NDLI: Dysfonction érectile.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Giuliano, F. Droupy, S.
Description	Country affiliation: France Author Affiliation: Giuliano F ( Neuro-uro-andrologie, service de médecine physique et réadaptation, université de Versailles Saint-Quentin en Yvelines, hôpital Raymond-Poincaré, Garches, AP-HP, 104, boulevard R.-Poincaré, 92380 Garches, France. francois.giuliano@uvsq.fr)
Abstract	INTRODUCTION: Erectile dysfunction (ED) is the most commonly studied sexual disorder. ED is defined by a consistent or recurrent inability to attain and/or maintain penile erection sufficient for sexual activity. METHODS: Medical literature was reviewed and combined with expert opinion of the authors. RESULTS: A review of ED prevalence is less than 10% in men aged below 50, superior to 20% for men over 60. Age, cardiovascular diseases, diabetes, hypercholesterolemia, smoking, depression and psychiatric illness, psychological disorders, unfavorable socio-economic conditions are all risk factors for erectile dysfunction. Drug sexual side-effects must also be envisaged. Erectile dysfunction can be psychogenic, organic or a mix of both. The pathophysiological mechanisms are diverse and can implicate deterioration of the central or peripheral neural pathways, from the arterial supply to the penis, endothelial dysfunction, smooth muscle tone impairment, structural damage of the sinusoidal spaces of the erectile tissue, or even hormonal disorders. Psychological and sexological management can help some patients suffering from psychogenic erectile dysfunction, usually associated with pharmacological treatment. Phosphodiesterase type 5 inhibitors (PDE5i) on demand or daily are an efficient symptomatic treatment in two thirds of patients with all forms of erectile dysfunction. Diabetic patients, after radical prostatectomy and/or with severe cardiovascular diseases respond poorly to PDE5i. Intracavernous injections of PGE1 or vacuum pump provide second line treatment for most patients. Penile implants are third line treatment and when the indication is carefully established give excellent results. DISCUSSION: ED work-up and treatment are highly standardized. Therapeutic success rates are high.
File Format	HTM / HTML
ISSN	11667087
Issue Number	9
Journal	Progr`es en Urologie
Volume Number	23
Language	French
Publisher	Elsevier
Publisher Date	2013-07-01
Publisher Place	France
Access Restriction	Subscribed
Subject Keyword	Erectile Dysfunction Therapy Discipline Urology Etiology Humans Male Diagnosis Review English Abstract Journal Article Physiopathology
Alternative Title	Erectile dysfunction
Content Type	Text
Resource Type	Article
Subject	Urology

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