Impotence: A patient's goal-directed approach to treatment

The past decade has seen a better understanding of the physiology of erection and the pathophysiology of impotence as a result of considerable innovative research. These advances also introduce a new era in the diagnosis and treatment of impotence. Many functional tests and effective medical and surgical treatments are now available. With the sudden explosion of these many tests and therapies, clinicians are often confronted by questions such as: What constitues an adequate workup? What is the treatment of choice of arteriogenic impotence? Is nocturnal penile tumescence testing necessary? Is penile arteriography necessary? Over the past several years, the author has been using a patient's goal-directed approach to the diagnosis and treatment of impotence. This approach is based on (1) the most recent advances of diagnostic technique and therapy of impotence and (2) the patient's physical and mental health, motivation, and goal. This article briefly summarizes this practical patient's goal-directed management of impotence.