ABSTRACT
Erectile dysfunction (ED) is defined as the consistent or recurrent inability of a man to attain and/or maintain a penile erection sufficient for sexual activity.
It is present in more than 50% of men between ages 40 and 70 years and is associated with cardiovascular disease, smoking and peripheral vascular disease.
Evaluation is primarily based upon history and physical exam.
Oral type 5 phosphodiesterase inhibitors are a highly efficacious and safe form of treatment. They should be considered as first-line therapy.
Other types of treatment include intracavernous injection of vasoactive agents (alprostadil, papaverine, phentolamine, ora combination of all three known as tri-mix), intraurethral injection of alprostadil, vacuum constriction devices, and penile prostheses.
Peyronie’s disease is a localized connective tissue disorder of the penis characterized by changes in the collagen composition of the tunica albuginea.
Peyronie’s disease typically presents as a palpable penile plaque, penile pain, penile curvature and erectile dysfunction. Treatment includes medical therapy (efficacy uncertain) and surgery.
