Which investigations are necessary with erectile dysfunction?

A thorough examination and history taking is necessary to understand the nature of erectile dysfunction. Patients with psychogenic erectile dysfunction may be further investigated with a nocturnal penile tumescence test to confirm that the nocturnal erections are preserved. The confirmation of the presence of normal nocturnal erections excludes the presence of an organic cause of erectile dysfunction and the patients should be therefore reassured and offered psychosexual counselling.

When organic erectile dysfunction is suspected and an underlying cause is not obvious from the examination and history, efforts should be made towards the identification of any underlying condition, since erectile dysfunction may represent the first sign of diffuse cardiovascular disease.

A prompt identification of any of the cardiovascular risk factors such as diabetes, high blood pressure and high cholesterol levels is paramount to set up an adequate treatment plan and prevent further progression of the cardiovascular disease.

The Doppler Ultrasound scan of the penis is a relatively simple investigation but it provides very important information on the blood supply to the penis.

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