[Erectile dysfunction-It is time to act! : Practical tips and current guideline recommendations for diagnostics and treatment of a still underestimated disease].

The main risk factors for erectile dysfunction (ED) are age, smoking, metabolic syndrome, cardiovascular diseases, diabetes and status following pelvic surgery. The diagnostics include a (psychosexual) medical history, a physical examination, basic laboratory diagnostics with fasting glucose, lipid profile and morning testosterone level. Extended hormone diagnostics follow if there is a corresponding suspicion. The same applies to the special functional tests, such as measurement of nocturnal erections or intracavernous injection tests with Doppler sonography. The guideline-based staging schedule of conservative treatment options includes risk factor and lifestyle modifications, phosphodiesterase 5 inhibitors (PDE5I), topical/intraurethral vasoactive substances and penile vacuum therapy. The surgical treatment options include revascularization in cases of posttraumatic ED and implantation of penile prosthetics as the gold standard.