Diabetes and male sexual function (Part 6)
Buy diabetes drugs ED, oral therapy is the best first line treatment. Currently, the only effective oral treatment is sildenafil, provided that there are no specific contraindications. In a large double-blind placebo study of 268 diabetic men with ED, erections were improved in 57% of patients who received sildenafil compared with 10% of men who received placebo. Sexual intercourse was successful in 48% of men receiving sildenafil compared with 12% of men who were given a placebo.
If oral therapy is not effective, a number of other options are available such as a vacuum erection device (VED), an intraurethral prostin, an intracavernosal injection (ICI) of an vasoactive substance or penile implantation. Individual patient preferences often determine the next step.
ICI provides satisfactory sexual activity in 72.5% of patients with DM ED. The optimal dose is usually higher than that for the general population with ICI. Fifty-five per cent of patients require more than 20 |ig of prostaglandin Er The dropout rate is high, however, and complaints of penile pain are reported in 61% of patients; however, it is tolerated by most patients. Although less efficacious than ICI, an intraurethral prostin can be a good alternative for patients who do not wish more invasive therapies.