Neurologic erectile dysfunction can be defined broadly as an inability to sustain or maintain a penile erection owing to neurologic impairment or dysfunction.<sup>125 Nehra A., Barrett D.M., Moreland R.B. Pharmacotherapeutic advances in the treatment of erectile dysfunction Mayo Clin Proc 1999 ;  74 : 709-722

Cliccare qui per andare alla sezione Riferimenti, 166 Sharlip I. Evaluation and nonsurgical management of erectile dysfunction Urol Clin North Am 1998 ;  25 : 647-659  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> The traditional clinical classifications of erectile dysfunction include vasculogenic (organic), psychogenic, neurogenic, and endocrinologic disease. Unfortunately, such clear designations are less defined in actual practice with mixed etiologies of disease. Neurologic erectile dysfunction can overlap vasculogenic (organic), endocrinologic, or psychogenic erectile dysfunction secondary to unrelated disorders resulting in peripheral neuropathies, nerve damage, or traumatic loss of neural function. Underlying etiologies can include diabetes, multiple sclerosis, Parkinson's disease, hereditary peripheral neuropathies, spina bifida, radical retropubic prostatectomy, spinal cord injury, and lumbar disk herniation. Each of these conditions presents with its own set of unique and confounding pathophysiologies.

The physiology of erectile dysfunction has been explored over the past 25 years from a peripheral penile smooth muscle perspective,<sup>10 Andersson K.-E., Wagner G. Physiology of erection Physiol Rev 1995 ;  75 : 191-236

Cliccare qui per andare alla sezione Riferimenti</sup> whereas the contributions of the central and peripheral nervous system to penile erection are less well defined. Following a brief review of neurophysiology, the etiologies of disease, diagnosis, and office work-up and treatment of neurologic erectile dysfunction are discussed herein. Prospectives for future research and treatment strategies are explored.