The term “phallic fistula” and its concept in China’s traditional medicine has long been, but also in the folk widely used, but the end of the 20th century the medical profession in various countries have gradually used the term “erectile dysfunction” instead of “impotence”. The term “impotence”. Impotence refers to the male in the sexual desire of the urge and adequate sexual stimulation, ready for sexual intercourse, but the penis can not be erected; some can be erected a little but not hard enough to put into the vagina; there are also good erection, but the time is short, has not been put into the vagina that becomes weak; there are also people who can be erected into the vagina, but not yet have sexual intercourse or a little twitching has not yet ejaculated, the penis will be soft and failed to have sexual intercourse. The causes of impotence are functional, i.e., psychosomatic, i.e., non-organic, as well as organic. Organic impotence also has a psychological component, so the treatment of organic impotence should also pay attention to the treatment of its psychological disorders. Functional impotence means that there is no specific organic lesion in the organism, and the cause of impotence is due to psycho-psychological factors and insufficient sexual knowledge. Common mental psychological factors that lead to impotence are as follows. 1, lack of sexual knowledge education. 2, wrong sex education. Religion or parents of children or adolescents appear normal sexual reaction overly condemnation, punishment, intimidation, etc., so that they believe that sexual life is a sinful, dirty, nasty behavior, so that they are forced to inhibit the normal emergence of sexual physiological phenomena. 3, interpersonal factors. Marriage is not as good as expected, husband and wife relationship, tension, divorce, widowhood and other mental trauma is difficult to eliminate. 4, medical factors. Patients occasionally fail to have sexual intercourse or erection is slightly poor, this is a normal phenomenon, the patient is very nervous, and the doctor easily make the diagnosis of erectile dysfunction, family members are also overly concerned about the introduction of prescription supplements, more heavy patients’ ideological pressure, aggravated the condition. 5, other. Such as work is too tense, tired, work, environmental changes are not satisfied, sex life environment, poor living conditions, fear of club psychological pressure, fear of pregnancy, fear of his wife can not achieve orgasm and complain, blame, fear of others to see, fear of infection of sexually transmitted diseases and so on. Functional impotence is characterized by the emergence of erectile dysfunction is intermittent, sometimes erection is very good, and sometimes not good, there is a large fluctuation; there is a history of mental or psychological trauma, but there is no disease that can affect the erection of diseases such as mental illness, diabetes, cardiovascular disease and neurological disorders, etc.; do not take drugs or food to affect the erection of drugs or foods, such as cotton seed oil and so on. In addition, the patient’s biggest feature is that although his complaint of erectile dysfunction, but at night or in the morning before waking up to hold urine or non-intercourse with full erection, this phenomenon is mostly suggestive of psychological sexual dysfunction. The main causes of organic impotence are as follows: 1. Systemic diseases, often the following. Endocrine diseases, such as primary hypogonadotropic hypogonadism, the main lesion is in the testes, and the lack of male hormone secretion by the kuwans causes erectile dysfunction. 2, cardiovascular disease. Penile erection depends on the coordination of penile arteries, cavernous sinus and veins to complete, any one of these lesions can lead and erectile dysfunction. Arterial erectile dysfunction has arteriosclerosis, arteritis, arterial thrombosis, affecting the iliac arteries and penile arterial blood flow, into the penile cavernous body of the blood is reduced and caused by erectile dysfunction, which most often occurs in hypertension, arteriosclerosis, hyperlipidemia, myocardial infarction, angina pectoris, coronary artery insufficiency, diabetes mellitus and other patients. Venous erectile dysfunction refers to the penis venous blood drainage is too fast and can not keep the penis cavernous body full of blood to maintain the penis is erect. 3, neurological. Caused by craniocerebral and neurological diseases, mainly due to the penile erection center or peripheral nerve control dysfunction caused by brain tumors, cerebrovascular accidents, etc., followed by the central and erection center narrow conduction disorders, such as multiple neurological sclerosis, spinal tuberculosis, diabetes mellitus, or spinal cord trauma, etc.. 4, reproductive system diseases. Such as urethral episiotomy, hypospadias and so on. 5, mental illness. Such as depression, schizophrenia, etc. 6.Hematologic diseases. Such as leukemia, pernicious anemia, etc. 7.Others. Such as chronic renal failure, pulmonary insufficiency, hepatic cirrhosis and liver failure. Second, trauma and surgery, such as brain and spinal cord trauma, pelvic fracture, total prostatectomy, rectal resection, sympathectomy and aortic or iliac artery surgery. Third, drug factors. Erectile dysfunction caused by drugs mainly have three categories. 1, the role of the central nervous system drugs such as hypnotic sedative drugs. 2, antihypertensive drugs such as guanethidine, rifampicin, antitussive, thiazide diuretics, etc. 3, antipsychotics such as phenothiazine, amitriptyline, etc.. Fourth, alcoholism . , drug abuse, smoking, etc. can also cause penile erectile dysfunction. The diagnosis of impotence is easier, encountering patients who claim to have penile erectile dysfunction, the first step is to identify whether it is functional or organic, and whether it has any relationship with taking drugs. For the latter, just ask what disease? What kind of medication is taken, the general diagnosis can be made. Functional erectile dysfunction, generally younger patients, mostly under 40 years of age, the onset of sudden, or intermittent onset, sometimes good and sometimes bad, but before getting up in the morning or at night can be found in the erection of a good, there may be a history of mental or psychological trauma, vulvar examination and blood sex hormone measurement is normal. Organic erectile dysfunction, often older, more than 50 years old, poor erection gradually aggravated, mostly persistent, erectile function is very poor to completely unable to erection, the wife to help no improvement, morning or night are no erection phenomenon or can not achieve full erection, physical examination of the vulva may be found in the testicles are slightly smaller and softer. If it is endocrine dysfunction, blood hormone measurement will help to diagnose. After knowing the above, we can initially identify whether the erectile dysfunction is caused by functional or organic factors. In order to further confirm the diagnosis, auxiliary examinations such as nocturnal penile distension test, penile erection test or penile arteriography can be chosen for differentiation. The treatment of psychological and organic erectile dysfunction is different. The former is mainly the introduction of sexual knowledge, sexual physiology, sexual techniques and psychotherapy, while the organic erectile dysfunction also has different degrees of psychological disorders. Therefore, any cause of erectile dysfunction, can not ignore the psychological aspects of the treatment and adjustment. Human sexual behavior is susceptible to external and internal factors, therefore, the treatment of erectile dysfunction should first remove the psychological factors that can affect erection, such as the two sides of the view of sexual life, sexual life is harmonious, whether they can do each other, whether there is interference in the living room environment, etc., to correct the formation of the past misconceptions and habits, to stop the use of drugs that may affect the erection, stop smoking and quit drinking and so on. Then, according to the different types and different causes of erectile dysfunction, psychological, drug, Chinese herbal medicine and surgical treatments are used. As there are many methods and medications to treat impotence, the results vary. I wish all patients can cure this disease and live a beautiful, happy and sweet life soon.