Erectile dysfunction (ED) is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance.
Erection is mediated by neurovascular mechanisms involving nitric oxide release, cyclic guanosine monophosphate (cGMP) production, and smooth muscle relaxation in the corpora cavernosa. Endothelial dysfunction impairs this cascade.
Risk factors include diabetes mellitus, hypertension, dyslipidemia, obesity, smoking, and psychological stress. ED frequently precedes cardiovascular disease due to shared vascular pathology.
The American Urological Association emphasizes comprehensive assessment, including cardiovascular risk evaluation.
Management includes lifestyle modification, phosphodiesterase type 5 inhibitors, intracavernosal therapy, vacuum devices, and, in selected cases, penile prosthesis erotic implantation.
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