Erectile dysfunction.

Erectile dysfunction affects millions of men in this country. Impairment of neurologic, hormonal and vascular function can inhibit the corporal smooth muscle relaxation necessary for erectile function. Physicians should employ a diagnostic work-up that proceeds from a history and physical examination to laboratory studies and physiologic testing. Treatment, which should be prescribed with constant patient input, is successful in a high percentage of cases. For erectile dysfunction with psychogenic or hormonal etiologies, treatments target the specific underlying problem. For dysfunction caused by nonspecific vascular and neurogenic problems, useful treatments include medication, vacuum devices, intracavernosal injections and penile implants.