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PubMed1998

Comparative study between corpus cavernosum-electromyography findings and electron microscopy of cavernosal muscle biopsies in erectile dysfunction patients.

BACKGROUND: Biopsy and electrical activity recordings of the corpus cavernosum are 2 new diagnostic methods for the evaluation of impotent men. We evaluated the corpus cavernosum ultrastructure and electromyography (EMG) recordings from patients with erectile dysfunction. METHODS: Twenty erectile dysfunction patients with veno-occlusive dysfunction underwent a detailed history, physical examination, biochemical tests, hormonal analysis, injection of an intracavernous vasoactive agent (60 mg papaverine-HCl), color penile Doppler ultrasonography, cavernosometry/ cavernosography and corpus cavernosum electromyography (CC-EMG). Thirteen patients underwent total vein ligation and 7 had penile prosthesis implantations. Tissue samples were obtained during surgery from both corpora cavernosa and examined by transmission electron microscopy. Control corporal tissue samples were taken from 3 cadavers. RESULTS: In 15 patients, CC-EMG recordings were 15.6 +/- 0.65 microV in the flaccid state, which decreased in 13 patients after papaverine (5.61 +/- 0.25 microV; P < 0.001). Five patients with diabetes mellitus had low amplitudes in the flaccid state (5.26 +/- 0.45 microV), which did not vary significantly after a papaverine injection (4.99 +/- 0.75 microV). The pathology of the corpus cavernosum biopsy specimens revealed a smooth muscle cell thickened basal membrane, dilated rough endoplasmic reticulum, and increased numbers of fibroblasts, but ultrastructurally normal endothelial cells lining the sinusoids. There was no difference between samples from diabetic or nondiabetic patients, or from either side of the corpora cavernosa. The only pathologic change observed in the controls was mitochondrial swelling. CONCLUSION: CC-EMG is less invasive and a valuable method in patients with erectile dysfunction, whereas no specific findings were observed from penile biopsy specimens.

Adult↗

PubMed1997

[Psychological aspects of erectile dysfunction].

It is widely accepted opinion that male sexuality comprises more than an erected penis. This fact should be considered in the management of erectile dysfunction. Therefore, the valuation of sexual disturbances have to be essentially included in the general examination programme of erectile impotence. Several causes are known to contribute to an erectile dysfunction. The anamnesis can be taken as an important tool for classification of the erectile dysfunction. The following questions are helpful in the clinical practice: erectile dysfunction during sexual intercourse only but also during masturbation; spontaneous erections; dependence of the erectile impotence on special situations, partners and events; questions for somatic and psychosocial risks. Sexual therapy represents a complex intervention will be aim of improvement of the functional disturbances in consideration of the general risks for sexual impairments.

Erectile Dysfunction↗

PubMed2000

Testosterone supplementation for erectile dysfunction: results of a meta-analysis.

PURPOSE: To our knowledge a causal relationship between altered levels of androgens and erectile dysfunction has not yet been established. We reviewed the literature to assess the usefulness of androgen replacement for erectile dysfunction. MATERIALS AND METHODS: Meta-analysis was chosen as the method of evaluating the literature. Study inclusion criteria were testosterone given as the only therapy for erectile dysfunction and a clearly stated definition of response for evaluating treatment success or failure. RESULTS: We evaluated 73 articles obtained by a MEDLINE search of 1966 to 1998 and included 16 in our study. The overall response rate was 57%. In the 9 series with response rate by etiology patients with primary versus secondary testicular failure had a response rate of 64% versus 44% (p <0.001). Intramuscular and oral methods of delivery were equivalent with a response rate of 51.3% and 53.2%, respectively. However, the response to transdermal therapy was significantly different from that of intramuscular and oral treatment (80.9% versus 51.3% and 53.2%, respectively, p <0.001). The mean confidence level response for testosterone treatment was 16. 7% in the placebo and 65.4% in the treated group (p <0.0001). CONCLUSIONS: Our meta-analysis of the usefulness of androgen replacement therapy for erectile dysfunction indicates that the response rate for a primary etiology was improved over that for a secondary etiology, transdermal testosterone therapy was more effective than intramuscular or oral treatment, and intramuscular and oral treatments were equivalent. In addition, there was a statistically significant difference in favor of testosterone over placebo, implying a role for supplementation in select groups.

