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Erectile dysfunction in men with diabetes (literature review). Part 2

The second part of review article highlights modern views on the diagnosis and treatment of erectile dysfunction (ED) in men with diabetes mellitus (DM). Google Scholar and PubMed databases were used to search for literature sources. The role of comorbid diseases in the development of ED in men with diabetes mellitus has been shown. The generalized data on the main clinical manifestations of erectile dysfunction, methods of its diagnosis and treatment are given. A number of epidemiological studies over the past 20 years have found that erectile dysfunction in men with diabetes may be an early marker of cardiovascular complications. Thus, in the algorithm for the diagnosis of ED in patients with diabetes it is necessary to conduct a thorough examination of the cardiovascular system. The article describes modern therapeutic and surgical methods of ED treatment. Numerous literature sources indicate an important role of the correction of androgen deficiency in men with type 2 diabetes to enhance the effectiveness of phosphodiesterase type 5 (PDE5) inhibitors. The literature review shows the data on the emergence of new PDE5 inhibitors, which have a higher selectivity compared to existing ones that provides a better therapeutic effect and reduces the frequency and severity of side effects. The modern algorithm for the treatment of ED in men involves the sequential stages of using different treatments. The last link of therapy, in case of inefficiency of the previous ones, is penile prosthesis. Implantation of three-piece penile prosthesis is an effective method of ED treatment. The use of this method in patients with severe forms of ED on the background of diabetes, in case of ineffectiveness of PDE5 inhibitors and intracavernous injections of vasoactive drugs, is considered promising.