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Erectile Dysfunction

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Autonomic Disorders in Clinical Practice

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Abstract

Male erectile dysfunction (ED) increases with age and afflicts 52% of the 40–70 year old men. Neurological, endocrine, vascular, inflammatory, metabolic diseases, traumata, tumorous causes, illicit or “recreational “drugs, numerous prescription drugs, and psychological or psychiatric causes may induce ED. Diabetes mellitus is a leading cause of ED. ED can be the first sign of diabetes but also of coronary artery disease and thus requires a careful evaluation. In addition to a detailed history, ED patients need a general physical examination and may need additional urological, internal medicine, endocrinological-andrological, psychiatric and neurological assessment. Phosphodiesterase type 5 inhibitors should only be prescribed to patients at low cardiovascular risk. Various side effects and strict contraindications, such as treatment with nitrates, NO-donors, or alpha-blockers, and several others must be considered. Other ED treatments include lifestyle changes, where appropriate testosterone replacement, psychosexual counselling, intracavernous or intra-urethral prostaglandin E1 applications, vacuum erection pumps, constrictions rings, penile arterial reconstructive surgery, and penile prosthesis.

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  • 22 February 2024

    A correction has been published.

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Authors and Affiliations

  1. Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany

    Max Hilz & Ruihao Wang

  2. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Max Hilz

  3. Division of Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia

    David B. Vodušek

  4. Medical Faculty, University of Ljubljana, Ljubljana, Slovenia

    David B. Vodušek

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  1. Max Hilz
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  2. Ruihao Wang
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Editors and Affiliations

  1. Emergency Neurology, Fondazione Istituto Neurologico Nazionale Mondino, Pavia, Italy

    Giuseppe Micieli

  2. Dept. of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany

    Max Hilz

  3. Neurology, Operative Director IRCCS ISNB, University of Bologna, Bologna, Italy

    Pietro Cortelli

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Hilz, M., Wang, R., Vodušek, D.B. (2023). Erectile Dysfunction. In: Micieli, G., Hilz, M., Cortelli, P. (eds) Autonomic Disorders in Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-031-43036-7_14

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