Guidelines for Treatment of Erectile Dysfunction

Each patient with erectile dysfunction should receive individualized and integrated treatment of his erectile dysfunction, with all indicated modalities applied.
The first step after the thorough evaluation, diagnosis determination, and patient education should be the modification of reversible causes, such as alcohol abuse, smoking, prescription or nonprescription drugs, and cardiovascular risk factors (e.g. hypertension).
 Some authors divide the possible treatment interventions into first-, second-, and third-line ones. According to Goldstein (1999), the first-line interventions include oral erectogenic agents (e.g., sildenafil, oral apomorphine, oral phentolamine), vacuum erectile devices, and psychosexual therapy. These interventions are easy to administer, noninvasive, and reversible. Mobley and Baum (1998) also include all of these modalities in their first-line therapies, with the addition of yohimbine.....