Resumo
Definição
History and exam
Key diagnostic factors
- presença de fatores de risco
- anormalidades no exame físico do pênis
- androgenização anormal
Other diagnostic factors
- ejaculação precoce
- exame da próstata anormal
- estressores psicossociais
- Doença de Peyronie
- dor ou dormência genital
Risk factors
- doença arterial coronariana
- doença arterial periférica
- hiper/hipotireoidismo
- problemas psicossexuais/de relacionamento
- consumo excessivo de álcool
- hipertensão
- hiperlipidemia
- diabetes mellitus
- obesidade
- tabagismo
- síndrome metabólica
- doença neurológica
- cirurgia pélvica radical
- lesão na medula espinhal
- fratura pélvica
- Doença de Peyronie
- depressão
- ejaculação precoce
- hipogonadismo
- ciclismo de longa distância
- uso de anti-hipertensivo
- uso de antidepressivos
- uso de corticosteroide
- uso de agente antiandrogênico
- distúrbios de desejo/libido
- hiperplasia prostática benigna
Diagnostic tests
1st tests to order
- International Index of Erectile Dysfunction
- Sexual Health Inventory for Men
- glicemia de jejum
- perfil lipídico
Tests to consider
- hemoglobina A1c em homens diabéticos
- testosterona (matinal)
- hormônio folículo-estimulante (FSH) e hormônio luteinizante (LH)
- hormônio estimulante da tireoide
- prolactina
- ultrassonografia com Doppler
- angiografia pélvica/peniana
Treatment algorithm
todos os pacientes (exceto aqueles com doença de Peyronie, disfunção erétil [DE] psicogênica e lesão pélvica prévia com comprometimento arterial)
Doença de Peyronie
lesão pélvica prévia com comprometimento arterial
disfunção erétil (DE) psicogênica
Contributors
Authors
Omer Raheem, MD, MSc, MCh, MRCS
Assistant Professor of Surgery and Urology
The University of Chicago Medical Center
Pritzker School of Medicine
Chicago
IL
Disclosures
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
Disclosures
AS declares that she has no competing interests.
Acknowledgements
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.
Disclosures
EDK, ACK, DHW, and JKK declare that they have no competing interests.
Peer reviewers
Justin Vale, MS, FRCS
Urological Surgeon
Imperial Healthcare NHS Trust
London
UK
Disclosures
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
Disclosures
ALB declares that he has no competing interests.
References
Key articles
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.Full text Abstract
Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA guideline. J Urol. 2018 Sep;200(3):633-41.Full text Abstract
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.Full text Abstract
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. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Ejaculação precoce
- Priapismo
More DifferentialsGuidelines
- Diagnostic evaluation of sexual dysfunction in the male partner in the setting of infertility
- Sexual and reproductive health: management of erectile dysfunction
More GuidelinesPatient information
Problemas de ereção
Problemas de ereção: perguntas a fazer ao seu médico
More Patient information
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