Beecken Wolf-D, Kersting Max, Kunert Wilko, Blume Giordano, Bacharidis Nico, Cohen Deborah S, Shabeeh Husain, Allen Mark S
UroGate, Practice for Urology, Frankfurt, Germany; Regimen/with O Inc, San Jose, CA, USA.
Regimen/with O Inc, San Jose, CA, USA.
Sex Med Rev. 2021 Jul;9(3):445-463. doi: 10.1016/j.sxmr.2020.11.004. Epub 2020 Dec 24.
Up to 50% of all men over 50 years of age suffer from erectile dysfunction. Since the late 1990s erectile dysfunction has been treated mostly with phosphodiesterase 5 inhibitors (PDE5I). Over the past 20 years, numerous scientific findings on the development of erectile dysfunction have been collected, which have so far received little attention in the treatment of erectile dysfunction.
The objectives of this study were to review the existing medical literature on erectile dysfunction regarding physiology, pathophysiology, and especially therapeutic options beyond treatment with PDE5I and to enable a more effective and especially sustainable treatment for erectile dysfunction.
A literature review was performed by using PubMed from 1985 to 2020 regarding the physiology, pathophysiology, and treatment of erectile dysfunction.
Since the end of the 1990s an enormous amount of knowledge has been gained about the physiology/pathophysiology of erection/erectile dysfunction. Based on these findings, numerous physical, drug, and holistic therapeutic options (beyond the application of PDE5I) have been developed for the treatment of erectile dysfunction. However, these are still relatively rarely used in the therapeutic concept of erectile dysfunction today.
Based on scientific findings of the last 20 years, there are numerous therapeutic approaches, including lifestyle modification, specific pelvic floor exercises, shock wave treatment, and the application of different supplements. The long-term treatment of erectile dysfunction should now go beyond the purely symptomatic use of PDE5I. W-D Beecken, M Kersting, W Kunert, et al. Thinking About Pathomechanisms and Current Treatment of Erectile Dysfunction-"The Stanley Beamish Problem." Review, Recommendations, and Proposals. Sex Med Rev 2021;9:445-463.
50岁以上的男性中，高达50%患有勃起功能障碍。自20世纪90年代末以来，勃起功能障碍主要用5型磷酸二酯酶抑制剂（PDE5I）进行治疗。在过去20年里，已经收集了大量关于勃起功能障碍发病机制的科学发现，但这些发现在勃起功能障碍的治疗中迄今很少受到关注。
本研究的目的是回顾现有关于勃起功能障碍的医学文献，涉及生理、病理生理，尤其是PDE5I治疗以外的治疗选择，以实现对勃起功能障碍更有效、特别是更可持续的治疗。
利用PubMed对1985年至2020年期间关于勃起功能障碍的生理、病理生理和治疗的文献进行综述。
自20世纪90年代末以来，在勃起/勃起功能障碍的生理/病理生理方面已经获得了大量知识。基于这些发现，已经开发出多种物理、药物和整体治疗选择（PDE5I应用以外）用于治疗勃起功能障碍。然而，这些治疗方法在当今勃起功能障碍的治疗理念中仍然相对较少使用。
基于过去20年的科学发现，有多种治疗方法，包括生活方式改变、特定盆底肌锻炼、冲击波治疗以及不同补充剂的应用。勃起功能障碍的长期治疗现在应超越单纯对症使用PDE5I。W-D·贝肯、M·克斯廷、W·库纳特等。关于勃起功能障碍的发病机制及当前治疗的思考——“斯坦利·比米什问题”。综述、建议与提案。《性医学评论》2021年；9：445-463。
