Chen Yun, Dai Yutian, Wang Run
Department of Urology, Affiliated Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210008, China.
Expert Opin Pharmacother. 2008 Feb;9(2):257-66. doi: 10.1517/14656566.9.2.257.
Erectile dysfunction is a common complication of diabetes. Clinical practice has no treatment modality specifically designed for the difficult to treat diabetic erectile dysfunction due to the multifactorial and complex pathophysiology of development. PDE type 5 inhibitors are the first-line treatment option. Non-responders should have total and free testosterone checked and testosterone replacement is recommended for hypogonadal patients. For patients who cannot take PDE type 5 inhibitors, or are proven non-responders, the vacuum constriction device continues to serve as a major treatment option. Intracavernosal injection is the most effective medical therapy for diabetic erectile dysfunction despite its high dropout rate. Use of the Medicated Urethral System for Erection to overcome the disadvantages of needle injection is disappointing due to lack of effectiveness. Penile prosthesis will continue to play an important role in diabetic patients with severe erectile dysfunction in coming years.
勃起功能障碍是糖尿病的常见并发症。由于其发病的多因素和复杂病理生理学，临床实践中没有专门针对难治性糖尿病性勃起功能障碍设计的治疗方式。5型磷酸二酯酶（PDE）抑制剂是一线治疗选择。无反应者应检查总睾酮和游离睾酮，对于性腺功能减退患者建议进行睾酮替代治疗。对于不能服用5型PDE抑制剂或已证实无反应的患者，真空缩窄装置仍是主要治疗选择。阴茎海绵体内注射是治疗糖尿病性勃起功能障碍最有效的药物治疗方法，尽管其停药率高。用于勃起的药物尿道系统因缺乏有效性而无法克服针剂注射的缺点，令人失望。未来几年，阴茎假体将继续在重度勃起功能障碍的糖尿病患者中发挥重要作用。
