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Schadendorf D, Long GV Grog JJ, Nathan P, Ribas A, Davies MA , Flaherty KT, Squires M, Jaeger S, Powell W, Tan P Robert C

Referral to specialist urology or sexual health services is appropriate when: Initial treatments fail Underlying conditions require specialist management The cause of ED remains unclear after initial investigation There is penile deformity or Peyronie's disease Cardiovascular risk stratification is needed before treatment Seek urgent same-day medical attention if you experience an erection lasting more than four hours (priapism), as this requires emergency treatment

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