Treatment of erectile dysfunction is based on pharmacotherapy for most patients.
To review the current data on pharmacotherapy for erectile dysfunction based on efficacy, psychosocial outcomes, and safety outcomes.
A review of the literature was undertaken by the committee members. All related articles were critically analyzed and discussed, and consensus statements were developed after presentation at the 2024 ICSM.
Eight recommendations are provided with the corresponding level of evidence and grade of recommendation.
The management of erectile dysfunction should be personalized to address the psychosocial needs and expectations of both the patient and their partner. PDE5 inhibitors remain the first-line treatment for most men, while intracavernosal injections, vacuum erection devices, and penile prostheses serve as second-line options, with treatment decisions guided by patient preferences. Key recommendations are summarized in table 1.
Sexual medicine reviews. 2025 Aug 03 [Epub ahead of print]
Noah Stern, Petar Bajic, Jeffrey Campbell, Paolo Capogrosso, Trustin Domes, Eduardo P Miranda, John P Mulhall, Bruno Nascimento, Michael Pignanelli, Alexander W Pastuszak, Gerald Brock
Department of Surgery, Division of Urology, North York General Hospital, Toronto, ON, M2K 1E1, Canada., Men's Health Section, Cleveland Clinic Glickman Urological Institute, Cleveland, OH 44106, United States., Department of Surgery, Division of Urology, Schulich School of Medicine and Dentistry, Western University, London, ON, N6A 5C1, Canada., Department of Urology, Circolo & Fondazione Macchi Hospital - ASST Sette Laghi, Department of Medicine and Technical Innovation (DIMIT), University of Insubria, Varese VA, 21100, Italy., Division of Urology, University of Saskatchewan, Saskatoon, SK, S7M 2W2, Canada., Division of Urology, Centro Universitário Christus - UNICHRISTUS, Fortaleza CE, 60160-230, Brazil., Sexual and Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10022, United States., Department of Urology, Clinical Hospital FMUSP, São Paulo SP, 05403-010, Brazil., Department of Urology, Albany Medical College, Albany, NY, 12208, United States., Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT 84132, United States., Division of Urology, Department of Surgery, Western University, London, ON, N6A 5C1, Canada.