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Erectile Dysfunction (ED)
Erectile dysfunction is a common sexual dysfunction in males; it involves a change in the organic, relational, or psychological components of an erectile response. Erectile dysfunction results in the inability to achieve or maintain an erection that is adequate for sexual performance. Both the reflex and psychogenic erection are affected. Erectile dysfunction also serves as an indicator of systemic endothelial dysfunction. Additionally, it is often used as an early marker for men at risk of cardiovascular disease. The most common nonendocrine etiologies are vasculogenic, iatrogenic, and neurogenic. Diabetes, alcohol use, smoking cigarettes, benign prostate hyperplasia, and lower urinary tract symptoms increase risk of erectile dysfunction.
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Erectile Dysfunction Diagnosis
Detailed medical and sexual history are the first step of erectile dysfunction diagnosis, along with a genitourinary exam. Peyronie disease, phimosis, or frenulum breve may be indicated by the genitourinary exam. Standardized sexual inventories and self-reported questionnaires are useful for interpreting the patient’s sexual health responses, without embarrassing the patient. Physical examinations include evaluation of the chest, penis, testes, prostate, and hair growth to identify potential hypogonadism. Hyperthyroidism, hypothyroidism, arrhythmia, and atherosclerosis may be indicated by the evaluation of the peripheral vascular system.
Erectile Dysfunction (ED) Podcasts
Listen to leading physicians discuss erectile dysfunction (ed) on the BackTable Urology Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.
Dr. Jose Silva brings Dr. Jonathan Clavell back onto the show to discuss complex penile implant cases. They cover how to deal with mechanical complications of AMS700 and Coloplast Titan, penile implants in Peyronie's disease, penile implants in priapism, tips for successful revision surgery, and how to manage post-operative infections.
Dr. Ranjith Ramasamy explains the known effects of the COVID-19 virus and the pandemic on testosterone levels, vasculogenic erectile dysfunction, male fertility, and sexual practice patterns. Additionally, Dr. Ramaswamy uses evidence-based medicine to debunk myths about the adverse effects of the COVID-19 vaccine on men’s health.
Dr. Jose Silva interviews Dr. Jonathan Clavell, a high-volume prosthetic urology surgeon and assistant professor of urology at UT Health Science Center Houston, about erectile dysfunction counseling and penile implants. Dr. Clavell goes into detail about his journey as a men’s health specialist, ED workup and medical counseling, advantages and limitations of different penile implants, implants for complex ED patients (diabetics, cancer patients, etc.), and post-operative care for penile implant patients
Erectile Dysfunction Treatment
Lifestyle modifications, such as a diet change, increase in physical activity, or medication change are the first line of treatment for erectile dysfunction. PDE5 inhibitors and vacuum erection devices are first line therapies that are followed by lifestyle adjustments. If primary treatments are unsuccessful, intraurethral suppository and intracavernosal injection can be used as other nonsurgical interventions. Erectile dysfunction is treated with surgical interventions, such as penile implants and penile revascularization, when all other therapies have been attempted.
Erectile Dysfunction (ED) Articles
Read our exclusive BackTable Urology Articles for quick insights on erectile dysfunction (ed), provided by physicians for physicians.
Patients with chronic priapism require special considerations when undergoing penile implant surgery. Dr. Jonathan Clavell shares advice about assessing the extent of fibrosis present, special preoperative therapies, and additional surgical techniques in order to place a penile implant successfully.
 Yafi, F. A., Jenkins, L., Albersen, M., Corona, G., Isidori, A. M., Goldfarb, S., Maggi, M., Nelson, C. J., Parish, S., Salonia, A., Tan, R., Mulhall, J. P., & Hellstrom, W. J. G. (2016, February 4). Erectile dysfunction. Nature reviews. Disease primers. Retrieved October 31, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027992/
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