Weill Cornell Medicine Urology
Weill Cornell Medicine Urology
Erectile Dysfunction

Erectile Dysfunction

Header Text: 

Erectile dysfunction (ED, formerly known as Impotence) is defined as the consistent inability to obtain or maintain an erection for satisfactory sexual relations.

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Erectile dysfunction (ED) can be classified as organic, psychogenic or mixed. Organic ED is due to physical defects and can be further sub-classified. Psychogenic ED is secondary to psychological factors that are thought to inhibit a man's ability to achieve an erection because of specific stressors. ED often has a mixed component of both organic and psychogenic etiologies.

ED is a common concern for men and their partners, can cause significant depression and anxiety, and can greatly impact quality of life. ED can also lead to a lower level of physical and emotional intimacy resulting in a lower level of satisfaction within a relationship.

Data from various studies has estimated that roughly half of men aged 40-70 years old have some form of erectile dysfunction. It is further estimated that 10% of men aged 30-39 have erectile dysfunction, with prevalence increasing to 59% of men aged 70-79. This extrapolates to over twenty million men in the United States alone with ED.

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An understanding of the basic physiology of erections (how erections work) will allow understanding of the causes and treatments of ED. The penis is an organ with paired erection chambers (corpora cavernosa), which are filled with spongy erectile tissue (corporal sinusoids) composed predominantly of smooth muscle. Erection and loss of erection are related primarily to blood flow events regulated by the penile arteries and the erectile bodies. Penile erections are triggered by one of two main mechanisms: direct stimulation of the genitalia or through stimuli coming from the brain (fantasy, smell, sound, etc). Upon stimulation, chemicals are released in the brain that cause signals to pass down the spinal cord and outward through special nerves (nervi erigentes) into the penis. These nerves release another chemical (Nitric Oxide) that causes the aforementioned smooth muscle to relax and blood rushes into the erectile bodies, causing erection. Anxiety or fear can prevent the brain signals from reaching the level required to induce erection. Medical conditions can block the erection arteries or cause scarring of the spongy erection tissue, thereby preventing proper blood flow, or trapping of blood, and limiting the erection.

Erectile Dysfunction - Risks & Causes

Summary: 

In a process as complex as penile erections, problems can occur for many reasons. Very often an erectile problem will have more than one cause. The causes may be physical (organic ED), psychological (psychogenic ED), or a combination of both.

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Erectile Dysfunction - Symptoms & Evaluation

Summary: 

The evaluation of the male with erectile dysfunction consists of three distinct parts, namely, a structured interview, physical examination, and adjunctive testing.

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Erectile Dysfunction - Treatment

Summary: 

Therapy and psychological support combined with oral medical therapy may be beneficial to patients before considering further treatment options for erectile dysfunction.

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Physicians & Faculty

Dr. Peter N. Schlegel, MD, FACS | Cornell Urology

Peter N. Schlegel

M.D., F.A.C.S.

212.746.5491
212.746.5491
Aetna-Weill Cornell POS, Medicaid, Medicare, Rockefeller University-CoreSource
The LeFrak Center for Robotic Surgery
Dr. Marc Goldstein, M.D., F.A.C.S. | Weill Cornell Medicine

Marc Goldstein

M.D., F.A.C.S.

212.746.5470
212.746.5470
Aetna-Weill Cornell POS, Medicaid, Medicare, Rockefeller University-CoreSource
Brady Urologic Health Center
Dr.  Darius Paduch, M.D., Ph.D.

Darius A. Paduch

M.D., Ph.D.

212.746.5309
212.746.5309
AETNA-HMO, AETNA-PPO, Aetna-Weill Cornell POS, EBCBS PPO/EPO, Medicaid, Rockefeller University-CoreSource
The LeFrak Center for Robotic Surgery
Dr. James A. Kashanian, M.D.

James A. Kashanian

M.D.

212-746-5309
212-746-5309
AETNA [Medicare], AETNA-HMO, AETNA-PPO, Aetna-Weill Cornell POS, Affinity Access, Affinity Essential, Affinity Health Plan, Blue Priority Network, CIGNA, EBCBS HMO, EBCBS Mediblue, EBCBS Pathway X, EBCBS Pathway X Enhanced, EBCBS PPO/EPO, Emblem Select Care, Empire BCBS HealthPlus, Empire BCBS HealthPlus (CHP), Fidelis Care, GHI, Health First, Health Insurance Plan of NY (HIP), Health Insurance Plan of NY (HIP) [Medicaid], Health Insurance Plan of NY (HIP) [Medicare], Medicaid, Medicare, Oxford Freedom, Oxford Health Plans [Liberty], Oxford Health Plans [Medicare], Oxford Health Plans [Metro/Core/Charter], Rockefeller University-CoreSource, UHC Community Plan - Essential Plan, UHC Community Plan - Medicaid Plan, UHC Compass, UHC Compass-HMO, UHC Medicare, United Empire Plan, United Healthcare Commercial, VNSNY CHOICE Medicare, VNSNY CHOICE SelectHealth
The LeFrak Center for Robotic Surgery

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