Erectile dysfunction is the persistent inability to achieve and/or maintain an erection sufficient for satisfactory sexual performance. Although the incidence increases over the years, this condition can affect any age.
Erectile dysfunction can be caused by a combination of physical and psychological factors. Age, diabetes, dyslipidemia, hypertension and obesity are the main physical causes. Psychological causes may include anxiety, stress, depression. It is important to emphasize that an unhealthy lifestyle, such as lack of physical exercise, smoking, drugs use, can also negatively affect erectile function. Regardless of its causes, this condition has a negative impact on the quality of life of the patients and their partners.

DIAGNOSIS AND TREATMENT

The first step in treating erectile dysfunction is certainly a proper diagnostic evaluation, which involves three key moments:

• It is necessary to collect a detailed medical history of the patients and their partners to identify the severity and the duration of the symptoms. To this end it is essential to establish a connection with the patients and make them feel comfortable.

• A comprehensive physical examination is mandatory. it should not focus exclusively on the genitourinary system.
• Every patient should always undergo laboratory tests to assess not only their hormonal balance but also their overall physical condition. We must not forget that erectile dysfunction often can be a warning sign for a systemic condition. For this reason, the specialist’s role is not the one to stop at the symptom treating it, he needs to get to the roots of this condition.

Other tests, such as the nocturnal assessment of erections, dynamic penile ultrasound or cavernosography, are rarely necessary.

The doctor-patient dialogue is essential throughout the management of erectile dysfunction, as the treatment must be tailored to individual patients, considering the severity of the problem, the tolerability and effectiveness of the therapeutic options, and surely patients’ expectations.

Currently, we can offer a wide range of therapeutic options: medical, physical and surgical alternatives. These treatments range from the oral pharmacological therapies to physical therapy with shockwaves, and even to the implantation of penile prostheses in severe cases.
Nowadays, erectile dysfunction affects thousands of men worldwide. Nevertheless, many men suffer in silence due to social stigmas and embarrassment. These men often feel deprived of their self-esteem and struggle with their relationship. It is important not to neglect this condition and to consult a specialist, as proper management can lead to a significant improvement in quality of life.