Prognosis
Given the many therapeutic options, almost all patients can be successfully treated with currently available therapies. Treatment efficacy is dependent on the cause of ED, therefore, counseling is key to finding the correct regimen for an individual patient. Most patients respond well to oral phosphodiesterase-5 (PDE5) inhibitors, however, other therapies and combined therapies can be considered.[105]
PDE5 inhibitors
All PDE5 inhibitors were significantly more efficient than placebo in enhancing International Index of Erectile Function (IIEF) scores.[106] Combination therapy with testosterone and PDE5 inhibitors in patients with hypogonadism is effective and safe and may benefit some men.[107] In patients with diabetes, all PDE5 inhibitors are superior to placebo.[71] Lifestyle modifications and improved glycemic control are also recommended.[108] Patients with controlled diabetes experience improved success compared with poorly controlled diabetic men (62% vs. 44%).[109]
Intracavernosal injection
Success rates, defined as the ability to achieve an erection with injections at home, range from 53.7% to 100% without marked differences across medication type. Additionally, 46.3% to 98.8% of men report being satisfied with the treatment.[48]
Intraurethral suppository
Vacuum constriction device
Efficacy rates are fairly high, but with variable satisfaction rates ranging from 27% to 74%.[111]
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