Definition
The term impotence has come to encompass a wide range of disorders of erection, ejaculation and even sexual orientation or preference. Much of the discussion in this book, however, concerns the investigation and management of erectile problems, including the complete failure to achieve an erection. These conditions are described as Erectile Dysfunction (ED), which is defined here as the inability* to achieve an erection that is adequate for intercourse to the mutual satisfaction of both partners. Disorders of ejaculation and orgasm are defined in Chapter ‘97, Disorders of Ejaculation.
Epidemiology of Erectile Dysfunction
It is impossible to accurately define the population that sutlers from ED as such a large proportion of sufferers do not seek advice or help. However, although in past years men have tended to sutler in silence, in many societies ED is no longer a taboo subject, and people are now sufficiently well informed both to know that a variety of treatments exist and to expect to receive them. Proper sexual function is now seen as an important part of the quality of lite and as life expectancy increases more and more men are seeking treatment. Similarly, the effect on erectile ability has become a significant consideration in the evaluation of new products or operative treatments. Again, until recently there have been few published data relating to the effect of geography or ethnic origin on the prevalence of ED. However, epidemiological studies in a variety of countries including the United States, Germany, Italy, Japan, Brazil, Australia and Turkey have demonstrated few differences in prevalence. Although comparison is not easy given the differing ways of assessing ED, one of the few differences seen in these studies was the relatively high prevalence of ED in Turkey, which may reflect cultural differences.
