Performance and safety of treatment options for erectile dysfunction in patients with spinal cord injury: A review of the literature.
Erectile Dysfunction
/ diagnosis
Humans
Injections
Male
Patient Satisfaction
Penile Erection
/ drug effects
Penile Prosthesis
Phosphodiesterase 5 Inhibitors
/ administration & dosage
Prosthesis Implantation
/ instrumentation
Recovery of Function
Spinal Cord Injuries
/ complications
Treatment Outcome
Vacuum
Vasodilator Agents
/ administration & dosage
erectile dysfunction
intracavernous injection
penile prosthesis
phosphodiesterase 5-inhibitors
spinal cord injury
vacuum erection device
Journal
Andrology
ISSN: 2047-2927
Titre abrégé: Andrology
Pays: England
ID NLM: 101585129
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
28
04
2020
revised:
15
07
2020
accepted:
24
07
2020
pubmed:
3
8
2020
medline:
12
10
2021
entrez:
3
8
2020
Statut:
ppublish
Résumé
For a large proportion of patients with spinal cord injury, sexuality and reproduction are important issues. However, sparse data exist regarding available treatment options for this patient population. We sought to review performance and safety rates of all currently available treatment options for erectile dysfunction in spinal cord injury men. A systematic literature review without time restrictions was performed using PubMed/EMBASE database for English-, Italian-, German-, and Spanish-language articles. Articles' selection was performed according to the PRISMA guidelines. Relevant papers on erectile dysfunction in spinal cord injury patients were included in the final analyses. Overall, 47 studies were eligible for inclusion in this review. Of these, most evidence dealt with phosphodiesterase 5-inhibitors and intracavernous drug injection. Both treatment options are associated with high levels of performance and with patients/partners' satisfaction; side effects are acceptable. Overall, penile prostheses and vacuum erection devices are in general less approved by spinal cord injury patients and are correlated with increased rates of complications in comparison with phosphodiesterase 5-inhibitors and intracavernous drug injection. Sacral neuromodulation, transcutaneous electrical nerve stimulation, and intraurethral suppositories have been poorly studied, but preliminary studies did not show convincing results. The best treatment options for erectile dysfunction in spinal cord injury patients emerged to be phosphodiesterase 5-inhibitors and intracavernous drug injection. The choice of erectile dysfunction treatment should be based on several aspects, including residual erectile function, spinal cord injury location, and patients' comorbidities. Future studies assessing the applicability of less well-studied treatments, as well as evaluating innovative options, are needed in this specific population.
Sections du résumé
BACKGROUND
For a large proportion of patients with spinal cord injury, sexuality and reproduction are important issues. However, sparse data exist regarding available treatment options for this patient population.
OBJECTIVES
We sought to review performance and safety rates of all currently available treatment options for erectile dysfunction in spinal cord injury men.
MATERIALS AND METHODS
A systematic literature review without time restrictions was performed using PubMed/EMBASE database for English-, Italian-, German-, and Spanish-language articles. Articles' selection was performed according to the PRISMA guidelines. Relevant papers on erectile dysfunction in spinal cord injury patients were included in the final analyses.
RESULTS AND DISCUSSION
Overall, 47 studies were eligible for inclusion in this review. Of these, most evidence dealt with phosphodiesterase 5-inhibitors and intracavernous drug injection. Both treatment options are associated with high levels of performance and with patients/partners' satisfaction; side effects are acceptable. Overall, penile prostheses and vacuum erection devices are in general less approved by spinal cord injury patients and are correlated with increased rates of complications in comparison with phosphodiesterase 5-inhibitors and intracavernous drug injection. Sacral neuromodulation, transcutaneous electrical nerve stimulation, and intraurethral suppositories have been poorly studied, but preliminary studies did not show convincing results.
CONCLUSION
The best treatment options for erectile dysfunction in spinal cord injury patients emerged to be phosphodiesterase 5-inhibitors and intracavernous drug injection. The choice of erectile dysfunction treatment should be based on several aspects, including residual erectile function, spinal cord injury location, and patients' comorbidities. Future studies assessing the applicability of less well-studied treatments, as well as evaluating innovative options, are needed in this specific population.
Substances chimiques
Phosphodiesterase 5 Inhibitors
0
Vasodilator Agents
0
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1660-1673Informations de copyright
© 2020 American Society of Andrology and European Academy of Andrology.
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