Administration, Oral↗

PubMed2005

Salvage of end-stage erectile dysfunction using vascularized fibula as autologous implant.

INTRODUCTION: Patients in whom medical and surgical options for the treatment of erectile dysfunction have failed pose a unique challenge to reconstructive genitourinary surgeons. We report a novel reconstructive option for the treatment of end-stage erectile dysfunction using a microsurgically transferred vascularized fibula as an autologous implant in a patient in whom multiple inflatable prostheses had failed. TECHNICAL CONSIDERATIONS: A reconstructive team, consisting of urologic and plastic reconstructive surgeons, transferred a vascularized fibula into the corporeal body in 1 patient to restore sexual function. Using this technique, successful intercourse was achieved by 6 months of follow-up. We describe the surgical technique of autologous implant of a vascularized fibula in the salvage treatment of end-stage erectile dysfunction. CONCLUSIONS: Patients with multiple failed inflatable penile implants can present a formidable challenge to reconstructive surgeons with regard to restoring adequate sexual function. The standard approach to the patient after repeated episodes of unsuccessful salvage of penile prosthesis due to infection and/or extrusion is to remove the prosthesis, leaving the patient impotent. Vascularized autologous tissue transfer provides an option to salvage end-stage erectile dysfunction.

Erectile Dysfunction↗

PubMed2001

Injured external anal sphincter in erectile dysfunction.

The purpose of this study was to investigate the function of the bulbocavernosus muscle in patients with faecal incontinence as a result of injury to the external anal sphincter, and to find out whether faecal incontinence had any role in erectile dysfunction. The study comprised 16 men (age 41.6+/-6.8 years) whose erectile dysfunction and faecal incontinence followed an operation for anal fistula. Erection could not be maintained until ejaculation, which, if it did occur, was not in jets. Ten healthy volunteers acted as controls. The activity of the external anal sphincter and the bulbocavernosus muscle was recorded by electromyography; anal and penile bulb pressures were also recorded. Investigations showed that erectile function was normal. The external anal sphincter was repaired, and faecal control and erectile dysfunction were assessed. Patients were followed up for 19.6+/-3.2 months. The results showed that the bulbocavernosus reflex elicited no response in either the sphincter or the bulbocavernosus muscle. Their activity, recorded by electromyography, as well as anal and bulbar pressures at rest and on voluntary squeeze, and electrostimulation of the external anal sphincter, showed a significant reduction compared to the controls. Sphincteroplasty made the patients continent and restored erectile function and ejaculation to normal. We conclude from the current study that the reduced activity of the bulbocavernosus muscle is probably caused by injury to the external anal sphincter. It is suggested that erectile dysfunction is caused by the failure, during erection, of the contraction of the bulbocavernosus muscle to raise cavernosal pressure above systolic blood pressure. The loss of the rhythmical contractions of the bulbocavernosus muscle is probably why ejaculation did not occur in jets. Repair of the external anal sphincter provided a cure for faecal incontinence and erectile dysfunction. Anorectal disorders are believed to affect erectile function, a relationship that needs further investigation.

Adult↗

PubMedDate not supplied

[Risk factors and prevalence of erectile dysfunction amongst Icelandic men aged 45-75].

OBJECTIVE: Many population studies worldwide have shown high prevalence of erect ile dysfunction, a condition that increases dramatically with age. Other risk factors are also well known such as diabetes and arteriosclerosis. The aim was to study the prevalence and risk factors of erectile dysfunction among Icelandic men. MATERIAL AND METHODS: The participants were 4000 men age 45-75 year old randomly chosen from the Icelandic National Registry. They received a 27 item questionnaire to access the degree of erectile dysfunction using the 5 question International Index of Erectile Function (IEEF), and also other aspects of sexual health, medication and concomitant diseases. RESULTS: The response rate was 40.8%. The overall prevalence of erectile dysfunction was 35.5%. The condition was significantly more prevalent in the older age group (65-75) compared to the younger group (45-55), 21.6% vs 62.3% respectively. Other significant risk factors were smoking, diabetes, high cholesterol, hypertension, depression and anxiety disorder. Sexual activity and interest is high in all age groups. Physicians rarely take the initiative of asking men about sexual dysfunction. Only about 24% of males with erectile dysfunction have received some treatment. CONCLUSION: This first population based study among Icelandic men shows a high prevalence of erectile dysfunction and is in accordance with similar studies in other counties. Significant risk factors are the same as are well known for cardiovascular diseases. Thus preventive measures should be the same for both conditions.

