Erectile Dysfunction


Thorough evaluation of erectile dysfunction, from Campbell's


Key Questions

  1. Are you able to obtain + sustain an erection satisfactory for intercourse?
  2. Do you have morning and/or nocturnal erections?
  3. Are you able to masturbate?


Further Diagnostics

Adjunct testing

Test Arterial insufficiency Venous leak Psychogenic ED
NPTR Poor erection Good erection
ICI + stimulation
Penile ultrasound PSV < 30cm/s
PSV < 60cm/s (sum of R + L)
cavernous artery diameter < 0.7mm
Normal PSV, EDV < 3cm/s
RI ≤ 0.8
No abnormalities
Cavernosometry No abnormalities Flow to maintain < 3mL/min
IC pressure decay > 45mmHg in 30s
Cavernosography Venous drainage visualized
CASOP Brachial SBP - CASOP < 35mmHg No abnormalities
Penile brachial index PBI ≤ 0.7

Cardiac evaluation

Importance of evaluation

Princeton III criteria

PDE5 Inhibitors

Tips for Improved Efficacy



Drug Dosing Onset Avoid with fatty food Headache/Dyspepsia/Flushing Backache/Myalgias Blurred/Blue Vision
Sildenafil (Viagra) 25-100mg 30-60min Yes Yes Rare Yes
Tadalafil (Cialis) 5-20mg 60-120min No Yes Yes Rare
Vardenafil (Levitra) 5-20mg 30-60min Yes Yes Rare Rare

Everything but PDE5i and IPP

Lifestyle changes

Intracavernosal Injections

Vacuum Assist Device + Occlusion ring

Intraurethral Alprostadil (MUSE)

Testosterone therapy (see separate page)

Arterial revascularization

Penile Prosthesis


Risks + Side Effects