ED is a highly prevalent condition that impacts the quality of life of thousands of Canadian couples. Dramatic advances in understanding the pathophysiology of erection have led to the development of new, highly effective, minimally invasive therapeutic agents. ventolin inhaler
PCPs are rapidly acquiring the diagnostic and therapeutic skills necessary to become the dominant health care providers for this condition. Armed with effective oral agents able to treat ED, such as the phosphodiesterase type-5 inhibitors (PDE-5i) and the promise of a multitude of other new oral and sublingual agents in the research pipeline, ED is becoming more of a medical than surgical clinical entity. Family physicians, internists, cardiologists and other medical specialists are approached by couples with ED who are requesting treatment. In many cases, longstanding relationships exist between the couple and their treating physician, which fosters an important therapeutic alliance that may translate into an improved clinical response to the selected treatment approach. A shared-care model for the treatment of ED, in which PCPs initially identify and treat patients with ED and refer those individuals who require more invasive or specialized testing and treatment, is a valid concept. The combined experience and knowledge of PCPs, coupled with the diverse knowledge of specialists, may result in optimal care for the patient.
The present suggestions for management are based on peer-reviewed literature, the 1999 World Heath Organization consensus panel, and the evolving research on new medical approaches to ED management — all placed into a Canadian perspective, as described in the 2002 Canadian Urology Association guidelines.