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22. erecti$.tw.23. 21 or 2224. CLINICAL TRIAL.pt.25. exp CLINICAL TRIALS/26. (clin$ adj25 trial$).ti,ab.27. ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).ti,ab.28. PLACEBO.sh.29. placebo$.ti,ab.30. random$.ti,ab.31. versus.tw.32. METHODOLOGY.sh.33. or/24-3234. 23 and 3335. limit 34 to yr="1990 - 2008"36. limit 35 to female37. limit 35 to male38. 35 not (36 not 37)39. 20 not 38OVID MEDLINE – Intervention questions1. Impotence/2. erecti$.tw.3. 1 or 24. RANDOMIZED CONTROLLED TRIAL.pt.5. CONTROLLED CLINICAL TRIAL.pt.6. RANDOMIZED CONTROLLED TRIALS.sh.7. RANDOM ALLOCATION.sh.8. DOUBLE BLIND METHOD.sh.9. SINGLE-BLIND METHOD.sh.10. or/4-911. (ANIMALS not HUMAN).sh.12. 10 not 1113. CLINICAL TRIAL.pt.14. exp CLINICAL TRIALS/15. (clin$ adj25 trial$).ti,ab.16. ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).ti,ab.17. PLACEBOS.sh.18. placebo$.ti,ab.19. random$.ti,ab.20. versus.tw.21. RESEARCH DESIGN.sh.22. or/13-2123. 22 not 1124. 23 not 1225. 12 or 2426. 3 and 25A-3
27. limit 26 to yr="1990 - 2008"28. limit 27 to female29. limit 27 to male30. 27 not (28 not 29)31. limit 30 to english languageOVID MEDLINE – Intervention questions, Injectable medications1. Injections/2. inject$.tw.3. 1 or 24. Penis/5. (peni$ or intercav$).tw.6. or/4-57. 3 and 68. Papaverine/9. Phentolamine/10. Phenoxybenzamine/11. Alprostadil/12. Moxisylyte/13. (papaverine or prostaglandin E1 or PgE1 or phentolamine or phenoxybenzamine oralprostadil or moxisylyte or thymoxamine or Opilon or Icavex or Trimix).tw.14. or/8-1315. 3 and 1416. or/7,1517. Impotence/18. erectile dysfunction.tw.19. or/17-1820. 16 and 1921. limit 20 to (yr="1990 - 2008" and male and english language)22. limit 21 to (case reports or comment or editorial)23. 21 not 22OVID EMBASE – Intervention questions1. Erectile Dysfunction/2. erecti$.tw.3. 1 or 24. CLINICAL TRIAL.pt.5. exp CLINICAL TRIALS/6. (clin$ adj25 trial$).ti,ab.7. ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).ti,ab.8. PLACEBO.sh.9. placebo$.ti,ab.10. random$.ti,ab.11. versus.tw.12. METHODOLOGY.sh.13. or/4-12A-4
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This report is based on research co
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This document is in the public doma
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AcknowledgmentsThe authors would li
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ContentsExecutive Summary..........
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Table 17: Intra-urethral Treatment:
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Figure 63. Absolute Mean Change Fro
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associated with ED treatments. Two
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ED as a main complaint. In only one
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different formulations/modes of app
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Evidence Report
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flaccidity are no less important th
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prostatectomy, antipsychotic agents
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disease). Furthermore, there is ins
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Analytic FrameworkFigure 1. Analyti
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KQ 3. Harms of pharmaceutical treat
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Figure 2. Modified QUOROM Flow Char
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that included intervention characte
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Prevalence of Hypogonadism (Total S
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stimulation and a challenge test wi
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Overview of Trials79-84,86-88,90,91
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131,137,138,142,143,147,151,155,156
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pectoris occurred in a participant
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statistical test results for the ob
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individual Q1-Q15 items, 104,106,15
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Proportion of participants with hea
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erectile maintenance frequency, IIE
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Oral Treatments — Phosphodiestera
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Patients were instructed to take th
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Results obtained from two trials 19
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improved erections was higher in pa
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Clinically homogenous groups of pat
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Oral Treatments — Phosphodiestera
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The approximate proportion of smoke
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value was not reported). Even thoug
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Tadalafil (20 mg) versus tadalafil
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scheduled dosing regimen (90 percen
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Proportion of patients with improve
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Sublingual Treatments - Apomorphine
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been taking over the past two or fo
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apomorphine (5 and 6 mg: 38 and 49
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heterogeneity with respect to popul
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Finally, two studies reported on wh
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the second study, prolonged erectio
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Moxisylate versus placebo. One tria
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Quantitative SynthesisThere was a l
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erection” versus one placebo trea
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methods of allocation concealment.
