Laboratory of Experimental Urology, Department of Urology, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium.
Med Clin North Am. 2011 Jan;95(1):201-12. doi: 10.1016/j.mcna.2010.08.016.
Erectile dysfunction (ED) is a prevalent and important disease that has been associated with various comorbidities. The evaluation of patients with ED should include a general health assessment followed by a discussion of reversible factors and lifestyle changes that might help preserve erectile capacity. Numerous effective treatment options are currently available. A frank discussion about use and side effects of these therapies is required to optimize success. Although oral pharmacologic treatments can be initiated and monitored by the primary care physician, patients who do not experience response to these treatments may be best served by referral to a sexual medicine specialist for further assessment and consideration of other treatment options. This article discusses the physiology and pathophysiology of erectile function in men, how the primary care physician may address the clinical problem of ED in practice, and when specialty referral is indicated.
勃起功能障碍（ED）是一种普遍且重要的疾病，与多种合并症相关。ED 患者的评估应包括一般健康评估，然后讨论可能有助于保持勃起能力的可逆因素和生活方式改变。目前有许多有效的治疗选择。需要坦诚地讨论这些疗法的使用和副作用，以优化治疗效果。虽然初级保健医生可以启动和监测口服药物治疗，但对这些治疗没有反应的患者最好由性医学专家进一步评估，并考虑其他治疗选择。本文讨论了男性勃起功能的生理学和病理生理学，初级保健医生如何在实践中解决 ED 的临床问题，以及何时需要专科转诊。