Age Factors↗

PubMed2006

Prevalence and determinants of erectile dysfunction among people with type 2 diabetes in Ilorin, Nigeria.

STUDY OBJECTIVES: To determine the prevalence and determinants of Erectile Dysfunction (ED) among men with Type 2 diabetes mellitus. MATERIALS AND METHODS: Seventy-seven adult men with Type 2 Diabetes Mellitus were assessed for Erectile Dysfunction using the 'IIEF-5' questionnaire. They were also assessed for the presence of certain clinical factors in other to determine their degree of correlation with ED. RESULTS: The mean age of the study subjects was 56.8(+/-2.4) years. Almost all (96.1%) were married. Forty-four (56.4%) men volunteered a history of Erectile Dysfunction. When assessed with the 'IIEF - 5' questionnaire, the prevalence of any degree of ED was 74% while moderate to severe ED was found in 39(51%) of the patients. The only clinical variables that had statistically significant correlation with ED were the age of the patients (p=0.04) as well as the duration of diabetes (p=0.04). CONCLUSION: - Erectile Dysfunction is a very common condition among men with Type 2 Diabetes mellitus in Ilorin, Nigeria and should therefore be routinely sought for by the clinicians. The two clinical factors that confer significant risk to development of ED, from this study are non-modifiable. More emphasis should therefore be placed on treatment rather than the prevention of this condition.

Age Factors↗

PubMed2003

Neuroprotection and nerve grafts in the treatment of neurogenic erectile dysfunction.

PURPOSE: The rationale for protecting the nerve supply of the penis derives mainly from the fact that neurological injury or disease states involving this organ commonly result in erectile dysfunction. Novel directions in the management of neurogenic erectile dysfunction that pertain specifically to sustaining penile neuronal function are described. MATERIALS AND METHODS: The review constitutes a summary of neuroprotective strategies for penile erection that are under investigation at the basic science level or have been brought to clinical practice. The basic exercise consisted primarily of a literature search using the National Library of Medicine PubMed Services, with references made to such keywords as nerve grafts, nerve growth factors, neuroprotection and nerve regeneration. RESULTS: Primary advances in this field have centered on repairing structural defects and restoring the functional integrity of the cavernous nerves of the penis. In the former autologous nerve conduits, such as sural nerve grafts, have been explored and used prominently in the context of radical prostatectomy. In the latter diverse neurotrophic treatments have been investigated, with progress mostly limited to animal models of cavernous nerve injury. Basic concepts and ongoing developments in the neurobiology of axonal regeneration were identified as being applicable to this area of neurourology. CONCLUSIONS: Because neurogenic origins represent a leading categorical cause of erectile dysfunction, the importance of developing and applying treatment approaches to alleviate neuropathic effects on the erectile tissue of the penis is certain. Medical and surgical innovations for preserving and reconstituting the functional nerve supply of the penis offer great promise in the management of erectile dysfunction.

Animals↗

PubMed2001

Effects of moclobemide on sexual performance and nocturnal erections in psychogenic erectile dysfunction.

RATIONALE AND OBJECTIVES: We tested the hypothesis that the selective reversible MAO-A inhibitor moclobemide has a specific therapeutic effect on erectile dysfunction independent of its antidepressive properties. METHODS: In a double-blind placebo controlled study, 12 male outpatients suffering from psychogenic erectile dysfunction without any other psychiatric disorder were investigated. Based on comprehensive diagnosis before the beginning of the study, organic factors relevant for sexual function were excluded. The treatment period was 8 weeks. Half the patients received 450 mg moclobemide during the first week, and 600 mg afterwards; the others received placebo. Apart from assessment of erectile function by means of the Clinical Global Impression (CGI) scale, nocturnal erections were measured under polysomnographic control at baseline and at the end of the treatment period. RESULTS: The evaluation of the CGI scale revealed a clearly stronger improvement under moclobemide compared to placebo during the study period. The therapeutic efficacy found on the subjective level had no clear correlate on the neurophysiological level. No alterations of nocturnal erectile parameters were obvious under treatment, neither were clinically relevant alterations found regarding sleep EEG parameters. The medication was well tolerated without serious adverse events. CONCLUSIONS: The findings support the hypothesis that moclobemide has a specific effect on erectile dysfunction. Thus, patients suffering from psychogenic erectile dysfunction who are not depressed might benefit from moclobemide without relevant side effects.