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Prazosin (IU) versus placebo. One t
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reported adequate allocation concea
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Hormonal Treatments Literature Sear
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Harms. In the first trial, the diff
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sex with partner (scale 1-6, with =
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daily for 4 weeks followed by concu
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(MEDQoL) score (range 0-100) compar
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group (16.7, 12.5, and 8.3 percent,
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Question 3a. What Are the harms of
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Chapter 4. DiscussionThis evidence
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Question 1: What is the Clinical Ut
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Questions 2-3: What are the Benefit
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Harms. There were no obvious differ
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alone. Compared with trimix alone,
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PhentolamineEfficacy. The results i
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Question 2a-b: Do Specific Patient
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Methodological and Logistic Limitat
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Tables and Figures.Summary TablesTa
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123Study details 1 Study Design Set
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125Table 2: Prevalence of Hypogonad
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127Study Details 2 Study Design Set
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129Table 4: Prevalence of Hypogonad
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131Study Details 5 Study Design Set
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Table 7: Prevalence of Hyperprolact
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135StudyEDDetails 8 Study Design Se
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Table 10: Serious Adverse Events in
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Table 11: Efficacy Results of Tadal
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Treatment Control Relative RiskStud
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Treatment Control Relative RiskStud
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Table 14: Intracavernosal Injection
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StudyAdverse EventsTreatmentGroup%
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StudyAdverse EventsTreatment Contro
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Study / Typeof PatientsOutcome Defi
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Study ED Etiology OutcomeWilliams*1
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Physiologic:60.0 (18/30) 90.0 (27/3
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StudyAdverse EventTreatmentGroup% (
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TreatmentStudy ED Etiology Group% (
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StudyAdverse EventCavallini 1991 Pa
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Study/patient CharacteristicsGooma
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Aversa 2003Men witharteriogenicEDYa
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Study/patientCharacteristicsClopper
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Study/patientCharacteristicsOutcome
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Table 26: Testosterone Treatment: P
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McNicholas2002Patients reporting
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175Table 27: Miscellaneous Treatmen
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177Table 28: Nonarteritic Anterior
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Table 29: Penile Fibrosis in Studie
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Page 213 and 214: Figure 6. Improved erection (GEQ-Q1
Page 215 and 216: Figure 11. Visual disturbances (all
Page 217 and 218: Figure 16. Any adverse events (trea
Page 219 and 220: Figure 23. The mean IIEF-Q4 score:
Page 221 and 222: Figure 30. Improved erection (GEQ-Q
Page 223 and 224: Figure 37. Visual disturbances (all
Page 225 and 226: Figure 43. IIEF-EF ≥ 26 at follow
Page 227 and 228: Figure 49. Dyspepsia (all cause)Fig
Page 229 and 230: Figure 55. Serious adverse events (
Page 231 and 232: Figure 61. Mean per-patient percent
Page 233 and 234: Figure 67. Any adverse events (all-
Page 235 and 236: Figure 73. Any adverse events (all-
Page 237 and 238: in men with erectile dysfunction. J
Page 239 and 240: parameters in obese men with erecti
Page 241 and 242: comparative crossover study. Androl
Page 243 and 244: 153. Shabsigh R. Efficacy of silden
Page 245 and 246: 190.191.Stief C, Porst H, Saenz dT,
Page 247 and 248: treatment of men with erectile dysf
Page 249 and 250: randomized trial. J Urol 1997 Oct;1
Page 251 and 252: moderate and severe ED. Int J Impot
Page 253 and 254: 349.350.351.randomized, placebo-con
Page 255 and 256: 395. Moher D, Schulz KF, Altman DG.
