Year 2009 Vol. 17 No 4




The researches in the erectile dysfunction (ED) made during the last 15 years have led to the development of several new treatment options and strategies for ED. Worldwide availability of the three oral PDE 5 inhibitors (sildenafil, tadalafil, vardenafil) are associated with high efficacy and safety rates, even in difficult-to-treat populations (e.g. diabetes mellitus, radical prostatectomy). Many physicians without background knowledge and clinical experience of the diagnosis and treatment of ED are involved in decision-making concerning the evaluation and treatment of these men. Treatment options for patients not responding to oral drugs (or with contraindications) include intracavernous injections, intraurethral alprostadil, vacuum constriction devices and implantation of penile prosthesis. It must be emphasized that the physician should warn the patient that sexual intercourse is considered to be a high physical activity, which increases the heart rate as well as cardiac work. Physicians should assess the cardiac risks of patients prior to treating ED. Reconstructive vascular surgery is associated with poor outcomes in long-term follow-up. Further studies are underway. Data of numerous investigations have led to creation of standards of diagnostics and treatment of ED of the European Association of Urology (EAU-2009).

Keywords: erectile dysfunction, methods of diagnostics, standards of treatment, 5 PDE blockers
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