Andrology and Sexual Medicine Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.
J Sex Med. 2011 Dec;8(12):3418-32. doi: 10.1111/j.1743-6109.2011.02473.x. Epub 2011 Oct 13.
Erectile dysfunction (ED) is a very common multidimensional disorder affecting men worldwide. Physical illness, reaction to life stresses, or an unhappy couple relationship influence clinical outcome. Phosphodiesterase type 5 (PDE5) inhibitors are recognized as efficacious and well tolerated, and are the first-line treatment for ED. Sildenafil, tadalafil, and vardenafil are the most widely used and studied PDE5 inhibitors. Data acquired during a routine diagnostic workup for ED should be taken into account when choosing the best PDE5 inhibitor for the individual patient, creating an individualized treatment plan, and going beyond "experience-based" subjective opinion and unfounded ideas and prejudice regarding currently available drugs.
As the process of matching a given patient's profile to any selected PDE5 inhibitor often relies more on physician's personal convictions than on solid evidence, the aim of this review is to identify the main clinical, demographic, and relational factors influencing the choice of the PDE5 inhibitor to be used for the treatment of ED.
A systematic literature search and current treatment guidelines were evaluated in a systematic manner.
The main clinical, cultural, and demographical factors to be considered for the treatment of ED have been identified.
Main factors influencing the choice of the treatment for ED have been described. A short list of items that may help in choosing the right PDE5 inhibitor for the treatment of different patients in daily clinical practice has been prepared.
The simple algorithms prepared should be a useful tool to be used in daily practice, which may help in choosing the right treatment for each subject affected by ED.
勃起功能障碍（ED）是一种非常常见的多维疾病，影响着全球的男性。身体疾病、对生活压力的反应或不幸福的夫妻关系会影响临床结果。磷酸二酯酶 5（PDE5）抑制剂被认为是有效且耐受良好的，是 ED 的一线治疗药物。西地那非、他达拉非和伐地那非是最广泛使用和研究的 PDE5 抑制剂。在为 ED 进行常规诊断工作时获得的数据，应在为个体患者选择最佳 PDE5 抑制剂、制定个体化治疗计划以及超越目前可用药物的“经验为主”的主观意见和毫无根据的想法和偏见时加以考虑。
由于将给定患者的特征与任何选定的 PDE5 抑制剂相匹配的过程通常更多地依赖于医生的个人信念，而不是基于确凿的证据，因此本综述的目的是确定影响 PDE5 抑制剂选择的主要临床、人口统计学和关系因素，以治疗 ED。
系统地评估了文献检索和当前的治疗指南。
确定了用于 ED 治疗的主要临床、文化和人口统计学因素。
描述了影响 ED 治疗选择的主要因素。列出了一些可能有助于在日常临床实践中为不同患者选择正确的 PDE5 抑制剂的项目。
准备好的简单算法应该是日常实践中有用的工具，可以帮助为每个受 ED 影响的患者选择正确的治疗方法。
