Printed in IRAN Erectile Dysfunction: Clinical Guidelines (1)

Purpose: According to a survey, the Massachusetts Male Aging Study, 52 % of men beyond 40 years of age may have some degrees of erectile failure, and it is projected to affect 322 million men worldwide by 2025. We present a framework for the evalu-ation, treatment, and follow-up of the male patient who presents with erectile dysfunc-tion. Materials and Methods: A comprehensive review of the literature was conducted using the MEDLINE database for all articles from 1975 through 2004 on male sexual dysfunction and the most pertinent articles are discussed. Results: Remarkable progress has been made in the treatment of erectile dysfunc-tion (ED). Erectile dysfunction is a common condition associated with aging, chronic illnesses and various modifiable risk factors. Erectile dysfunction can be due to vascu-logenic, neurogenic, hormonal, and/or psychogenic factors as well as alterations in the nitric oxide/cyclic guanosine monophosphate pathway or other regulatory mecha-nisms. The number of consultations from new patients presenting with erectile dys-function and resulting costs for health care systems are increasing. Urologist should be the evaluating physician who supervises the surgical, medical, and hormonal treat-ment and who refers the patient, as necessary, to other members of the multidiscipli-nary team. Conclusion: Erectile dysfunction has a significant negative impact on quality of life. Male sexual dysfunction, especially erectile dysfunction, necessitates a comprehensive medical and psychologic evaluation involving both partners. All possible risk factors should be outlined and corrected, when feasible