Abstract
Erectile dysfunction is defined as persistent inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse that lasts at least six months. Prevalence of erectile dysfunction in diabetic men ranges from 35% to 90%.
Erectile dysfunction in diabetic men has faster progression and is more resistant to the treatment. Higher age, longer duration of illness, inadequate compensation of diabetes mellitus, other comorbidities (hypertension, hyperlipidemia, hypogonadism), sedentary lifestyle and smoking contribute to development of erectile dysfunction in diabetic men.
Complex therapy approach requires optimal control of glycaemia, cure of comorbidities, adjustment of lifestyle and appropriate treatment of erectile dysfunction. The most frequent treatment of erectile disorder is by phosphodiesterase type 5 inhibitors.
Second-line of a therapy includes intracavernous or intraurethral prostaglandin suppository, use of vacuum constriction devices and psychotherapy. We recommend, in indicated cases, androgen supplementation in men with androgenous deficiency.
If resisted to the above therapy, as ultimum refugium is possible to consider a penile prothesis.