Introduction: Erectile dysfunction (ED) is one of the most common complications of diabetes. The complex pathophysiology of this disease makes it difficult to create clinical treatments tailored specifically for diabetic patients.
Areas covered: This article will provide an update of both medical and surgical treatment approaches for diabetic ED, as well as discuss established treatments that are the cornerstone of this field.
Expert opinion: Currently, PDE type 5 inhibitors represent the first-line treatment for all patients with ED. In the interim since this article's first publication several new PDE5 inhibitors have come to market. Several others that were previously on the market are now available for daily dosing. Analysis of both testosterone level and hemoglobin A1c is an essential part of treatment. Intracavernosal injections and vacuum constriction devices remain safe, and are highly effective treatment options. The implantable penile prosthesis remains a safe, and definitive treatment modality for those patients with refractory ED. Over the coming years as the understanding of the underlying causes of diabetic ED continues, the development of new, noninvasive, but effective medical treatments will lead to even more options for the treatment of this difficult disease.
Keywords: PDE5 inhibitor; diabetes; erectile dysfunction; review; treatment.