Page 257 and 258: PSVRCTRIRIASBPSCSDSETTGTRTWMDpeak s
Page 259 and 260: dDegDept.Ff/uFHxhrHxIGMmaxminmoNANI
Page 261: 30. or/24-2931. (ANIMALS not HUMAN)
Page 265 and 266: 5. exp clinical trials/6. random$.m
Page 267 and 268: 20. or/17-1921. 16 and 2022. limit
Page 269 and 270: A systematic review of harms associ
Page 271: B-4Summary Table- Randomized Contro
Page 274 and 275: The Quality Assessment of Studies o
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C-20 AuthorFundingN; study design;
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C-146 C5-Intracavernousal Injection
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C-202 C8-Topical Treatments of ED A
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C-216 C9-Testosterone Treatment of
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men with erectile dysfunction and s
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symptoms associated with benign pro
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(84) Zinner N. Do food and dose tim
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(117) Carrier S, Brock GB, Pommervi
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(150) Hagemann JH, Berding G, Bergh
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(183) Moriel EZ, Rajfer J. Sodium b
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(219) Gomaa A, Shalaby M, Osman M e
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(255)(256)dysfunction. Psychopharma
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Adams Henry E, Motsinger Patrice, M
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Althof S E, Turner L A, Levine S B
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Anonymous. Surgery & watchful waiti
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Baker Christine D. A cognitive-beha
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Bayes M, Rabasseda X, Prous J R. Ga
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Bhatnagar V, Stewart S T, Huynh V e
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Boswell-Smith V, Spina D, Page C P.
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Burke J P, Jacobson D J, McGree M E
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Carson C C. Combination of phosphod
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Chen Y. Acupuncture treatment of fu
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Cooke B M, Breedlove S M, Jordan C
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Daitch J A, Angermeier K W, Lakin M
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Derouet H, Jost W H, Osterhage J et
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Doust J, Miller E, Duchesne G et al
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Elhilali M M. Alfuzosin: An a1-rece
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Ferri C, Giuggioli D, Cazzato M et
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Frucht S J. Parkinson disease: An u
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Ghofrani H A, Pepke-Zaba J, Barbera
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Baldwin D S. Sexual dysfunction ass
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Douglass M A, Lin J C. Update on th
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Hatch J P. Psychophysiological aspe
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Lau D H, Mumtaz F H, Thompson C S e
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Morales A, Heaton J P. Hormonal ere
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Roehrborn C G, McNicholas T. The Ma
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Uckert S, Stief C G, Jonas U. Curre
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Leungwattanakij S, Flynn V, Hellstr
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Musacchio Najah S, Hartrich Molly,
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Akkus E, Kadioglu A, Esen A et al.
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Ashok S, Sigman M. Bioavailable tes
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Briganti A, Salonia A, Gallina A et
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Chinegwundoh F, Anie K A. Treatment
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Dundar S O. Visual loss associated
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Giammusso B, Gattuso U, Vanaclocha
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Hawton Keith, Catalan Jose, Fagg Jo
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Kell P. Cardiovascular safety of si
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Laumann Edward O, West Suzanne, Gla
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Matthew A G, Goldman A, Trachtenber
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Mulhall J P. Deciphering erectile d
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Parsons J K, Marschke P, Maples P e
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Rojewski M T, Korper S, Schrezenmei
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Shabsigh R. Testosterone therapy in
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Tam S W, Worcel M, Wyllie M. Yohimb
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Webb D J, Freestone S, Allen M J et
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Katlowitz N M, Albano G J, Morales
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Sparwasser C, Treiber U, Bahren W e
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van Basten J P, Van Driel M F, Jonk
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Youssef A F, Fort F L, Ronsen B et
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Cooper A J. Evaluation of I-C papav
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Isidori A M, Giannetta E, Gianfrill
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Armstrong D K, Convery A, Dinsmore
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Buvat J, Montorsi F. Safety and tol
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De Rose A F, Giglio M, Traverso P e
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Gana T E, Quizanos L F, Castell R e
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Hatzichristou D G, Apostolidis A, T
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Kim E D, McVary K T. Topical prosta
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Lundberg L, Olsson J-O, Kihl B. Lon
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Moncada I, Jara J, Subira D et al.
