Ian Mac Innes

University of Sheffield, Sheffield, UK

Introduction 156

Anatomy and Physiology of Erection 159

Pathophysiology 161

Does He have a Psychogenic Basis to His ED? 161

Does He have an Endocrinological Cause to His ED? 161

Does He have Diabetes (a Major Cause of ED)? 162

Does He have a Neurogenic Basis to His ED? 162

Does He have a Vascular Basis to His ED? 162

Does He have Drug Related Issues? 162

History and Clinical Examination 163

The History 163

Use of Questionnaires 164

Physical Examination 165

Blood Investigations 165

Treatment Options for ED in Men 166

Pharmacotherapy for Men with ED 166

First Line (Oral) Therapies 166

Centrally Acting Oral Therapy 176

Second Line (Injectable and Intraurethral) Treatments 178

Third Line Therapies 180

Psychological Therapies for Men with ED 181

Psychosexual and Relationship Therapies for Men with ED 182

Integrated Therapies 182

Other Unlicensed Treatment Therapies for Men with ED 183

Treatment for Priapism 183

Surgical Interventions for Men with ED 183

Vascular Surgery 183

Prostheses 183

Special Situations Requiring Interventions for Men with ED 184

Depression and Serotonin Reuptake Inhibitors 184

Testosterone Deficiency 184

Conclusion 184

Appendix 184

References 185

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