Successful treatment of erectile dysfunction (ED) is associated with improvements in quality of life; however, treatment utilisation is sub-optimal. The aim of this systematic review was to identify the rates of ED treatment utilisation and the barriers and enablers men experience when using treatment. We searched: MEDLINE^®, Embase, the Cochrane library; AMED; HMIC; HTA; CINAHL; PsychARTICLES; PsychINFO up to August 2018. Data on rates of treatment utilisation and barriers and enablers of utilisation were extracted and summarised. Fifty studies were included. Discontinuation rates ranged from 4.4 to 76% for phosphodiesterase type 5 inhibitors, 18.6 to 79.9% for intracavernosal injections, and 32 to 69.2% for urethral suppositories. In relation to those with a penile prosthesis, 30% discontinued having sex due to, e.g. device complications, lack of partner or a loss of sexual interest. Most research included in the current review examined barriers to treatment utilisation and therefore focussed on reasons for discontinuing treatment. However, a small number explored factors that men found helpful with regards to treatment utilisation. The most prevalent barriers to utilisation were treatment ineffectiveness, side effects, the quality of men’s intimate relationships and treatment costs. With regards to treatment enablers, the most salient finding was that men who reported side effects to a healthcare professionals (HCPs) were significantly less likely to discontinue treatment. There were limitations in methodology in that the studies did not use validated measures of treatment utilisation or barriers and enablers and no study used psychological theory to inform the examination of factors that influenced treatment utilisation. This review identifies a number of influential factors relating to ED treatment utilisation and highlights the importance of men’s beliefs with regards to ED and its treatment. Beliefs are potentially modifiable and therefore the findings of this review highlight important considerations for HCPs with regards to supporting men to make better use of treatment.

成功治疗勃起功能障碍（ED）与改善生活质量有关；但是，治疗利用率不是最佳的。这项系统评价的目的是确定ED治疗的利用率以及男性在使用治疗时遇到的障碍和促成因素。我们检索：MEDLINE ^®，Embase，Cochrane库；AMED；HMIC; HTA；CINAHL；心理文章；截至2018年8月的PsychINFO。提取并总结了有关治疗利用率，利用障碍和促成因素的数据。包括五十项研究。5型磷酸二酯酶抑制剂的停药率范围为4.4％至76％，海绵体内注射的停药率范围为18.6％至79.9％，尿道栓剂的停药率范围为32％至69.2％。对于具有阴茎假体的患者，有30％的患者由于器械并发症，缺乏伴侣或失去性兴趣而中断了性生活。本综述中包括的大多数研究都检查了治疗利用的障碍，因此将重点放在中止治疗的原因上。然而，少数人探索了男性发现对治疗利用有帮助的因素。利用方面最普遍的障碍是治疗无效，副作用，男性亲密关系的质量和治疗费用。关于治疗促成因素，最显着的发现是，向医疗保健专业人员（HCP）报告有副作用的男性中止治疗的可能性大大降低。方法学方面存在局限性，因为该研究未使用经过验证的治疗利用率或障碍和促成因素，也没有研究使用心理理论来告知影响治疗利用率的因素。这篇综述指出了与ED治疗的使用有关的许多影响因素，并强调了男人对于ED及其治疗的信念的重要性。