Erectile dysfunction affects millions of men in this country. Impairme
nt of neurologic, hormonal and vascular function can inhibit the corpo
ral smooth muscle relaxation necessary for erectile function. Physicia
ns should employ a diagnostic work-up that proceeds from a history and
physical examination to laboratory studies and physiologic testing. T
reatment, which should be prescribed with constant patient input, is s
uccessful in a high percentage of cases. For erectile dysfunction with
psychogenic or hormonal etiologies, treatments target the specific un
derlying problem. For dysfunction caused by nonspecific vascular and n
eurogenic problems, useful treatments include medication, vacuum devic
es, intracavernosal injections and penile implants.