Pharmacotherapy for erectile dysfunction

Objective To review current pharmacologic treatment options for erectile dysfunction.Methods Relevant literatures from the past two decades regarding the following treatments were reviewed: intracavernous injection, topical therapy, transurethral therapy and oral drugs.Study selection More than 125 originally identified articles were reviewed, and 45 were selected that especially addressed the stated purpose.Results Among the pharmacologic treatment options available, intracavernous injection therapy remains the most effective although the drop-out rate is high.Topical creams and gels have not been very successful.Transurethral alprostadil can be more effective if a constriction device is applied at the base of the penis.Oral sildenafil has the highest patient acceptance rate although systemic side effects can be a major drawback.Conclusions Effective pharmacotherapies for ED of various etiologies are now available.However, proper evaluation of every patient should be performed before giving treatment so that a number of potentially life-threatening causes of erectile dysfunction would not be missed.