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Sildenafil for erectile dysfunction.

At any one time, around 10% of men are unable to achieve and/or maintain an erection sufficient for satisfactory sexual activity, a condition known as erectile dysfunction. Several mechanical, surgical and medical approaches have been developed for the treatment of this problem but none are ideal. Sildenafil (Viagra-Pfizer), a selective phosphodiesterase inhibitor, is the first licensed oral drug treatment for erectile dysfunction. It was marketed in the UK in October 1998, at which time the Department of Health was advising doctors that they "should not prescribe sildenafil" and that health authorities should not "support the provision of sildenafil at NHS expense to patients requiring treatment for erectile dysfunction, other than in exceptional circumstances". Here we review sildenafil for the management of erectile dysfunction and discuss whether it should be available on the NHS.