ED is very common in diabetic men - between a third and a half develop the problem during their lifetime. Common reasons include impaired blood supply to the penis, neurological damage, hormonal imbalance (in particular testosterone deficiency), damage to the penile smooth muscle or the use of drugs (eg anti-hypertensive agents) which can precipitate the condition in susceptible individuals. The precise aetiology can often be difficult to fathom out and is usally multi-factorial.
Patients who do not respond to PDE5 inhibitors, have side effects or cannot take it (eg concomitatnt nitrate use)are best referred to the specialist diabetes ED service provided by Dr Mike Cummings (Consultant) and Sarah Moutter (Diabetes ED nurse specialist).
Patients will be re-assessed and consideration given to further therapies which include:
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MUSE - a medicated urethral pellet of prostaglandin E1
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Intra-cavernosal (penile) injections of prostaglandin E1
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Vacuum devices for tumescence
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Testosterone therapy or treatment of any other endocrine abnormality eg hyperprolactinaemia
