Erectile Dysfunction: A Comprehensive Review of Pathophysiology, Diagnosis and Contemporary Management

Area of Science:

• Urology
• Andrology
• Sexual Medicine

Background:

• Erectile dysfunction (ED) is a prevalent condition affecting men of all ages.
• ED significantly impacts physical, psychological, and relational well-being.
• Rising prevalence in younger men necessitates updated diagnostic and therapeutic approaches.

Purpose of the Study:

• To review contemporary evidence on erectile dysfunction (ED) pathophysiology, diagnosis, and management.
• To emphasize guideline-directed care and emerging treatment modalities for ED.
• To provide practical guidance for clinicians managing ED.

Main Methods:

• Comprehensive literature search of clinical guidelines, landmark trials, and recent studies.
• Synthesis of evidence on ED pathophysiology, diagnostic workup, and treatment options.
• Critical appraisal of established and emerging ED therapies.

Main Results:

• Lifestyle optimization and phosphodiesterase type 5 inhibitors (PDE5is) are foundational ED treatments.
• Second-line ED therapies include alprostadil, vacuum devices, and penile prosthesis surgery.
• Psychosexual therapy is crucial for psychogenic or mixed ED etiologies.

Conclusions:

• A multidisciplinary, individualized approach is essential for modern ED management.
• Established treatments offer high efficacy and satisfaction.
• Regenerative therapies and digital tools require further high-quality research for ED treatment.