Risk factors for erectile dysfunction:
(1) microvasculopathy (small vessel disease)
(2) Raynaud's phenomenon
(3) peripheral neuropathy
(4) autonomic dysfunction
(5) penile fibrosis, which may affect skin, smooth muscle, blood vessels and nerves
(6) depression and anxiety
(7) drug-related
(8) hypogonadism
Other problems:
(1) Peyronie's disease
The patient assessment should include:
(1) skin score
(2) serum testosterone and other hormones
(3) Doppler ultrasound to assess vascular status
(4) nailfold capillaroscopy (for evaluation of microvasculature)
Targeted evaluations may include:
(1) intravascular injection of a vasoactive agents (for assessment of neuropathy)
(2) cavernosometry (for assessment of corporal veno-occlusive disease)
(3) tests of autonomic function
(4) measurement of penile blood pressure
