Does Testosterone Salvage PDE5i Non-Responders? A Scoping Review

Erectile physiology, in order to function normally, requires the complex coordination of endocrine, neurocognitive, neuromuscular and vascular mechanisms. Testosterone (T) influences male sexuality as well penile erections at multiple levels, including a direct influence on nitric oxide synthase (NOS)/cGMP/phosphodiesterase 5 pathway penis. However, precise role testosterone replacement (TRT) “salvage” men with mixed ED failing phosphdiesterase-5 inhibitors (PDE5i) remains unclear. We conducted scoping review identifying rationale for TRT PDE5i, we critically discuss clinical trials that have examined setting PDE5i use. Overall, appears be tolerated may enhance response quality life, particularly ED, among very low levels testosterone. most available literature examines concurrent alone or simultaneous + usage, without necessarily selecting failure cases. The present studies are limited heterogenous small sample sizes, an exact predominant etiologic factor causing ED. Furthermore, showing benefit non-placebo-controlled trials; however, correction more profound hypogonadism lead improved PDE5i. Stronger conclusions would require properly selected patient populations larger placebo-controlled RCTs.