The document discusses various treatment options for erectile dysfunction, including oral phosphodiesterase type 5 inhibitors (PDE5Is), intracavernosal injections, penile prostheses, and lifestyle modifications. It provides guidelines and recommendations from sources such as the American Urological Association and European Association of Urology on when to initiate certain treatments, how to administer PDE5Is effectively, and the role of treatments after procedures like prostatectomy. The treatment algorithm highlights PDE5Is as first-line treatment but notes alternatives like intracavernosal injections or topical therapies for some patients.

3. •
•
•
•
•
•
•
•
•
•
2

4. Figure 27-10. Treatment algorithm for erectile dysfunction recommended
by the International Consultations on Sexual Medicine.
PDE5, phosphodiesterase type 5.
3

5. Hackett G et al. British Society for Sexual Medicine Guidelines on the Management of Erectile
Dysfunction in Men – 2017. J Sex Med 2018;15:430-57. 4

6. •
•
•
•
•
•
•
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
5

7. RECOMENDACIONES
7. Clinicians should counsel men with ED who have comorbidities known to negatively affect
erectile function that lifestyle modifications, including changes in diet and increased physical
activity, improve overall health and may improve erectile function. (Moderate
Evidence Level: Grade C)
Initiate lifestyle changes and risk factor modification prior to or at the same time as initiating
erectile dysfunction (ED) treatments. Strong
Arthur L. Burnett, MD; Ajay Nehra, MD; Rodney H. Breau, MD; Daniel J. Culkin, MD; Martha M. Faraday, PhD;
Lawrence S. Hakim, MD; Joel Heidelbaugh, MD; Mohit Khera, MD; Kevin T. McVary, MD; Martin M. Miner, MD;
Christian J. Nelson, PhD; Hossein Sadeghi-Nejad, MD; Allen D. Seftel, MD; Alan W. Shindel, MD. Erectile
Dysfunction: AUA Guideline (2018).
EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam
2020. ISBN 978-94-92671-07-3. 6

8. •
•
•
•
•
•
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
7

9. •
•
•
•
•
•
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
8

10. •
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
9

11. CLASE MEDICAMENTO ALTERNATIVA SUG.
ANTIHIPERTENSIV DIURETICO TIAZIDICOS
BETA BLOQUEADORES
NO SELECTIVOS
BLOQUEADOR DE CANAL
DE CALCIO
BETA BLOQUEADORES
ESPECIFICOS
ARA II
IECAS
PSICOTROPICO ANTISICOTICOS
ANTIDEPRESIVOS
ANSIOLITICOS
RECIENTES
(BUPROPION,
ANTIANDROGENO ANTIANDROGENOS
AGONISTAS DE LHRH
INHIBIDORES DE 5 A
REDUCTASA
OPIOIDES
ANTIRRETROVIRAL
S
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
10

12. •In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
11

13. Hackett G et al. British Society for Sexual Medicine Guidelines on the Management of Erectile
Dysfunction in Men – 2017. J Sex Med 2018;15:430-57. 12

14. •
•
•
•
• SE DETERMINA MEJOR EVALUANDO LA RESPUESTA CLÍNICA
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
13

15. •
•
•
•
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
14

16. •In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
15

17. •In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
16

18. TRATAMIENTOS FARMACOLÓGICOS
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
17

19. •In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
18

20. Pocket Guide to Urology, 5th Edition, Jeff A.Wieder, J. Wieder Medical,
2014
19

21. 20

22. 21

23. MARCA ABSORCION
VIAGRA ® x
CIALIS®
LEVITRA® x
STAXYNTM
STENDRATM
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
22

24. MARCA HORAS
VIAGRA ® 1
CIALIS® 2
LEVITRA® 1
STAXYNTM 1.5
STENDRATM .5-.75
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
23

25. MARCA HORAS
VIAGRA ® 4
CIALIS® 17.5
LEVITRA® 4-5
STAXYNTM 4-6
STENDRATM 5
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
24

