#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

An algorithm of conservative erectile dysfunction treatment


Authors: Tomáš Hradec;  Libor Zámečník
Authors place of work: Iscare Praha ;  Urologická klinika Všeobecné fakultní nemocnice a 1. lékařské fakulty Univerzity Karlovy v Praze
Published in the journal: Ces Urol 2023; 27(1): 17-28
Category: Review articles

Summary

Identification of reversible factors, correction of associated diseases and lifestyle change is essential for effective causal treatment of erectile dysfunction (ED). Other conservative treatment methods available are only symptomatic. We present currently available methods in this review article. Four phosphodiesterase 5 inhibitors (PDE5i) are available on the market. The differences between PDE5i and criteria of choice are described in the article. Application of low intensity shockwaves on cavernous tissue and intraurethral application of prostaglandin are other treatment modalities. Application of low intensity shock waves on the cavernous tissue is a very promising treatment option. Huge heterogeneity in available studies does not allow to evaluate its effectiveness correctly. Intraurethral application of prostaglandin E1 is a less invasive alternative to intracavernous injection. This treatment is also significantly less effective.

Keywords:

Erectile dysfunction – conservative treatment – phosphodiesterase 5 inhibitors – prostaglandin E1


Zdroje

1. Minhas S, Bettocchi C, Boeri L, et al. EAU Working Group on Male Sexual and Reproductive Health. European Association of Urology Guidelines on Male Sexual and Reproductive Health: 2021 Update on Male Infertility. Eur Urol. 2021; 80(5): 603–620.

2. Isidori AM, Buvat J, Corona G, et al. A critical analysis of the role of testosterone in erectile function: from pathophysiology to treatment‑a systematic review. Eur Urol. 2014; 65(1): 99–112

3. Maggi M, Buvat J, Corona G, Guay A, Torres LO. Hormonal causes of male sexual dysfunctions and their management (hyperprolactinemia, thyroid disorders, GH disorders, and DHEA). J Sex Med. 2013; 10(3): 661–677.

4. Gupta BP, Murad MH, Clifton MM, et al. The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta‑analysis. Arch Intern Med. 2011; 171(20): 1797–1803.

5. Gerbild H, Larsen CM, Graugaard C, Areskoug, Josefsson K. Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies. Sex Med. 2018; 6(2): 75–89.

6. Collins CE, Jensen ME, Young MD, et al. Improvement in erectile function following weight loss in obese men: the SHED‑IT randomized controlled trial. Obes Res Clin Pract. 2013; 7(6): e450–e454.

7. Baumhäkel M, Schlimmer N, Kratz M, et al. Cardiovascular risk, drugs and erectile function a systematic analysis Int J Clin Pract. 2011; 65(3): 289–298.

8. Glina S, Sharlip ID, Hellstrom WJ. Modifying risk factors to prevent and treat erectile dysfunction. J Sex Med. 2013; 10(1): 115–119.

9. Vlachopoulos C, Jackson G, Stefanadis C, Montorsi P. Erectile dysfunction in the cardiovascular patient. Eur Heart J. 2013; 34(27): 2034–2046.

10. Vlachopoulos CV, Terentes‑Printzios DG, Ioakeimidis NK, Aznaouridis KA, Stefanadis CI. Prediction of cardiovascular events and all‑cause mortality with erectile dysfunction: a systematic review and meta‑analysis of cohort studies. Circ Cardiovasc Qual Outcomes. 2013; 6(1): 99–109.

11. Dong JY, Zhang YH, Qin LQ. Erectile dysfunction and risk of cardiovascular disease: meta‑analysis of prospective cohort studies. J Am Coll Cardiol. 2011; 58(13): 1378–1385.

12. Gandaglia G, Briganti A, Jackson G, et al. A systematic review of the association between erectile dysfunction and cardiovascular disease. Eur Urol. 2014; 65(5): 968–978.

13. Goldstein I, Lue TF, Padma‑Nathan H, et al. Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med. 1998; 338(20): 1397–1404.

14. Moncada I, Jara J, Subirá D, Castaño I, Hernández C. Efficacy of sildenafil citrate at 12 hours after dosing: re‑exploring the therapeutic window. Eur Urol. 2004; 46(3): 357–361.

15. Curran M, Keating G. Tadalafil. Drugs. 2003; 63(20): 2203–2214.

16. Ventimiglia E, Capogrosso P, Montorsi F, Salonia A. The safety of phosphodiesterase type 5 inhibitors for erectile dysfunction. Expert Opin Drug Saf. 2016; 15(2): 141–152.

