Patient: Dr. Tian, last time you talked about impotence patients need to do some auxiliary tests to figure out the cause of the disease, please talk about what auxiliary tests I should do. Doctor: There are many ancillary tests, and different tests should be chosen according to each patient’s condition. A good doctor should find clues to the cause of the disease from a detailed history and physical examination, and then select some tests in a targeted manner. Generally speaking, the first thing that should be identified is psychological ED or organic ED, when the nocturnal penile erection test (NPT test) can be done, in the past with a stamp paste, now there is a very sophisticated instrument, called hardness tester (Rigiscan), two test rings are placed on the front and root of the penis before going to sleep at night, the instrument is tied to the thigh, respectively, to record the number of erections, hardness and thickness of the penis at night. The number, hardness and thickness of erections at night are recorded, and the results are printed out on an electronic computer the next day. If no nocturnal penile erection is recorded, it is generally organic ED. once the psychological ED is ruled out, the cause of organic ED should be further clarified, then some laboratory tests can be done, such as blood sugar, blood lipids, liver and kidney function. If you suspect endocrine ED, we should check sex hormones, corticosteroids, thyroid hormones, etc. If you suspect neurological ED, we should do some neurological testing, such as cavernous electromyography (EMG), temperature domain testing (TTT), etc. If you suspect vascular ED, the first step should be done penile cavernous injection test (ICI test), the second step can be done color bifunctional ultrasound If vascular ED is suspected, the first step should be the penile cavernosal injection test (ICI test), the second step can be color bifunctional ultrasound, and the third step should be invasive penile cavernosal manometry and penile cavernosography. Patient: I seem to have a lot of clarity after your talk, but I sometimes go to the hospital and the doctor doesn’t do so many tests, can this take care of my disease? Doctor: Nowadays, it is popular to have a view that the diagnosis of erectile dysfunction is oriented to the patient’s goal, what does it mean? It means that many patients prefer non-invasive or less invasive treatments to those that are more invasive and prone to comorbidities such as penile prosthesis implantation, revascularization, vein ligation and cavernous injection of vasoactive drugs, plus some existing drugs can solve the problems of most ED patients, so there is no need to do many tests. However, as a well-trained physician should have the diagnostic mindset to perform these tests when necessary.