Erectile dysfunction
小结
定义
病史和体格检查
关键诊断因素
- abnormalities on exam of penis
- abnormal androgenization
其他诊断因素
- premature ejaculation
- abnormal prostate exam
- psychosocial stressors
- Peyronie disease
- genital pain or numbness
危险因素
- coronary arterial disease
- peripheral arterial disease
- hyper/hypothyroidism
- psychosexual/relationship problems
- excess alcohol intake
- hypertension
- hyperlipidemia
- diabetes mellitus
- obesity
- smoking
- metabolic syndrome
- neurologic disease
- radical pelvic surgery
- spinal cord injury
- pelvic fracture
- Peyronie disease
- depression
- premature ejaculation
- hypogonadism
- long-distance cycling
- antihypertensive use
- antidepressant use
- corticosteroid use
- antiandrogenic agent use
- desire/libido disorders
- benign prostatic hyperplasia
诊断性检查
首要检查
- International Index of Erectile Dysfunction
- Sexual Health Inventory for Men
- fasting blood glucose
- lipid profile
需考虑的检查
- hemoglobin A1c in diabetic men
- testosterone (morning)
- follicle-stimulating hormone and luteinizing hormone
- thyroid-stimulating hormone
- prolactin
- Doppler ultrasonography
- pelvic/penile angiography
治疗流程
all patients (except those with Peyronie disease, psychogenic ED, and previous pelvic injury with arterial compromise)
Peyronie disease
previous pelvic injury with arterial compromise
psychogenic ED
撰稿人
作者
Omer Raheem, MD, MSc, MCh, MRCS
Assistant Professor of Surgery and Urology
The University of Chicago Medical Center
Pritzker School of Medicine
Chicago
IL
利益声明
OR declares that he has no competing interests.
Anjali Shekar, MD
Urology Resident
The University of Chicago Medical Center
Pritzker School of Medicine
Chicago
IL
利益声明
AS declares that she has no competing interests.
鸣谢
Dr Omer Raheem and Dr Anjali Shekar would like to gratefully acknowledge Dr Edward D. Kim, Dr Andrew C. Kramer, Dr Daniel H. Williams, and Dr James K. Kuan, previous contributors to this topic.
利益声明
EDK, ACK, DHW, and JKK declare that they have no competing interests.
同行评议者
Justin Vale, MS, FRCS
Urological Surgeon
Imperial Healthcare NHS Trust
London
UK
利益声明
JV declares that he has no competing interests.
Arthur L. Burnett, MD
Professor of Urology
Cellular and Molecular Medicine
The James Buchanan Brady Urological Institute
The Johns Hopkins Hospital
Baltimore
MD
利益声明
ALB declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Dewitte M, Bettocchi C, Carvalho J, et al. A psychosocial approach to erectile dysfunction: position statements from the European Society of Sexual Medicine (ESSM). Sex Med. 2021 Dec;9(6):100434.全文 摘要
Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA guideline. J Urol. 2018 Sep;200(3):633-41.全文 摘要
Nehra A, Jackson G, Miner M, et al. The Princeton III Consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clin Proc. 2012 Aug;87(8):766-78.全文 摘要
Rosen RC, Cappelleri JC, Smith MD, et al. Development and evaluation of an abridged, 5-item version of the international index of erectile function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999 Dec;11(6):319-26. 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Premature ejaculation
- Priapism
更多 鉴别诊断指南
- Diagnostic evaluation of sexual dysfunction in the male partner in the setting of infertility
- Sexual and reproductive health: management of erectile dysfunction
更多 指南患者教育信息
Erection problems
Erection problems: questions to ask your doctor
更多 患者教育信息
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