| Title | Evaluation and treatment of erectile dysfunction in men with diabetes mellitus. | | Author(s) | Dey J, Shepherd MD | | Institution | Endocrinology Consultants PLLC, Tupelo, MS 38803, USA. jayantdey@hotmail.com | | Source | Mayo Clin Proc 2002 Mar; 77(3):276-82. | | MeSH | Aged
Algorithms
Alprostadil
Decision Trees
Diabetes Complications
Humans
Impotence
Incidence
Male
Medical History Taking
Middle Aged
Phosphodiesterase Inhibitors
Physical Examination
Piperazines
Prevalence
Primary Health Care
Risk Factors
Treatment Outcome
Vasodilator Agents
| | Abstract | Diabetic men have a more than 3-fold increased prevalence of erectile dysfunction (ED) compared with nondiabetic men. Erectile function is primarily a vascular phenomenon, triggered by neurologic controls and facilitated by appropriate hormonal and psychological components. Recent advances in the understanding of the physiology of penile vasculature and its role in male sexual performance have influenced the clinical approach to ED. The pathophysiological alterations leading to impotence in diabetic men include vasculogenic, neurogenic, and hormonal etiologies. A clinical work-up, including a thorough history and physical examination, is an important aspect of ED management. Biochemical evaluations to rule out secondary causes like hypogonadism and thyroid abnormalities are suggested. Oral medications acting through phosphodiesterase inhibition in penile vasculature have revolutionized treatment of impotence in diabetic men. Because of a high success rate in treating ED of various etiologies, these agents are the treatment of choice for most patients. Safety and efficacy of vacuum-constriction devices, intraurethral suppositories, intracavernosal injections, and other therapies are discussed. A clinical algorithm for the evaluation and management of ED is provided for use in the primary care setting. | | Language | eng | | Pub Type(s) | Journal Article
Review
| | PubMed ID | 11888032 |
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