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Evolving medical management of erectile dysfunction: recommendations from the Fifth International Consultation on
Noah Stern1, Petar Bajic2, Jeffrey Campbell3
1Department of Surgery, Division of Urology, North York General Hospital, Toronto, ON, M2K 1E1, Canada.
Introduction:
Treatment of erectile dysfunction is based on pharmacotherapy for most patients.
Aim:
To review the current data on pharmacotherapy for erectile dysfunction based on efficacy, psychosocial outcomes, and safety outcomes.
Methods:
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.
Results:
Eight recommendations are provided with the corresponding level of evidence and grade of recommendation.
Conclusions:
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.
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