Department of Urology, Ohio State University Medical Center, Columbus, OH, USA.
Ther Adv Urol. 2009 Dec;1(5):235-42. doi: 10.1177/1756287210362069.
Phosphodiesterase type 5 inhibitors (PDE5-i) have become first line therapy for the treatment of erectile dysfunction. Most initial prescriptions for PDE5-i are by primary care practitioners. Urologists must now routinely manage the patient who has failed initial therapy with PDE5-i. Lifestyle modifications can be of benefit to patients. Patient education and optimization of the PDE5-i can result in a successful response. Interestingly, there are reports of up to 60% salvage after changing the PDE5-i utilized. Daily PDE5-i have shown benefit, and treatment of hypogonadism can enhance response to PDE5-i. We review the management of PDE5-i failures with emphasis on noninvasive approaches to gaining improved erectile response to these medications. An algorithm based on the reviewed strategies is proposed to guide clinicians in the treatment of erectile dysfunction.
磷酸二酯酶 5 抑制剂 (PDE5-i) 已成为治疗勃起功能障碍的一线药物。大多数 PDE5-i 的初始处方都是由初级保健医生开具的。现在泌尿科医生必须定期治疗初始 PDE5-i 治疗失败的患者。生活方式的改变可能对患者有益。对患者进行教育并优化 PDE5-i 可以获得成功的反应。有趣的是，有报道称更换 PDE5-i 后，有高达 60%的患者可以挽救。每日 PDE5-i 已显示出益处，治疗性腺功能减退症可以增强对 PDE5-i 的反应。我们回顾了 PDE5-i 失败的管理，重点是采用非侵入性方法来改善这些药物的勃起反应。提出了一种基于所审查策略的算法，以指导临床医生治疗勃起功能障碍。