17. Keating GM, Scott LJ. Vardenafil: a review of its use in erectile dysfunction. Drugs. 2003; 63(23): 2673–2703.

18. Capogrosso P, Ventimiglia E, Boeri L, et al. Time of onset of vardenafil orodispersible tablet in a real‑life setting - looking beyond randomized clinical trials. Expert Rev Clin Pharmacol. 2017; 10(3): 339–344.

19. Chung E, Broc GB. A state of art review on vardenafil in men with erectile dysfunction and associated underlying diseases. Expert Opin Pharmacother. 2011; 12(8): 1341–1348.

20. Wang R, Burnett AL, Heller WH, et al. Selectivity of avanafil, a PDE5 inhibitor for the treatment of erectile dysfunction: implications for clinical safety and improved tolerability. J Sex Med. 2012; 9(8): 2122–2129.

21. Goldstein I, McCullough AR, Jones LA, et al. A randomized, double‑blind, placebo‑controlled evaluation of the safety and efficacy of avanafil in subjects with erectile dysfunction. J Sex Med. 2012; 9(4): 1122–1133.

22. Corona G, Rastrelli G, Burri A, Jannini EA, Maggi M. The safety and efficacy of Avanafil, a new 2(nd) generation PDE5i: comprehensive review and meta‑analysis. Expert Opin Drug Saf. 2016; 15(2): 237–247.

23. McCullough AR, Barada JH, Fawzy A, Guay AT, Hatzichristou D. Achieving treatment optimization with sildenafil citrate (Viagra) in patients with erectile dysfunction. Urology. 2002; 60(2 Suppl 2): 28–38.

24. Rajagopalan P, Mazzu A, Xia C, Dawkins R, Sundaresan P. Effect of high‑fat breakfast and moderate‑fat evening meal on the pharmacokinetics of vardenafil, an oral phosphodiesterase-5 inhibitor for the treatment of erectile dysfunction. J Clin Pharmacol. 2003; 43(3): 260–267.

25. Forgue ST, Patterson BE, Bedding AW, et al. Tadalafil pharmacokinetics in healthy subjects. Br J Clin Pharmacol. 2006; 61(3): 280–288.

26. Swearingen D, Nehra A, Morelos S, Peterson CA. Hemodynamic effect of avanafil and glyceryl trinitrate coadministration. Drugs Context. 2013; 2013: 212248.

27. Gur S, Kadowitz PJ, Gokce A, et al. Update on drug interactions with phosphodiesterase-5 inhibitors prescribed as first‑line therapy for patients with erectile dysfunction or pulmonary hypertension. Curr Drug Metab. 2013; 14(2): 265–269.

28. Corona G, Razzoli E, Forti G, Maggi M. The use of phosphodiesterase 5 inhibitors with concomitant medications. J Endocrinol Invest. 2008; 31(9): 799–808.

29. Kloner RA. Novel phosphodiesterase type 5 inhibitors: assessing hemodynamic effects and safety parameters. Clin Cardiol. 2004; 27(4 Suppl 1): I20–I25.

30. Nehra A, Jackson G, Miner M, et al. The Princeton III Consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clin Proc. 2012; 87(8): 766–778.

31. Pickering TG, Shepherd AM, Puddey I, et al. Sildenafil citrate for erectile dysfunction in men receiving multiple antihypertensive agents: a randomized controlled trial. Am J Hypertens. 2004; 17(12 Pt 1): 1135–1142.

32. Satake N, Zhou Q, Morikawa M, Inoue M, Shibata S. Potentiating effect of nicorandil, an antianginal agent, on relaxation induced by isoproterenol in isolated rat aorta: involvement of cyclic GMP‑inhibitable cyclic AMP phosphodiesterase. J Cardiovasc Pharmacol. 1995; 25(3): 489–494.

33. Padma‑Nathan H, Yeager JL. An integrated analysis of alprostadil topical cream for the treatment of erectile dysfunction in 1732 patients. Urology. 2006; 68(2): 386–391.

34. Sokolakis I, Hatzichristodoulou G. Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic review and meta‑analysis of randomised controlled trials. Int J Impot Res. 2019; 31(3): 177–194.

35. Capogrosso P, Frey A, Jensen CFS, et al. Low‑Intensity Shock Wave Therapy in Sexual Medicine‑Clinical Recommendations from the European Society of Sexual Medicine (ESSM). J Sex Med. 2019; 16(10): 1490–1505.

36. Kitrey ND, Gruenwald I, Appel B, et al. Penile Low Intensity Shock Wave Treatment is Able to Shift PDE5i Nonresponders to Responders: A Double‑Blind, Sham Controlled Study. J Urol. 2016; 195(5): 1550–1555.

