|
Daily Medical Update
Erectile dysfunction
Thursday, July 16, 2026
|
🔬 Practice-Changing Findings
Evidence from RCTs and meta-analyses published in the
last 12 months.
|
The journal of sexual medicine (2026) - Systematic Review
Key Findings
- Across 83 studies with 6029 participants, sildenafil 100 mg had the largest erectile-function benefit versus placebo, with OR 9.06.
- Treatment-related adverse events were highest with vardenafil and lowest with tadalafil versus placebo, although some estimates had wide confidence intervals.
📋 Practice Implication: When choosing on-demand PDE5 therapy, dose-specific efficacy and tolerability data support individualized selection rather than treating the class as interchangeable.
|
The journal of sexual medicine (2026) - Systematic Review
Key Findings
- Five studies including 428 myocardial infarction survivors found a pooled de novo ED incidence of 64.4% after first MI.
- Most new ED cases appeared within 6 months after MI, and sexual activity and intercourse frequency declined versus pre-MI levels.
📋 Practice Implication: Post-MI follow-up and cardiac rehabilitation should include proactive sexual-function assessment and counseling because ED commonly emerges early in recovery.
|
Sexual medicine reviews (2026) - Meta-Analysis
Key Findings
- Eleven studies with 1254 men with LUTS/BPH found a pooled ED prevalence of 79.53%, with country-level estimates ranging from 60.0% to 98.7%.
- ED prevalence was higher in low- and middle-income settings at 78.7% versus 70.9% in high-income settings, with overlapping confidence intervals.
📋 Practice Implication: Men presenting with LUTS/BPH warrant routine sexual-health screening, particularly when age, symptom burden, or cardiometabolic comorbidity raises baseline risk.
|
Andrology (2025) - Systematic Review
Key Findings
- Topical alprostadil improved IIEF scores by 4.7 points versus placebo, with a 95% CI of 2.4 to 7.1.
- Intraurethral alprostadil significantly improved ED versus placebo, and reported adverse events were mainly penile pain and erythema without serious events.
📋 Practice Implication: Topical or intraurethral alprostadil is a reasonable non-oral option for patients who cannot use or do not respond adequately to PDE5 inhibitors.
|
Sexual medicine reviews (2026) - Systematic Review
Key Findings
- Among 31 RCTs with 1874 participants, electrical stimulation plus exercise improved IIEF-5 versus sham/placebo by MD 6.81 and ranked highest by SUCRA 98.1%.
- Electrical stimulation alone improved IIEF-5 versus sham/placebo by MD 2.86, while Li-ESWT showed a smaller benefit with MD 0.65.
📋 Practice Implication: For patients seeking non-pharmacologic adjuncts, exercise paired with electrical stimulation has stronger comparative support than shockwave therapy alone.
|
|
💡
Summary
Recent erectile dysfunction evidence is dominated by systematic reviews and network meta-analyses that refine treatment selection across PDE5 inhibitors, topical or intraurethral alprostadil, and non-pharmacologic options. The most clinically useful findings also emphasize routine ED screening in high-risk groups, especially men with LUTS/BPH and survivors of a first myocardial infarction.
|
|