Treatment of erectile dysfunction following spinal cord injury.

Spinal cord injury (SCI) has a significant impact on erectile dysfunction. Treatment modalities for individuals with SCI are similar to treatments for those without SCI. Some of the most common methods of management include penile implants, oral phosphodiesterase (PDE) inhibitors, vacuum devices, intraurethral prostaglandins, and intracavernous injections. In addition to the advantages and disadvantages of these various modalities for able-bodied men, there are special considerations for men with SCI. Penile implants may help to keep an external condom catheter in place and provide more penile stability for intermittent catheterization. However, they have an increased risk of infection. Semirigid rods have an increased risk of erosion. Although convenient to use, PDE inhibitors are usually not effective in lower motor injuries. The hypotensive effects of intraurethral prostaglandins and PDE inhibitors need to be considered in SCI men with injuries at or above T6. Intracavernous injections are very effective; however, men with SCI require much lower doses than able-bodied men.