from oral pharmacological agents to surgery and may be pursued according to a stepwise management approach. Psychosocial interventions also may serve as useful therapeutic adjuncts.
ED is a highly manageable disorder in most patients. The patient and his partner have integral roles in the decision making process, since preferences regarding the importance of sexual activity, and the risks and benefits of treatment will vary greatly among individuals.
对男性勃起功能障碍（ED）的流行病学、病理生理学及管理方面的最新概念进行概述。
回顾该领域共识机构所倡导的关于ED管理的已发表文献及当前范式。
ED是一种由阴茎的激素、局部生化及生物力学/结构因素调节的神经血管现象。ED曾主要被视为心理问题，如今主要被认为是由器质性病因所致。它与心血管疾病显著相关，且可能是后续心血管事件的先兆。目标导向的评估与管理意味着关注患者（及伴侣）对各种治疗选择的偏好。这些选择从口服药物到手术不等，可按照逐步管理方法进行。社会心理干预也可作为有用的治疗辅助手段。
在大多数患者中，ED是一种易于管理的疾病。患者及其伴侣在决策过程中起着不可或缺的作用，因为个体对性活动重要性的偏好以及治疗的风险和益处差异很大。
