Erectile Dysfunction: Update on Clinical Management

Abstract

Background and objective: Erectile dysfunction (ED) is a common condition affecting patients' quality of life. Clinical management has changed over the past three decades, with new diagnostic and therapeutic options available. Our aim was to provide an overview of novel evidence regarding clinical management of ED.

Methods: A non-systematic literature review was conducted to identify relevant studies on the diagnosis and treatment of erectile dysfunction. The review encompassed pharmacological, regenerative, and surgical approaches, summarising recent advances and highlighting persisting gaps in clinical practice.

Key findings and limitations: ED is a common reason for seeking medical consultation. The correlation between ageing and ED prevalence is rooted in neurovascular tissue impairment. Medical history, along with the use of validated questionnaires, still represents the mainstay of ED assessment because of the lack of reliable imaging tests. The most widely used and effective treatment is an oral phosphodiesterase type 5 inhibitor, but this is lifelong therapy that is associated with high dropout rates. Among novel regenerative treatments, low-intensity shockwave therapy is supported by more evidence, although high-quality trials and long-term data are lacking. More conclusive evidence is needed for platelet-rich plasma injections and stem cell treatment. Botulinum neurotoxin and new emerging oral drugs are also under investigation.

Conclusions: Several treatment options are available for ED. Clinical tailoring of treatment for individual patients and rigorous research are crucial for further advances.

Patient summary: Erectile dysfunction (ED) is a common medical problem. Various types of treatment can improve ED, but there is still no cure for this condition.

Keywords: Erectile dysfunction; Hypogonadism; Impotence; Incidence; Phosphodiesterase type 5 inhibitor; Platelet-rich plasma; Shockwave therapy; Stem cell therapy; Treatment; Vertica.