Clinical evaluation of impotence

Area of Science:

• Urology
• Andrology
• Men's Health

Background:

• Erectile dysfunction (ED) pathophysiology is increasingly understood, enabling accurate diagnosis of impotence causes.
• Clinical evaluation of ED should encompass comprehensive sexual and medical history, alongside physical examination.

Purpose of the Study:

• To critically evaluate special investigations for erectile dysfunction.
• To define indications and pitfalls of diagnostic modalities for impotence.
• To establish a logical approach to ED evaluation.

Main Methods:

• Review of special investigations including nocturnal penile tumescence studies, duplex ultrasonography, dynamic infusion cavernosometry and cavernosography, and arteriography.
• Critical analysis of the impact of these investigations on patient management and outcomes.

Main Results:

• The utility of special investigations in ED is debated, as results often do not alter patient management.
• Investigations should be selectively ordered based on their potential to influence patient outcomes.

Conclusions:

• A logical approach to ED evaluation prioritizes clinical assessment.
• Special investigations for impotence should be reserved for cases where they will guide treatment decisions.