Oral drug therapy with yohimbine: outcomes were assessed using 2 to 4 treatment groups (297 to 445 patients).
Oral drug therapy with placebo: 3 treatment groups (N=110).
Vacuum devices: 7 to 22 treatment groups (218 to 2,481 patients).
Vasoactive drug injection therapy with papaverine monotherapy: 1 to 10 treatment groups (20 to 997 patients).
Vasoactive drug injection therapy with papaverine-phentolamine dual therapy: 1 to 19 treatment groups (172 to 2,084 patients).
Vasoactive drug injection therapy with PGE1: return to intercourse was assessed using 1 to 14 treatment groups (10 to 1,191 patients).
Vasoactive drug injection therapy with papaverine-phentolamine-PGE1 triple therapy: 1 to 3 treatment groups (146 to 490 patients).
Prostheses: semirigid type, 2 to 6 treatment groups (43 to 695 patients); mechanical (non-hydraulic) type, 1 to 2 treatment groups (16 to 89 patients); hydraulic type, 1 to 12 treatment groups (12 to 1,051 patients); multicomponent hydraulic type, 3 to 36 treatment groups (478 to 5,133 patients).
Venous surgery: 1 to 43 treatment groups (72 to 1,801 patients).
Arterial surgery: 1 to 19 treatment groups (11 to 713 patients).
Results indicated the following 3 acceptable treatment alternatives for the standard patient.
1. Vacuum constriction devices: return to intercourse, median 0.757 (95% CI: 0.668, 0.828); patient satisfaction, median 0.763 (95% CI: 0.686, 0.826); partner satisfaction, median 0.742 (95% CI: 0.582, 0.867); drop-outs, median 0.253 (95% CI: 0.218, 0.291); local adverse events, median 0.095 (95% CI: 0.054, 0.150); discomfort or pain, median 0.188 (95% CI: 0.135, 0.254). Careful attention must be paid to patient education in the use of these devices.
2. Intracavernous vasoactive drug injection therapy, initially with PGE1 (alprostadil): return to intercourse, median 0.771 (95% CI: 0.642, 0.872); patient satisfaction, median 0.706 (95% CI: 0.442, 0.898); partner satisfaction, median 0.886 (95% CI: 0.619, 0.989); drop-outs, median 0.346 (95% CI: 0.098, 0.677); systemic adverse events, median 0.019 (95% CI: 0.008, 0.036); local adverse events, median 0.098 (95% CI: 0.057, 0.151); discomfort or pain, median 0.233 (95% CI: 0.175, 0.304); prolonged erection or priapism, median 0.031 (95% CI: 0.017, 0.053); fibrosis, nodules or plaques, median 0.001 (95% CI: 0.000, 0.008). Patients should be informed that a prolonged erection can occur, and that they should present themselves with any erection lasting more than 4 hours.
3. Penile prosthesis implants: the patient should be informed of the risks of infection and erosion, which requires removal of the device, and that the risk of failure is related to the complexity of the device.
Arterial and venous surgery: measures of success were found to be non-standardised and unpredictable.