Up to 20% of men suffer with moderate to severe erectile dysfunction (ED), with risk factors including smoking, obesity and diabetes.

ED is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance.

According to Dr Syed Jaffrey, a consultant urological surgeon at the Galway Clinic, a lot of risk factors for ED are modifiable and even reversible. He said that when a patient presents with this condition, the aim ‘is to identify and treat the cause and not just the symptom'.

"A multifactorial management plan is necessary to address the treatable causes of ED, lifestyle changes and risk factor modification and to educate and counsel the patient and his partner," Dr Jaffrey and his team explained.

Treatment can include the use of specific drugs and vacuum constriction devices (VCDs). A VCD is a plastic tube applied over the penis which creates a seal with the skin at the base of the penis. A pump creates a vacuum within the tube, leading to an erection. Side-effects can include, pain bruising and an inability to ejaculate.

If these methods fail, the patient may be referred to a urologist who may consider the insertion of a penile prosthesis or implant.

When treating patients, doctors should focus on their ‘sexual, medical and psychosexual history, in particular, identifying the reversible and irreversible risk factors for ED', the Galway team added.

They made their comments in Modern Medicine: The Irish Journal of Clinical Medicine.