26. MARCA HORAS
VIAGRA ® 6-8
CIALIS® 24-36
LEVITRA® 6-8
STAXYNTM 6-8
STENDRATM 6
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
25

27. MARCA
VIAGRA ®
CIALIS®
LEVITRA® SI
STAXYNTM SI
STENDRATM
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
26

28. MARCA
VIAGRA ® PRN
CIALIS® PRN O DIARIA
LEVITRA® PRN
STAXYNTM PRN
STENDRATM PRN
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
27

29. MARCA
VIAGRA ® ZUIT ® LAMINILLA
CIALIS®
LEVITRA®
STAXYNTM Se disuelve en la lengua
STENDRATM
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
28

30. MARCA ISOENZIMA
VIAGRA ® 6
CIALIS® 11
LEVITRA® 6
STAXYNTM 6
STENDRATM
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
29

31. •
•
•
•
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
30

32. Hackett G et al. British Society for Sexual Medicine Guidelines on the Management of Erectile
Dysfunction in Men – 2017. J Sex Med 2018;15:430-57.
31

33. RECOMENDACIONES AUA
9. When men are prescribed an oral PDE5i for the treatment of ED, instructions should be
provided to maximize benefit/efficacy. (Strong Recommendation; Evidence Level: Grade C)
10. For men who are prescribed PDE5i, the dose should be titrated to provide optimal efficacy.
Arthur L. Burnett, MD; Ajay Nehra, MD; Rodney H. Breau, MD; Daniel J. Culkin, MD; Martha M. Faraday, PhD; Lawrence S. Hakim, MD; Joel
Heidelbaugh, MD; Mohit Khera, MD; Kevin T. McVary, MD; Martin M. Miner, MD; Christian J. Nelson, PhD; Hossein Sadeghi-Nejad, MD; Allen D.
Seftel,
MD; Alan W. Shindel, MD. Erectile Dysfunction: AUA Guideline (2018).
32

34. RECOMENDACIONES
Use PDE5Is as first-line therapeutic option. Strong
Use topical/intraurethral alprostadil as an alternative first-line therapy in well-
informed patients who do not wish or are not suitable for oral vasoactive
therapy. Use topical/ intraurethral alprostadil as an alternative therapy to
intracavernous injections in patients who prefer a less-invasive therapy.
Weak
EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam 2020.
ISBN 978-94-92671-07-3.
33

35. 11. Men who desire preservation of erectile function after treatment for prostate cancer by
radical prostatectomy (RP) or radiotherapy (RT) should be informed that early use of PDE5i
post-treatment may not improve spontaneous, unassisted erectile function. (Moderate
Recommendation; Evidence Level: Grade C)
Arthur L. Burnett, MD; Ajay Nehra, MD; Rodney H. Breau, MD; Daniel J. Culkin, MD; Martha M. Faraday, PhD; Lawrence S. Hakim, MD; Joel
Heidelbaugh, MD; Mohit Khera, MD; Kevin T. McVary, MD; Martin M. Miner, MD; Christian J. Nelson, PhD; Hossein Sadeghi-Nejad, MD; Allen D.
Seftel,
MD; Alan W. Shindel, MD. Erectile Dysfunction: AUA Guideline (2018).
34

36. 35

37. Pocket Guide to Urology, 5th Edition, Jeff A.Wieder, J. Wieder Medical,
2014
36

38. •
•
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
37

39. •
•
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
38

40. •
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
39

41. Pocket Guide to Urology, 5th Edition, Jeff A.Wieder, J. Wieder Medical,
2014
40

42. •
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
41

43. •
•
•
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
42

44. •
•
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
43

45. •
•
•
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
44

46. •
•
•
•
•
•
•
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
45

47. Arthur L. Burnett, MD; Ajay Nehra, MD; Rodney H. Breau, MD; Daniel J. Culkin, MD; Martha M. Faraday, PhD; Lawrence S. Hakim, MD; Joel
Heidelbaugh, MD; Mohit Khera, MD; Kevin T. McVary, MD; Martin M. Miner, MD; Christian J. Nelson, PhD; Hossein Sadeghi-Nejad, MD; Allen D.
Seftel,
MD; Alan W. Shindel, MD. Erectile Dysfunction: AUA Guideline (2018).
46