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Ohebshalom M, Parker M, Guhring P e
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Rajpurkar A, Dhabuwala C B. Compari
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Shabsigh R. Hypogonadism and erecti
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Terradas C, Levalle O, Nagelberg A
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Yenicerioglu Y, Kefi A, Aslan G et
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Anonymous. New erectile dysfunction
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Bolona E R, Uraga M V, Haddad R M e
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Chen J, Greenstein A, Kaver I et al
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Derby C A, Barbour M M, Hume A L et
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Foulks C J, Cushner H M. Sexual dys
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Hamed S, Mohamed K, El-taher A et a
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Jeong S-J, Park K, Moon J-D et al.
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La Pera G, Franco Giannotti C, Tagg
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Mann R D. Introduction - Tadalafil.
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Montorsi F, Burnett A L. Erectile d
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Ozdel O, Oguzhanoglu A, Oguzhanoglu
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Ramasubbu Rajamannar. Switching to
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Schwartz E J, Wong P, Graydon R J.
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Stolk E A, Busschbach J J, Caffa M
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Vitezic D. A risk-benefit assessmen
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Bancroft J, Smith G, Munoz M et al.
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Knispel H H, Huland H. Influence of
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Padma-Nathan H, Eardley I, Kloner R
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Bai W J, Zhu J C, Jiang H et al. [A
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Carosa E, Martini P, Brandetti F et
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Doggrell S A. Comparison of clinica
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Gingell C, Buvat J, Jardin A et al.
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Heaton J P, Morales A, Adams M A et
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Kloner R A, Mitchell M, Emmick J T.
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Marks L S, Duda C, Dorey F J et al.
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Montorsi F, Guazzoni G, Bergamaschi
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Padma-Nathan H, Goldstein I, Klimbe
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Reznik I, Zemishlany Z, Kotler M et
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Shamloul Rany, Kamel Ihab, E-Mail A
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Tsujimura A, Yamanaka M, Takahashi
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Zippe C D, Kedia A W, Kedia K et al
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Anonymous. Diagnostic and therapeut
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Briganti A, Chun F K H, Salonia A e
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Clough J. CNS-targeted sexual dysfu
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Emilien G. Alprox-TD NexMed Inc. Cu
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Gryglewska B, Grodzicki T. Betaxolo
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Kadioglu A, Erdogru T, Tellaloglu S
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Mealy N E. GPI-1485. Drugs of the F
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O'Sullivan J D. Apomorphine as an a
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Riley Alan. Oral treatments for ere
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Silvestri A, Galetta P, Cerquetani
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Unnikrishnan A G, Rajaratnam S, Ses
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Zhao L. Clinical observation on the
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The UO-EPC gratefully acknowledges
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AuthorYearHellstrom 2005 37 Jadad Q
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AuthorYearJadad Q-1 Jadad Q-2 Jadad
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AuthorTotal AllocationJadad Q-1 Jad
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AuthorYearSaylan 2006 265 Jadad Q-1
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F-10STUDY IDQ1:SpectrumQ2.Selection
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Figure G-2. Sildenafil (any dose) v
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Figure G-8. Sildenafil (25 mg) vs.
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Figure G-10. Vardenafil (any dose)
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Tadalfil20 mg vs. PlaceboFigure G-1
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Figure G-14. Tadalafil (20 mg) vs.
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Figure G-16. Tadalafil (20mg) vs. T
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5 = Eleven+ attempts Q7: When you a
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The IIEF-5 score is the sum of ques
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El Malik EMA. Erectile dysfunction:
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