简介：Erectiledysfunction(ED)isahighlyprevalentdisorderaffectinganestimated152millionmenworldwideandisassociatedwithavarietyofbehavioralriskfactors,suchascigarettesmokingandexcessivealcoholconsumption,aswellasnumerousage-relatedmedicalconditions,notablytype-2diabetesmellitusandcardiovasculardisease.Arationalstep-wiseapproachwhichincludescomprehensivemedicalandsexualhistory,afocusedphysicalexaminationandessentiallaboratorytestssuchasfastingglucose,lipidprofileandtestosteroneassayistobepreferred.Currentdiagnosticwork-updoesnotrecommendanyofthespecializedtestswhichwerepreviouslyconsideredmandatory-i.e.penilepharmacotesting,Duplexultrasoundandnocturnalpeniletumescence.HormonalreplacementtherapyisappropriateonlyinthehypogonadalmalewithED.Priortodirectintervention,thephysicianshouldconsideralteringmodifiableriskfactorsorcauses,althoughfrequentlyinsufficienttoreverseEDcompletely.Whenindicated,oraltherapywithnewmolecules(phosphodiesteraseinhibitorsorapomorphine)isthefirst-linetreatmentforthemajorityofpatientsbecauseofpotentialbenefitsandlackofinvasiveness.