目次
ED 診療ガイドライン 2012 年版 作成の経緯と手順.......................................................1
本ガイドラインの目的. .............................................................................................................1
本ガイドラインの対象と作成方法. ..................................................................................1
改訂の予定.........................................................................................................................................2利益相反...............................................................................................................................................3略語表....................................................................................................................................................41 ED の定義. .......................................................................................................................................................52 ED の分類. .......................................................................................................................................................63 ED の疫学. .......................................................................................................................................................84 ED のリスクファクター.....................................................................................................................101. 加齢. .....................................................................................................................................................102. 喫煙. .....................................................................................................................................................113. 高血圧.................................................................................................................................................124. 糖尿病.................................................................................................................................................135. 脂質異常症（高脂血症）..........................................................................................................15
6. 肥満と運動不足. ..........................................................................................................................167. うつ症状............................................................................................................................................178. 下部尿路症状 / 前立腺肥大症（LUTS/BPH）...........................................................19
9. 慢性腎臓病（CKD）....................................................................................................................2110. 睡眠時無呼吸症候群（SAS）...............................................................................................2211. 神経疾患............................................................................................................................................23
12. 不妊症.................................................................................................................................................24
13. 薬剤. .....................................................................................................................................................24

5 ED と心血管疾患.....................................................................................................................................34
1. 心血管系のリスクがある患者の管理...........................................................................35
2. 血管外科疾患と ED. .................................................................................................................38

6 ED と前立腺癌...........................................................................................................................................42
1. 根治的前立腺摘除術と術後 ED. ......................................................................................42
2. 根治的前立腺摘除術後の陰茎リハビリテーション...........................................45
3. 放射線治療後の ED. .................................................................................................................47
4. アンドロゲン除去療法による ED..................................................................................49

ED 診療ガイドラインED 診療ガイドライン

7 診断 .................................................................................................................................................................. 56
ED 診断のフローチャート（非専門医の行う範囲）......................................... 56
1. 基本評価 .......................................................................................................................................... 57
2. 特殊診断検査 ............................................................................................................................... 58

8 治療 .................................................................................................................................................................. 63
ED 治療のフローチャート................................................................................................. 63
1. 目的 ..................................................................................................................................................... 63
2. リスクファクターと合併症への対応 ......................................................................... 64
3. 治癒可能な ED の発見と治療 .......................................................................................... 64
4. 薬物療法 .......................................................................................................................................... 67
5. 陰圧式勃起補助具 .................................................................................................................... 75
6. 陰茎海綿体注射 .......................................................................................................................... 76
7. 陰茎プロステーシス挿入術 ............................................................................................... 77

9 持続勃起症 .................................................................................................................................................. 83
1. 定義 ..................................................................................................................................................... 83
2. 分類 ..................................................................................................................................................... 83
3. 治療方針 .......................................................................................................................................... 84
4. 虚血性持続勃起症（ischemic priapism）................................................................. 84
5. 非虚血性持続勃起症（non-ischemic priapism）................................................. 88

10 ペロニー病（Peyronieʼs disease）.......................................................................................... 93
1. 定義と原因..................................................................................................................................... 93
2. 疫学，自然史，リスクファクター ............................................................................... 93
3. 診断 ..................................................................................................................................................... 94
4. 治療 ..................................................................................................................................................... 95

11 勃起機能に関した書類・診断書希望例への対処法 ...................................................... 98
1. 分類 ..................................................................................................................................................... 98
2. 書類・診断書を希望された場合の対処法............................................................... 99
付録 ............................................................................................................................................................... 101
付録 1 International Index of Erectile Function（IIEF）の日本語訳................................................................................................................... 102
付録 2 IIEF5 と Sexual Health Inventory for Men（SHIM）の日本語訳................................................................................................................... 104
付録 3 国際前立腺症状スコア（International Prostate
Symptom Score: IPSS）と QOL スコア ....................................... 106
付録 4 Diagnostic and Statistical Manual of Mental Disorders
IV-TR（DSM-IV-TR）によるうつ病の診断基準......................... 107
索引 ............................................................................................................................................................... 108vi