Trước khi đầu những năm 1970, bất lực hầu như luôn luôn được coi là kết quả của nguyên nhân tâm lý, và điều trị của nó thường bao gồm quản lý testosterone theo kinh nghiệm hoặc giới thiệu đến một bác sĩ tâm thần | 13 Erectile Dysfunction Drogo K. Montague MD and Milton M. Lakin MD Contents Introduction Erectile Dysfunction Summary References INTRODUCTION Before the early 1970s impotence was almost always considered to be the result of psychological causes and its treatment usually consisted of empiric testosterone administration or referral to a psychiatrist 1 . Three sentinel events mark the modern history of impotence treatment. These include the invention of the inflatable penile prosthesis in 1973 2 the introduction of penile injection therapy in the early 1980s 3 4 and the launch of the first significantly effective systemic agent sildenafil citrate in 1998 5 . The first two of these sentinel events established urologists as the primary caregivers for men with impotence however since 1998 the availability of effective systemic therapy has shifted the focus for the initial treatment of this disorder away from the urologist and toward the primary care physician PCP . Indeed according to Pfizer Inc the manufacturers of sildenafil citrate PCPs write more than 60 of the prescriptions for this medication data on file Pfizer Inc. New York NY . At the first National Institutes of Health Consensus Development Panel on Impotence in 1993 it was suggested that the term erectile dysfunction ED should replace the term impotence which was imprecise and carried negative connotations. This consensus panel defined ED as the inability to attain and or maintain penile erection sufficient for satisfactory sexual performance 6 . Some form of sexual dysfunction affects 10 to 52 of men and 25 to 63 of women 7 8 . These disorders have a significant impact on quality of life and many of them can be effectively treated in the primary care setting. The Massachusetts Male Aging Study From Essential Urology A Guide to Clinical Practice Edited by J. M. Potts Humana Press Inc. Totowa NJ 213 214 Montague and Lakin showed that 52 of men between the ages of 40 and 70 have ED if mild moderate and severe .
