Erection and ejaculation disorders practice

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Cardiovascularcommon

A 61-year-old man has erectile dysfunction and stable angina treated with regular glyceryl trinitrate spray. He would like to resume sexual activity and has no penile deformity, severe lower urinary tract symptoms or untreated endocrine disorder. His cardiac symptoms are currently controlled, but he is unwilling to stop his nitrate. Which treatment is most appropriate for his erectile dysfunction?