Medicinal erectile dysfunction therapy - state of the art

In the medicinal therapy of erectile dysfunction (ED), both oral as well as local application are possible. The introduction of the PDE-5 inhibitor Sildenafil, as the first highly potent oral therapy for ED, caused dramatic changes in the diagnostic and therapeutic strategies in this area. The later PDE-5 inhibitors Taclalafil and Vardenafil show, as far as it is currently possible to judge, a similar profile to Sildenafil. The only previously available oral, therapeutic, Yohimbin, plays an insignificant role,and the initial hopes for Apomorphin as an ED therapeutic have settled to realistic level. Local application therapies have also become less important,with the intra-urethral application of PGE(1) being reduced to a few clinical indicated situations. The intra-cavernosal pharmacotherapy with PGE(1) is considered the gold standard when oral therapies do not work or can not be used.