Urology

ERECTILE DYSFUNCTION. Erectile dysfunction is defined as the recurring inability to achieve and/or maintain an erection suitable for successful sexual intercourse.

In addition to its adverse effect on sexual function, erectile dysfunction can have a psychosocial effect and a negative impact on quality of life for affected patients, as well as for their partners. Erectile dysfunction may also be an independent marker of cardiovascular disease, such as coronary artery disease or lower limb arterial disease (peripheral vasculopathy).

In Italy, erectile dysfunction has a prevalence of around 13%, increasing significantly among older patients, although around one patient in every four diagnosed with erectile dysfunction is under 40.

There are many risk factors for erectile dysfunction, including cigarette smoking, substance abuse (including alcohol), cardiovascular diseases such as arterial hypertension or ischaemic heart disease, diabetes mellitus, taking medication, hormonal imbalances, injuries, operations in the pelvic area, etc.

Diagnostic evaluation is crucial in order to identify and treat the “curable” causes of erectile dysfunction and to alter a patient's lifestyle. Doctor-patient dialogue which includes the patient's partner is an important part of the clinical management of erectile dysfunction.

The first line of treatment for erectile dysfunction in terms of medication is oral phosphodiesterase type 5 inhibitors (PDE5-I).

These drugs have been shown to improve the condition in patients with erectile dysfunction from a range of causes and at varying levels of severity, as well as in patients with concomitant diseases such as diabetes, hypertension or dyslipidemia.