A Cochrane review included 8 studies with a total of 1717 subjects. 80% of the participants had type 2 diabetes. Weighted mean difference (WMD) for the International Index of Erectile Function (IIEF) questions 3 and 4 (frequency of penetration during and maintaining erection to completion of intercourse) was 0.9 (95% CI 0.8 to 1.1) and 1.1 (95% CI 1.0 to 1.2) at the end of the study period, in favour of the intervention group. The RR for answering "yes" to a global efficacy question ( "did the treatment improve your erections?") was 3.8 (95% CI 3.1 to 4.5) in the PDE-5 inhibitors compared with the control arm. The WMD between the percentage of successful attempts in the PDE-5 inhibitors and in the control arm was 26.7 (95% CI 23.1 to 30.3). Headache was the most frequent adverse event reported.
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