[Impotence: viewpoint of the internist]

Male sexual inadequacy due to erection dysfunction is often the result of cumulative organic (vascular, neurologic, endocrinologic) and psychogenic factors. Diagnosis and therapy must take into account all these various causative factors, and treatment failures are often due to unilateral appraisal of the patient. Sex counseling is necessary in all cases, even when organic causes have been documented. However, vasodilating drugs, androgens, and arterial or venous surgery also have a definite place in the treatment of erection failure.