Erectile dysfunction has an organic etiology in most cases, with vascu
lar disease the single most common cause. In addition to a thorough hi
story and physical examination, clinical evaluation may include hormon
al assessment, diabetes screening, nocturnal tumescence testing and co
lor Doppler flow studies of the penile vasculature. Therapy for erecti
le dysfunction has progressed rapidly during the past decade, with alt
ernatives including hormone supplements, vacuum constriction devices,
penile self-injection therapy and penile prostheses. The majority of p
atients and their partners report satisfactory results with these trea
tments.