48. Hackett G et al. British Society for Sexual Medicine Guidelines on the Management of Erectile
Dysfunction in Men – 2017. J Sex Med 2018;15:430-57.
47

49. •
•
•
•
48

50. •
•
•
•
•
49

51. •
•
•
•
•
•
•
•
•In Wein, A. J., In Kavoussi, L. R., Campbell, M.
F., & Walsh, P. C. (2016). Campbell-Walsh
urology.
50

52. •
•
•
•
•
•
•
•
51

53. 52

54. Pocket Guide to Urology, 5th Edition, Jeff A.Wieder, J. Wieder Medical,
2014
53

55. 54
In Wein, A. J., In Kavoussi, L. R., Campbell, M. F., &
Walsh, P. C. (2016). Campbell-Walsh urology.

56. 55
In Wein, A. J., In Kavoussi, L. R., Campbell, M. F., &
Walsh, P. C. (2016). Campbell-Walsh urology.

57. • VENTAJAS
• INCIDENCIA DISMINUIDA
• ERECCIÓN PROLONGADA
• EFECTOS ADVERSOS SISTÉMICOS
• FIBROSIS PENIANA.
• DESVENTAJA
• MAYOR INCIDENCIA DE ERECCIÓN DOLOROSA
• MAYOR COSTO
• UNA VEZ RECONSTITUIDO EN LÍQUIDO SE ACORTA SU VIDA MEDIA SI
NO SE O MANTIENE REFRIGERADO.
56
In Wein, A. J., In Kavoussi, L. R., Campbell, M. F., &
Walsh, P. C. (2016). Campbell-Walsh urology.

58. PAPAVERINA
Bimix
• Papaverine
• Phentolamine
Trimix
• Papaverine
• Phentolamine
• Alprostadil
57

59. •
•
•
•
•
•
•
•
58

60. •
•
•
•
•
•
59

61. Hackett G et al. British Society for Sexual Medicine Guidelines on the Management of Erectile
Dysfunction in Men – 2017. J Sex Med 2018;15:430-57. 60

62. RECOMENDACIONES
Use intracavernous injections as an alternative first-line
therapy in wellinformed patients or as second-line therapy.
Strong
EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam 2020.
ISBN 978-94-92671-07-3.
61

63. 62

64. Figure 27-10. Treatment algorithm for erectile dysfunction recommended
by the International Consultations on Sexual Medicine.
PDE5, phosphodiesterase type 5.
63

65. •
•
•
•
•
•
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
64

66. •
•
•
•
•
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
65

67. •
•
•
•
•
•
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
66

68. •
•
•
•
•
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
67

69. •
•
•
•
•
•
•
•
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
68

70. •
〈 8.5 HABOUS M
ET AL BJUI 2017
69

71. • KEY TO SUCCESS
• IMPROVE
•
•
• NOT IMPROVE
•
•
•
•
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
70

72. •
•
•
•
•
•
•
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
71

73. 72

74. 73

75. CIRUGÍA PROTÉSICA PENIANA
74

76. •
•
•
•
•
•
•
•
•
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
75

77. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
76

78. PENOESCROTAL
77

79. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
78

80. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
79

81. 4
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
80

82. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
81

83. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
82

84. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
83

85. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
84

86. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
85

87. Corporotomy
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
86

88. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
87

89. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
88

90. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
89

91. Reservoir placement: retropubic space
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
90

92. Ectopic (aka intraabdominal wall or high submuscular)
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
91

93. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
92

94. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
93

95. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
94

96. Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
95

97. •
•
•
•
•
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
96

98. INFRAPUBIC
97

99. •
•
•
•
•
•
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
98

100. •
•
•
•
•
•
Gupta, N. K., Ring, J., Trost, L., Wilson, S. K., & Köhler, T. S. (2017). The penoscrotal surgical
approach for inflatable penile prosthesis placement. Translational Andrology and Urology, 6(4),
628–638. https://doi.org/10.21037/tau.2017.07.32
99

