Evidence map›Paper›PMID 40105058›Full record

SynthesisAndrology2025

The effect of topical and intraurethral alprostadil on erectile function: A systematic review and meta-analysis.

Iason Papadopoulos, Maksim Tishukov, Ioannis Sokolakis, Ioannis Katafigiotis, Ioannis Leotsakos, Markos Karavitakis, Julian Marcon, Christian G Stief, Nikolaos Pyrgidis

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Andrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Iason PapadopoulosDepartment of Urology, University Hospital, LMU Munich, Munich, Germany.ORCID 0009-0000-0108-7150
Maksim TishukovSchool of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Ioannis SokolakisSecond Department of Urology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Ioannis KatafigiotisDepartment of Laparoscopy and Endourology, Central Urology, Lefkos Stavros the Athens Clinic, Athens, Greece.
Ioannis LeotsakosDepartment of Laparoscopy and Endourology, Central Urology, Lefkos Stavros the Athens Clinic, Athens, Greece.
Markos KaravitakisDepartment of Laparoscopy and Endourology, Central Urology, Lefkos Stavros the Athens Clinic, Athens, Greece.
Julian MarconDepartment of Urology, University Hospital, LMU Munich, Munich, Germany.
Christian G StiefDepartment of Urology, University Hospital, LMU Munich, Munich, Germany.
Nikolaos PyrgidisDepartment of Urology, University Hospital, LMU Munich, Munich, Germany.ORCID 0000-0002-7707-8426

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundErectile dysfunction (ED) affects up to 50% of men over 40. While phosphodiesterase-5 inhibitors (PDE5i) are the first line of medical treatment, they are not always effective. Alprostadil, available in injectable, topical, and intraurethral forms, offers an alternative treatment modality.

objectivesThis systematic review and meta-analysis aim to evaluate the efficacy and safety of topical and intraurethral forms of alprostadil. MATERIALS AND

methodsThe objectives and methods of this systematic review and meta-analysis were predefined in a protocol registered on PROSPERO (CRD42021260894). We systematically searched PubMed, EMBASE, and the Cochrane Library up to April 2024. Using a random-effects model, we compared the efficacy of topical and intraurethral forms of alprostadil against placebo. Additionally, we performed a qualitative assessment of the studies using RoB-2 and ROBINS-I tools.

resultsThe analysis included 11 randomized controlled trials and 4 non-randomized studies, encompassing 5869 patients with a mean age of 60 ± 9.4 years. The meta-analysis showed a statistically significant improvement in the IIEF score by 4.7 points (95% CI: 2.4-7.1, I DISCUSSION: These results are limited by the variability in study designs and the relatively small number of included studies in the meta-analysis. Moreover, the low methodological quality of the included studies further limits the strength of the conclusions.

conclusionsTopical and intraurethral alprostadil significantly improve ED symptoms compared to placebo and are generally safe, with no serious adverse events. Further trials are necessary to confirm and expand on these findings.

Indexed as

AlprostadilErectile DysfunctionPenile ErectionVasodilator AgentsAdministration, TopicalHumansMaleMiddle AgedTreatment OutcomeUrethraAlprostadilVasodilator Agentsalprostadilerectile dysfunctionintraurethralsafetytopicaltreatment

Identifiers

PMID40105058
PMCPMC12569735

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.