A review on pharmacological options for the treatment of erectile dysfunction: state of the art and new strategies

INTRODUCTION

Erectile dysfunction (ED) affects between 12.9% and 28.1% of men worldwide, presenting a strong aged-correlated prevalence. Several pharmacological treatments are currently available for ED, which can be classified into oral, injection, and topical/intraurethral therapies.

AREAS COVERED

Extensive research on PubMed/MEDLINE until February 2023 was performed. For each of the aforementioned drug classes, available molecules, and formulations, their efficacy and most common adverse events as well as general guidelines on prescription were investigated and extensively described. A glimpse into future directions regarding ED pharmacotherapy is also present.

EXPERT OPINION

In recent years, there have been significant developments in pharmacological treatments for ED. It is essential for physicians to identify the best treatment option for patients based on their preferences and sexual habits. The treatment approach for ED has shifted from a sequential to a parallel paradigm, where all treatment options are available as first-line therapies. While there are promising regenerative therapies for ED, such as shockwaves and platelet-rich plasma injections, pharmacological treatment is still the most effective option for most patients.

Benefits of erectile function recovery programs after radical prostatectomy (Review)

Radical prostatectomy is one of the most frequent therapeutic options used for the management of patients diagnosed with prostate cancer. Normal erectile function after radical prostatectomy is a great problem for numerous patients and a real challenge for urologists worldwide. The advancements that have been made over the years in terms of minimally invasive surgery, as well as in terms of surgical techniques, have reduced the incidence of erectile dysfunction, but even so, its rate remains high and the post-operative recovery of erectile function is a long and costly process. Phosphodiesterase 5 inhibitors have provided excellent results and have become the first-line treatment for these patients, followed by intracavernous injections with alprostadil. Several studies have underlined the impact of phosphodiesterase 5 inhibitors in terms of preventing the fibrotic changes that are responsible for the irreversible erectile dysfunction. The general opinion is that an erectile function recovery process should be started as soon as possible after surgery to prevent the negative effects of neuropraxia.