The safety and efficacy of PDE5-inhibitors-vardenafil on treating diabetes mellitus erectile dysfunction

Abstract ABSTRACT Background: To systematically evaluate the efficacy and safety of the PDE5 inhibitors in patients with diabetes mellitus erectile dysfunction (DMED). Methods:Random control trials (RCTs) in PubMed, EMBASE, Cochrane library, ClinicalTrials, China Knowledge Network (CNKI), Weipu Chinese Science and Technology Journal Full-text Database (VIP), Wanfang Data Resource System (WANFANG) were searched. Two researchers independently screened the literature, extracted the data and checked the results, and used the risk assessment tool to conduct a methodological quality assessment, and finally conducted a meta-analysis. The primary outcome, the erectile function scores of the International Index of Erectile Dysfunction (IIEF-EF), was recorded, while secondary outcomes (IIEF-Q3, IIEF-Q4, SEP 2 and 3, GAQ) and safety outcomes also needed attention. Results: Twelve studies included 3,124 patients and six PDE5 inhibitors were included. Compared with placebo, PDE5 inhibitors significantly improved male erectile function in IIEF-EF (WMD = 5.73; 95% CI: 3.62 to 7.84), IIEF-Q3 (WMD = 1.14; 95% CI: 0.87 to 1.40), IIEF-Q4 (WMD=1.28; 95% CI: 1.04 to 1.51), SEP2 (WMD=21.24; 95% CI: 15.50 to 26.98), SEP3 (WMD=25.77; 95% CI: 18.78 to 32.77), GAQ (RR) =2.98; 95% CI: 2.06 to 4.32), and with the safety (WMD=5.73; 95% CI: 3.62 to 7.84). Conclusions: PDE5 inhibitors can significantly improve the patient's erectile function, but cannot ignore their side effects.

Download Full-text

Erectile dysfunction in men with diabetes (literature review). Part 2

INTERNATIONAL JOURNAL OF ENDOCRINOLOGY ◽

10.22141/2224-0721.17.6.2021.243218 ◽

2021 ◽

Vol 17 (6) ◽

pp. 513-519

Author(s):

Е.V. Luchytskiy ◽

V.E. Luchytskiy

Keyword(s):

Diabetes Mellitus ◽

Erectile Dysfunction ◽

Literature Review ◽

Clinical Manifestations ◽

Penile Prosthesis ◽

Epidemiological Studies ◽

Diagnosis And Treatment ◽

Pde5 Inhibitors ◽

Surgical Methods

The second part of review article highlights modern views on the diagnosis and treatment of erectile dysfunction (ED) in men with diabetes mellitus (DM). Google Scholar and PubMed databases were used to search for literature sources. The role of comorbid diseases in the development of ED in men with diabetes mellitus has been shown. The generalized data on the main clinical manifestations of erectile dysfunction, methods of its diagnosis and treatment are given. A number of epidemiological studies over the past 20 years have found that erectile dysfunction in men with diabetes may be an early marker of cardiovascular complications. Thus, in the algorithm for the diagnosis of ED in patients with diabetes it is necessary to conduct a thorough examination of the cardiovascular system. The article describes modern therapeutic and surgical methods of ED treatment. Numerous literature sources indicate an important role of the correction of androgen deficiency in men with type 2 diabetes to enhance the effectiveness of phosphodiesterase type 5 (PDE5) inhibitors. The literature review shows the data on the emergence of new PDE5 inhibitors, which have a higher selectivity compared to existing ones that provides a better therapeutic effect and reduces the frequency and severity of side effects. The modern algorithm for the treatment of ED in men involves the sequential stages of using different treatments. The last link of therapy, in case of inefficiency of the previous ones, is penile prosthesis. Implantation of three-piece penile prosthesis is an effective method of ED treatment. The use of this method in patients with severe forms of ED on the background of diabetes, in case of ineffectiveness of PDE5 inhibitors and intracavernous injections of vasoactive drugs, is considered promising.

Download Full-text