Clinical Scientist Consulting, Framingham, MA 01701, USA.
J Sex Med. 2013 Feb;10(2):551-61. doi: 10.1111/j.1743-6109.2012.02998.x. Epub 2012 Nov 15.
Optimal pharmacologic management of diseases comorbid with erectile dysfunction (ED), such as cardiovascular disease, depression, diabetes, dyslipidemia, hypertension, and benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS), is dependent upon long-term treatment compliance and may be complicated by poor adherence to medication use. ED may contribute to poor adherence to medication use because poor quality erectile function may be an unwanted adverse effect of antihypertensives, antidepressants, and 5-α reductase inhibitors for treatment of BPH/LUTS. Diminished erectile spontaneity, rigidity, and/or sustaining capability also negatively affects mood, self-esteem, and confidence, which compromise motivation to be compliant with medications that treat diseases comorbid with ED.
Literature review was performed to explore the role of ED diagnosis and effective treatment in enhancing overall management of selected ED comorbidities, highlighting the role of medication adherence.
Several PubMed searches were performed.
Diagnosis and successful treatment of concomitant ED may promote improved adherence and management of comorbid diseases. Concomitant ED management may improve treatment outcome, decrease healthcare costs, and possibly prevent or even improve deterioration in medical conditions comorbid with ED. Because ED is a silent marker and predictor of comorbidities, especially cardiovascular disease, earlier diagnosis of ED may provide an opportunity to prevent future cardiovascular events. In men presenting with complaints of ED, screening for, monitoring, and appropriately treating diseases that are comorbid with ED is essential. Screening for and appropriately treating ED is important for enhanced life quality and improved motivation in men with existing ED comorbidities or risk factors.
Appropriate management of ED and its risk factors may have beneficial effects on diseases that are comorbid with ED, and vice versa, most likely via shared pathophysiological pathways. Clinicians may need to consider men's health overall, of which sexual health is a central component, in order to provide optimal disease management.
患有勃起功能障碍(ED)的患者常合并多种疾病,如心血管疾病、抑郁症、糖尿病、血脂异常、高血压和良性前列腺增生/下尿路症状(BPH/LUTS)等,这些疾病的最佳药物治疗取决于长期的治疗依从性,而药物使用的依从性可能会因较差的治疗效果而变得复杂。ED 可能会导致药物使用的依从性较差,因为治疗 BPH/LUTS 的降压药、抗抑郁药和 5-α 还原酶抑制剂可能会导致较差的勃起功能,从而产生不受欢迎的不良反应。勃起的自发性、硬度和/或维持能力下降也会对情绪、自尊心和自信心产生负面影响,从而影响患者服用治疗 ED 合并症的药物的依从性。
本研究通过文献回顾,探讨 ED 诊断和有效治疗在增强特定 ED 合并症整体管理中的作用,强调药物使用依从性的重要性。
进行了多次 PubMed 检索。
ED 的诊断和成功治疗可能会促进合并疾病的治疗依从性和管理。合并 ED 的管理可能会改善治疗效果,降低医疗费用,并可能预防甚至改善与 ED 合并的疾病的恶化。由于 ED 是合并症的无声标志物和预测因素,尤其是心血管疾病,因此早期诊断 ED 可能为预防未来心血管事件提供机会。对于出现 ED 症状的男性,筛查、监测和适当治疗与 ED 合并的疾病非常重要。对于患有 ED 合并症或风险因素的男性,筛查和适当治疗 ED 对于提高生活质量和改善治疗动机非常重要。
ED 及其危险因素的适当管理可能对合并 ED 的疾病产生有益影响,反之亦然,这很可能是通过共同的病理生理途径实现的。临床医生可能需要综合考虑男性健康,因为性健康是其重要组成部分,以提供最佳的疾病管理。