37. Bechara A, Casabé A, De Bonis W, Ciciclia PG. Twelve‑Month Efficacy and Safety of Low‑Intensity Shockwave Therapy for Erectile Dysfunction in Patients Who Do Not Respond to Phosphodiesterase Type 5 Inhibitors. Sex Med. 2016; 4(4): e225-e232.

38. Vinay J, Moreno D, Rajmil O, Ruiz‑Castañe E, Sanchez‑Curbelo J. Penile low intensity shock wave treatment for PDE5I refractory erectile dysfunction: a randomized double‑blind sham‑controlled clinical trial. World J Urol. 2021; 39(6): 2217–2222.

39. Kalyvianakis D, Mykoniatis I, Memmos E, et al. Low‑intensity shockwave therapy (LiST) for erectile dysfunction: a randomized clinical trial assessing the impact of energy flux density (EFD) and frequency of sessions. Int J Impot Res. 2020; 32(3): 329–337.

40. Chung E, Cartmill R. Evaluation of Long‑Term Clinical Outcomes and Patient Satisfaction Rate Following Low Intensity Shock Wave Therapy in Men With Erectile Dysfunction: A Minimum 5-Year Follow‑Up on a Prospective Open‑Label Single‑Arm Clinical Study. Sex Med. 2021; 9(4): 100384.

41. Levine LA, Dimitriou RJ. Vacuum constriction and external erection devices in erectile dysfunction. Urol Clin North Am. 2001; 28(2): 335–41.

42. Yuan J, Hoang AN, Romero CA, et al. Vacuum therapy in erectile dysfunction – science and clinical evidence. Int J Impot Res. 2010; 22(4): 211–219.

43. Cookson MS, Nadig PW. Long‑term results with vacuum constriction device. J Urol. 1993; 149(2): 290–294.

44. Lewis RW, Witherington R. External vacuum therapy for erectile dysfunction: use and results. World J Urol. 1997; 15(1): 78–82.

45. Trost LW, Munarriz R, Wang R, Morey A, Levine L. External Mechanical Devices and Vascular Surgery for Erectile Dysfunction. J Sex Med. 2016; 13(11): 1579–1617.

46. Shabsigh R, Padma‑Nathan H, Gittleman M, et al. Intracavernous alprostadil alfadex is more efficacious, better tolerated, and preferred over intraurethral alprostadil plus optional actis: a comparative, randomized, crossover, multicenter study. Urology. 2000; 55(1): 109-113.

47. Coombs PG, Heck M, Guhring P, Narus J, Mulhall JP. A review of outcomes of an intracavernosal injection therapy programme. BJU Int. 2012; 110(11): 1787–1791.

48. Porst H, Burnett A, Brock G, et al. SOP conservative (medical and mechanical) treatment of erectile dysfunction. J Sex Med. 2013; 10(1): 130–171.

49. Eardley I, Donatucci C, Corbin J, et al. Pharmacotherapy for erectile dysfunction. J Sex Med. 2010; 7(1 Pt 2): 524–540.

50. Lakin MM, Montague DK, VanderBrug Medendorp S, Tesar L, Schover LR. Intracavernous injection therapy: analysis of results and complications. J Urol. 1990; 143(6): 1138–1141.

51. Gupta R, Kirschen J, Barrow RC 2nd, Eid JF. Predictors of success and risk factors for attrition in the use of intracavernous injection. J Urol. 1997; 157(5): 1681–1686.

52. Oudelaar BW, Peerbooms JC, Huis In ’t Veld R, Vochteloo AJH. Concentrations of Blood Components in Commercial Platelet‑Rich Plasma Separation Systems: A Review of the Literature. Am J Sports Med. 2019; 47(2): 479–487.

53. Banno JJ, et al. The efficacy of platelet‑rich plasma (PRP) as a supplemental therapy for the treatment of erectile dysfunction (ED): Initial outcomes. J Sex Med. 2017; 14(2): e59–e60.

54. Ruffo A, Franco M, Illiano E, Stanojevi N. Effectiveness and safety of Platelet rich Plasma (PrP) cavernosal injections plus external shock wave treatment for penile erectile dysfunction: first results from a prospective, randomized, controlled, interventional study. European Urology Supplements. 2019; 18(1): e1622–e1623.

55. Poulios E, Mykoniatis I, Pyrgidis N, et al. Platelet‑Rich Plasma (PRP) Improves Erectile Function: A Double‑Blind, Randomized, Placebo‑Controlled Clinical Trial. J Sex Med. 2021; 18(5): 926–935.

56. El‑Shaer W, Ghanem H, Diab T, Abo‑Taleb A, Kandeel W. Intra‑cavernous injection of BOTOX® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial. Andrology. 2021; 9(4): 1166–1175.

Štítky
Paediatric urologist Nephrology Urology
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#