Levine S B
Ann Intern Med. 1976 Sep;85(3):340-50.
All clinicians are occasionally consulted by men complaining of impotence. The history is the most important step in the differential diagnostic process for this symptom. Answers to four basic questions enable the physician to recognize classic psychologic and organic patterns. In addition, these questions provide clues as to the cause of the dysfunction. Physical and laboratory examinations are usually required to identify the specific organic cause. Traditional prevalence figures for impotence may no longer be valid. This topic awaits epidemiologic data that reflect current diagnostic sophistication. Individual treatment approaches to both organic and psychologic impotence must counteract the adverse influence of performance anxiety.
所有临床医生偶尔都会接待抱怨阳痿的男性患者。病史是这一症状鉴别诊断过程中最重要的步骤。对四个基本问题的回答能使医生识别出典型的心理和器质性模式。此外，这些问题还能为功能障碍的病因提供线索。通常需要进行体格检查和实验室检查来确定具体的器质性病因。传统的阳痿患病率数据可能不再有效。这个话题有待反映当前诊断复杂性的流行病学数据。针对器质性和心理性阳痿的个体治疗方法必须抵消表现焦虑的不利影响。