101. Arthur L. Burnett, MD; Ajay Nehra, MD; Rodney H. Breau, MD; Daniel J. Culkin, MD; Martha M. Faraday, PhD;
Lawrence S. Hakim, MD; Joel Heidelbaugh, MD; Mohit Khera, MD; Kevin T. McVary, MD; Martin M. Miner, MD;
Christian J. Nelson, PhD; Hossein Sadeghi-Nejad, MD; Allen D. Seftel, MD; Alan W. Shindel, MD. Erectile
Dysfunction: AUA Guideline (2018).
100

102. INSERTION OF PENIL PROTHESES (IMPLANTS) FOR ERECTIL DYSFUCTION, BAUS, JUNE 2017, Leaflet No:
16/082 , http://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Penile prostheses.pdf
101

103. INSERTION OF PENIL PROTHESES (IMPLANTS) FOR ERECTIL DYSFUCTION, BAUS, JUNE 2017, Leaflet No:
16/082 , http://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Penile prostheses.pdf 102

104. •
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103

105. •
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104

106. RECOMENDACIONES
20. Penile prosthetic surgery should not be performed in the presence of systemic, cutaneous,
or urinary tract infection. (Clinical Principle)
Use implantation of a penile prosthesis if other treatments fail or based upon patient
Strong
Arthur L. Burnett, MD; Ajay Nehra, MD; Rodney H. Breau, MD; Daniel J. Culkin, MD; Martha M. Faraday, PhD;
Lawrence S. Hakim, MD; Joel Heidelbaugh, MD; Mohit Khera, MD; Kevin T. McVary, MD; Martin M. Miner, MD;
Christian J. Nelson, PhD; Hossein Sadeghi-Nejad, MD; Allen D. Seftel, MD; Alan W. Shindel, MD. Erectile
Dysfunction: AUA Guideline (2018).
EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam
2020. ISBN 978-94-92671-07-3.
105

107. Trost LW, Munarriz R, Wang R, Morey A, Levine L. External Mechanical Devices and Vascular
Surgery for Erectile Dysfunction. J Sex Med. 2016;13(11):1579-1617.
doi:10.1016/j.jsxm.2016.09.008
106

108. •
•
•
•
•
Trost, L. W., Munarriz, R., Wang, R., Morey, A., & Levine, L. (2016). External
Mechanical Devices and Vascular Surgery for Erectile Dysfunction. The Journal of
Sexual Medicine, 13(11), 1579–1617. https://doi.org/10.1016/j.jsxm.2016.09.008
107

109. •
•
•
•
•
Trost, L. W., Munarriz, R., Wang, R., Morey, A., & Levine, L. (2016). External
Mechanical Devices and Vascular Surgery for Erectile Dysfunction. The Journal of
Sexual Medicine, 13(11), 1579–1617. https://doi.org/10.1016/j.jsxm.2016.09.008
108

110. RECOMENDACIONES
21. For young men with ED and focal pelvic/penile arterial occlusion and without documented
generalized vascular disease or veno-occlusive dysfunction, penile arterial reconstruction may
be considered.
(Conditional Recommendation; Evidence Level: Grade C)
22. For men with ED, penile venous surgery is not recommended.
(Moderate Recommendation; Evidence Level: Grade C)
Arthur L. Burnett, MD; Ajay Nehra, MD; Rodney H. Breau, MD; Daniel J. Culkin, MD; Martha M. Faraday, PhD;
Lawrence S. Hakim, MD; Joel Heidelbaugh, MD; Mohit Khera, MD; Kevin T. McVary, MD; Martin M. Miner, MD;
Christian J. Nelson, PhD; Hossein Sadeghi-Nejad, MD; Allen D. Seftel, MD; Alan W. Shindel, MD. Erectile
Dysfunction: AUA Guideline (2018).
EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam
2020. ISBN 978-94-92671-07-3.
109