Adult↗

PubMed2005

[Duplex ultrasonography and internal pudendal arteriogram in the diagnosis of trauma-associated arteriogenic erectile dysfunction (a report of 7 cases)].

OBJECTIVE: To make a comparative study of duplex ultrasonography (DU) and internal pudendal arteriogram (IPA) in the diagnosis of trauma-associated arteriogenic erectile dysfunction (ED). METHODS: Seven patients suffering from arteriogenic erectile dysfunction caused by pelvic fracture trauma underwent comprehensive history inquiries and physical examinations by duplex ultrasonography and internal pudendal arteriogram, which ruled out neurogenic erectile dysfunction. RESULTS: DU suggested penile artery blood flow injury, and IPA indicated artery injury in all the cases, including left internal pudendal artery injury, right or left common penile artery injury and bilateral common penile artery injury. CONCLUSION: Trauma-associated arteriogenic erectile dysfunction may result from common penile artery injury and internal pudendal artery injury. DU is proved valuable for evaluating hemodynamic abnormalities of cavernous artery flow, and IPA useful in locating common penile artery and internal pudendal artery injury. DU can be used as the first line diagnostic means to define trauma-associated arteriogenic ED.

Adult↗

PubMed1999

Treatment of erectile dysfunction with sildenafil citrate (Viagra) after radiation therapy for prostate cancer.

OBJECTIVES: To determine the response to sildenafil citrate (Viagra) in patients with erectile dysfunction after radiation therapy for localized prostate cancer. METHODS: Baseline and follow-up data from 21 patients presenting with erectile dysfunction after radiation treatment for clinical T1-2 prostate cancer were obtained. Two patients had undergone iodine-125 seed implantation and the remaining 19 conformal external beam irradiation. All 21 patients were considered to have erectile dysfunction as assessed by the International Index of Erectile Function (IIEF) and were prescribed sildenafil at a dosage of 50 mg, with a titration to 100 mg if needed. The mean time between the completion of radiation therapy and initiation of sildenafil was 24.6 +/- 5.8 months. The quality of the erectile function was assessed after a minimum of four doses by using the Cleveland Clinic Erectile Function (CCEF) questionnaire and the IIEF questionnaire. A positive response to sildenafil on the CCEF questionnaire was defined as an erection sufficient for vaginal penetration. The responses on the IIEF questionnaire were rated on a scale of 1 (almost never) to 5 (almost always), with 0 being no sexual activity. RESULTS: On the CCEF questionnaire, 71% (15 of 21) of patients had a positive response, with a mean duration of 12.7 +/- 2.5 minutes of intercourse, and a corresponding spousal satisfaction rate of 71%. Twelve (80%) of the 15 responders required titration to the 100-mg dosage for maximal effect. The most common side effects seen were transient flushing (19%), abnormal color vision (14%), and headaches (10%). No patient discontinued the drug because of side effects. On the IIEF questionnaire, the responses to questions 3 (frequency of penetration), 4 (maintenance of erection), 7 (satisfactory intercourse), and 15 (erection confidence) increased from mean baseline scores of 1.3, 1.1, 1.2, and 1.8 to final mean scores of 4.0, 3.9, 3.2, and 3.4, respectively (P <0.001). On the global efficacy question (ability to achieve firm erections), 71% of the patients responded positively. CONCLUSIONS: Sildenafil citrate can improve the ability to achieve and maintain an erection in most patients with erectile dysfunction after radiation therapy for prostate cancer.

Aged↗

PubMedDate not supplied

Effect of sildenafil in cavernous arteries of patients with erectile dysfunction.

