Department of Urology, Aksaray University School of Medicine , Aksaray , Turkey.
Laboratory of Reproductive Biology, University of Copenhagen , Copenhagen , Denmark.
Expert Opin Drug Saf. 2019 Oct;18(10):965-975. doi: 10.1080/14740338.2019.1659244. Epub 2019 Aug 30.
: Treatment options for erectile dysfunction (ED) have evolved over the last two decades, particularly after the introduction of phosphodiesterase type-5 inhibitors (PDE5Is). The path, however, has not been straightforward with issues raised regarding safety and toxicity following ED treatments. : A literature review was conducted on current evidence related to the safety of PDE5Is, intracavernosal injections and various older forms of oral therapies. Relevant trials were identified through a literature search of PubMed from 1980 to 2019. : PDE5Is are now recommended as the first line therapy for the treatment of ED due to their efficacy and tolerable side effects. Comparison of the various PDE5Is on safety has not been supported by prime evidence, and consequently, the negative aspects of each inhibitor appear the same as defined in the literature. Other means of therapies for ED are still in the running, and these also present a different range of side effects. While intracavernosal injections have potential to cause priapism and penile fibrosis, intraurethral alprostadil may result in more systematic side effects. Alternative topical ED therapies are generally limited with their local side effects.
: 过去二十年来，治疗勃起功能障碍（ED）的方法不断发展，特别是在磷酸二酯酶 5 型抑制剂（PDE5Is）问世之后。然而，这条路并非一帆风顺，ED 治疗后出现了安全性和毒性方面的问题。: 对当前有关 PDE5Is、海绵体内注射和各种较旧的口服治疗方法安全性的证据进行了文献回顾。通过对 1980 年至 2019 年 PubMed 文献的检索，确定了相关试验。: 由于 PDE5Is 的疗效和可耐受的副作用，它们现在被推荐为 ED 的一线治疗药物。对各种 PDE5Is 的安全性比较没有得到主要证据的支持，因此，每种抑制剂的负面方面似乎与文献中定义的相同。ED 的其他治疗方法仍在研究中，这些方法也会带来不同的副作用。虽然海绵体内注射有可能导致阴茎异常勃起和阴茎纤维化，但尿道内前列地尔可能会导致更系统的副作用。替代的局部 ED 治疗方法通常受到局部副作用的限制。