111. • Although early proposed mechanisms suggested
that tumescence was achieved by passive
retrograde venous flow, more recent data have
indicated:
• penile oxygen saturations reached 79.2%
immediately after VED placement
• 58% arterial
• 42% venous
Trost, L. W., Munarriz, R., Wang, R., Morey, A., & Levine, L. (2016). External
Mechanical Devices and Vascular Surgery for Erectile Dysfunction. The Journal of
Sexual Medicine, 13(11), 1579–1617. https://doi.org/10.1016/j.jsxm.2016.09.008
110

112. •
•
•
Trost, L. W., Munarriz, R., Wang, R., Morey, A., & Levine, L. (2016). External
Mechanical Devices and Vascular Surgery for Erectile Dysfunction. The Journal of
Sexual Medicine, 13(11), 1579–1617. https://doi.org/10.1016/j.jsxm.2016.09.008
111

113. Hackett G et al. British Society for Sexual Medicine Guidelines on the Management of Erectile
Dysfunction in Men – 2017. J Sex Med 2018;15:430-57.
112

114. RECOMENDACIONES
Use vacuum erection devices as a first-line therapy in well-informed patients with infrequent
sexual intercourse and comorbidities requiring non-invasive, drugfree management of ED.
Weak
The vacuum erection device (VED) is effective in creating an erection satisfactory for
intercourse, even in difficult-to-treat populations such as DM, spinal cord injury, and after
radical proctectomy
(RP; LOE . 2; strength of recommendation . B; recommended).
EAU Guidelines. Edn. presented at the EAU Annual Congress
Amsterdam 2020. ISBN 978-94-92671-07-3.
113

115. •
SWT
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• NO
114
LI-
ESWT

116. •
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Yang, H., & Seftel, A. D. (2019). Controversies in low intensity extracorporeal shockwave
therapy for erectile dysfunction. International Journal of Impotence Research, 31(3), 239–242.
https://doi.org/10.1038/s41443-019-0124-0
115

117. •
•
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•
•
•
•
Yang, H., & Seftel, A. D. (2019). Controversies in low intensity extracorporeal shockwave
therapy for erectile dysfunction. International Journal of Impotence Research, 31(3), 239–242.
https://doi.org/10.1038/s41443-019-0124-0
116

118. •
• ONLY VASCULOGENIC
Yang, H., & Seftel, A. D. (2019). Controversies in low intensity extracorporeal shockwave
therapy for erectile dysfunction. International Journal of Impotence Research, 31(3), 239–242.
https://doi.org/10.1038/s41443-019-0124-0
117

119. RECOMENDACIONES
For men with ED, low-intensity extracorporeal shock wave therapy (ESWT) should be
considered investigational.
(Conditional Recommendation; Evidence Level: Grade C)
Arthur L. Burnett, MD; Ajay Nehra, MD; Rodney H. Breau, MD; Daniel J. Culkin, MD; Martha M. Faraday, PhD;
Lawrence S. Hakim, MD; Joel Heidelbaugh, MD; Mohit Khera, MD; Kevin T. McVary, MD; Martin M. Miner, MD;
Christian J. Nelson, PhD; Hossein Sadeghi-Nejad, MD; Allen D. Seftel, MD; Alan W. Shindel, MD. Erectile
Dysfunction: AUA Guideline (2018).
118

120. •
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•
HTTPS://DOI.ORG/10.1016/J.JSXM.2016.09.008
•
•
HTTPS://DOI.ORG/10.1016/J.JSXM.2016.09.008
•
HTTPS://DOI.ORG/10.21037/TAU.2017.07.32
•
• JEFF A.WIEDER
•
119

121. 120

122. 121

123. Philippou YA, Jung J, Steggall MJ, O'Driscoll ST, Bakker CJ, Bodie JA, Dahm P. Penile rehabilitation for
postprostatectomy erectile dysfunction. Cochrane Database of Systematic Reviews 2018, Issue 10. Art.
No.: CD012414. DOI: 10.1002/14651858.CD012414.pub2
122