A THERAPEUTIC TAXONOMY OF TREATMENTS FOR ERECTILE DYSFUNCTION - AN EVOLUTIONARY IMPERATIVE

Aim of the study: A functional classification of treatments for erecti le dysfunction is important but none exists at present. Advances in th e understanding of the mechanisms of drug action and of the mechanisms of penile erection suggest that there is now a rational basis for a t herapeutic classification, with the expectation that a logical diagnos tic classification will follow. Methods: The currently available treat ments for erectile function and the known relevant basic science were reviewed and assessed. From this, and analysis of classification syste ms in other fields, a classification was proposed and evaluated with r espect to existing treatments. Results: The treatments for erectile dy sfunction were classified into five major classes by their mode of act ion: (I) Central Initiators, (II) Peripheral Initiators, (III) Central Conditioners, (IV) Peripheral Conditioners and (V) Other. Drugs in th ese classes are further subdivided by the routes of administration and the mechanisms of specificity. Conclusions: It is possible to analyze all known treatments using this classification. The principles of thi s scheme should be sufficiently clear as to enable knowledgeable speci alists to arrive at similar conclusions about a drug. The classificati on proposed is general enough such that most new drugs should fall wit hin a class. However, it should be modified if necessary, if new thera peutic agents can not be appropriately classified. It is our conclusio n that with such endeavours the speciality itself and national regulat ory bodies will find it easier to define and control how to apply new drugs, how to evaluate new drugs, and how to establish reasonable equi valences among agents and in whom these drugs and devices should be us ed.