Effective therapy for the management of erectile dysfunction in MEN with diabetes mellitus: a review
Abstract
Diabetes is a significant cause of erectile and sex ual dysfunction. The pathologic processes in di abetes that particularly compromise the responsivity of vascula r systems preferentially impact on the vulnerable v ascular bed of the penis. About 36% of men with diabetes will experience some degree of erectile dysfunction. Unfortunately, this high-risk population is also di fficult to treat. All of the pharmacologic therapie s for erectile dysfunction have shown a decrease in efficacy in di abetic patients in comparison with non-diabetic pat ients. The many strategies for the treatment of erectile dysfu nction share an important distinction from most oth er medical conditions in that the treatment is directed by the choice of the patient and partner. Alprostadil by intracavernous injection has been shown to benefit up to 94% of me n with erectile dysfunction and diabetes. Sildenafi l will restore the capacity for intercourse in>40% of diab etic patients. More recently two other agents, vard enafil and tadalafil, have been introduced. All the drugs have been shown to be effective across a wide range of aetiologies of erectile dysfunction (ED), including diabetes. T he drugs have been shown to improve EF domain scores, penetration and maintenance of erection, resulting in more successful intercourse. Other pharmacologic treatments are available and in development. Ultima tely, penile rigidity may be created surgically if the sexual needs of the couple require it.
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