Erectile dysfunction is a recognised complication in male patients with multiple system atrophy, arising as part of the autonomic involvement of the disease. Structured management of this complication is supported by clinical trial evidence.
Male patients with multiple system atrophy may present with difficulty achieving or maintaining an erection. Evidence from a small, randomized, placebo-controlled trial supports targeted pharmacological management of erectile dysfunction specifically in this population.
For cases that prove refractory to initial management, intracavernous injection therapy is an established option supported by the protocol. The complete regimen — including the specific agents and clinical criteria for use — is detailed in the full structured protocol.
Sildenafil, a phosphodiesterase type 5 inhibitor, improved erectile dysfunction in a small, randomized, placebo-controlled trial in men with multiple system atrophy.
Intracavernous injections of papaverine or prostaglandin E1 can also be tried in refractory cases.
DOI: 10.1212/cont.0000000000001598
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