Derouet H, Osterhage J, Sittinger H
Urologische Universitätsklinik, 66421 Homburg/Saar, Germany.
Urologe A. 2004 Feb;43(2):197-207; quiz 208-9. doi: 10.1007/s00120-003-0527-9.
Erectile dysfunction is a common, age-dependent functional disturbance of men associated to various comorbidities. Interdisciplinary cooperation with neurologists in cases of a suspected neurological aetiology and with psychiatrists in cases with normal organic diagnostic findings is necessary. Hormone replacement and psychotherapy can cure certain patients. Oral pharmacotherapy is the most effective therapy for erectile dysfunction with the highest patient preference. Oral PDE-5-inhibitors (sildenafil, tadalafil, vardenafil) are superior in effectiveness to centrally acting drugs (apomorphin, yohimbine). Local pharmacotherapy (MUSE, ICI) is a second line therapy in cases of failure or contraindications for oral pharmacotherapy. Vacuum therapy and operative procedures (penile implants) complete the therapeutic options of erectile dysfunction.
勃起功能障碍是一种常见的、与年龄相关的男性功能障碍，与多种合并症有关。对于疑似神经病因的病例，需与神经科医生进行跨学科合作；对于器质性诊断结果正常的病例，则需与精神科医生合作。激素替代疗法和心理治疗可以治愈某些患者。口服药物治疗是治疗勃起功能障碍最有效的方法，患者的接受度也最高。口服磷酸二酯酶-5抑制剂（西地那非、他达拉非、伐地那非）在疗效上优于中枢作用药物（阿扑吗啡、育亨宾）。局部药物治疗（尿道内给药、阴茎海绵体内注射）是口服药物治疗失败或有禁忌证时的二线治疗方法。真空疗法和手术治疗（阴茎植入）完善了勃起功能障碍的治疗选择。
