Contemporary and novel imaging studies for the evaluation of erectile dysfunction

Traditionally, it was thought that the pathogenesis of erectile dysfunction (ED) can be divided into psychological and organic factors. However, recent literature supports the development and progression of ED due to multidimensional alterations of a complex interplay of central and peripheral systems, from neural cognitive and efferent networks to loco-regional neuro-hormonal factors which are responsible for impaired penile vascular hemodynamics and ensuing lack of, or suboptimal, blood flow into the penis and/or veno-occlusive dysfunction. It is recognised that ED is strongly correlated with cardiovascular health and published clinical guidelines advocate screening for cardiovascular and metabolic risk factors in men presenting with ED. Over the past few decades, various imaging modalities have been developed and utilised to provide objective evaluation for ED to better characterise the state of penile health and exclude psychogenic components. The following article evaluates current and emerging imaging diagnostic tools for ED.