Treatment of erectile dysfunction following spinal cord injury

Abstract

Spinal cord injury (SCI) has a significant impact on erectile dysfunction. Treatment modalities for individuals with SCI are similar to treatments for those without SCI. Some of the most common methods of management include penile implants, oral phosphodiesterase (PDE) inhibitors, vacuum devices, intraurethral prostaglandins, and intracavernous injections. In addition to the advantages and disadvantages of these various modalities for able-bodied men, there are special considerations for men with SCI. Penile implants may help to keep an external condom catheter in place and provide more penile stability for intermittent catheterization. However, they have an increased risk of infection. Semirigid rods have an increased risk of erosion. Although convenient to use, PDE inhibitors are usually not effective in lower motor injuries. The hypotensive effects of intraurethral prostaglandins and PDE inhibitors need to be considered in SCI men with injuries at or above T6. Intracavernous injections are very effective; however, men with SCI require much lower doses than able-bodied men.

Efficacy and safety of phosphodieterase-5 inhibitors for treatment of erectile dysfunction secondary to spinal cord injury: a systemic review and meta-analysis

“…31,32 A variety of management options could be adopted for individuals with SCI. 33 However, therapies for ED caused by SCI remain challenging, and PDE5 inhibitors, vacuum devices, penile implants, intraurethral prostaglandins, percutaneous perineal electrostimulation, transdermal nitroglycerin, intracavernous injection of papaverine and some other therapies are still under debate. [33][34][35][36][37][38][39] The aim of this systematic review focused on comprehensively appraising efficacy and safety of PDE5 inhibitors in patients with SCI.…”

Long-term efficacy and safety of self-intracavernous injection of prostaglandin E1 for treatment of erectile dysfunction in China

“…, 2006). This indicates that many ED patients have to switch to other therapeutic strategies including intracavernous injection, intraurethral therapies, vacuum devices and surgical prosthesis (Linsenmeyer, 2009).…”

The role of third-wave cognitive-behavioural factors on the sexual functioning of people with and without physical disabilities

“…E. Verschuren et al, 2015;Garrett et al, 2009;Gava et al, 2019;Lew-Starowicz & Rola, 2013). However, research tends to focus on differences between people with and without physical disabilities, under-looking the factors that may contribute to explain the sexual response, above and beyond the effects of the impairment (Beckwith & Yau, 2013;Javier et al, 2013;Linsenmeyer, 2009;Othman & Engkasan, 2011).…”