INTRODUCTION: Sildenafil citrate is a type 5 phosphodiesterase inhibitor, which has demonstrated excellent results in the treatment of erectile dysfunction. The effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction has not been established yet. The objective of this study was to assess the effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction, following an intracavernous injection of alprostadil. MATERIALS AND METHODS: 29 male patients, with mean age of 53.8 years (32 to 75 years), were prospectively evaluated. The mean time with complaint of erectile dysfunction was 50.5 months (6 to 168 months). Each patient was his own control. Patients underwent a measurement of peak systolic velocity before and after use of sildenafil citrate associated with 5 micrograms of alprostadil, through ultrasonic velocitometry Knoll/MIDUS system. In the interval between measurements, approximately 15 days, patients used 3 tablets of sildenafil at home with their partners. RESULTS: Using only 5 mcg of alprostadil, average peak systolic velocity was 23.9 cm/s, and when associated to 50 mg of sildenafil it was 24.8 cm/s. Despite the increase in the flow rate caused by sildenafil, the difference was not statistically significant, Z calculated = - 0.695 NS (Wilcoxon test). Twenty one of the 29 patients (72.4%) showed global improvement in sexual performance with the use of sildenafil citrate at home. There was not a statistically significant correlation between the global response to sildenafil citrate and the increase in the peak systolic velocity. CONCLUSION: We concluded that, even though the use of 50 mg of sildenafil citrate associated with 5 mcg of alprostadil provides an increase in the peak systolic velocity of the cavernous arteries, there was no statistic difference in relation to alprostadil alone. There was no correlation between the global response to sildenafil and the increase in the peak systolic velocity.

Journal Article↗

PubMed1998

Efficacy and safety of transurethral alprostadil in patients with erectile dysfunction following radical prostatectomy.

PURPOSE: A retrospective analysis of the MUSE clinical trial was performed to evaluate the efficacy and safety of transurethral alprostadil in patients with erectile dysfunction after radical prostatectomy. MATERIALS AND METHODS: Patients received doses of transurethral alprostadil in the clinic and those for whom a suitable dose was determined were treated at home with active drug or placebo for 3 months. Patients had undergone radical prostatectomy no less than 3 months before study entry. RESULTS: Of the 384 patients in whom radical prostatectomy was identified as a cause of erectile dysfunction 70.3% had an erection believed sufficient for intercourse in the clinic and 57.1% on active medication had sexual intercourse at least once at home. The product of clinic and home success rates (70.3 x 57.1%) was an overall success rate (the likelihood of active treatment to lead to intercourse at home) of 40.1%. The frequency of most adverse effects of radical prostatectomy was comparable to that of other organic etiologies of erectile dysfunction (1,127 patients). The percentage of patients with hypotension in the clinic was lower after radical prostatectomy compared to other erectile dysfunction etiologies (0.8 versus 4.2%, p < 0.001) but the percentage of patients with urethral pain/burning was higher (18.3 versus 10.4%, p = 0.027). No urinary tract infection, fibrosis or priapism occurred in the post-radical prostatectomy patients. CONCLUSIONS: Transurethral alprostadil is a well tolerated and efficacious method of treating erectile dysfunction after radical prostatectomy, although psychological changes associated with cancer and surgery may limit home response. The severe neurovascular deficit associated with prostatectomy neither limits the efficacy of transurethral alprostadil nor increases the risks.

Adult↗

PubMed2006

[Comparison of cavernometry and duplex ultrasound in the diagnosis of veno-occlusive erectile dysfunction].

OBJECTIVES: To compare pulsed duplex ultrasound and cavernometry in the aetiological diagnosis of veno-occlusive erectile dysfunction. MATERIAL AND METHODS: Between September 1995 and January 2005, 81 patients with a mean age of 48.45 +/- 12.35 years consulting for erectile dysfunction were investigated by cavernometry and pulsed duplex ultrasound before and after sensitization by intracavernous injection of 10 microg/ml of prostaglandin. The results of these two examinations were compared by the kappa concordance test. RESULTS: According to pulsed duplex ultrasound, 54 patients presented veno-occlusive incompetence. According to cavernometry, 56 patients presented veno-occlusive incompetence. The concordance between the results of the two examinations was only moderate (kappa = 0.52, p < 0.0001, 95% CI: 0.5886-0.7967). CONCLUSION: Duplex ultrasound is a first-line examination in a case of suspected organic erectile dysfunction due to a vascular cause. However, due to the limited concordance for the aetiological diagnosis of veno-occlusive erectile dysfunction between duplex ultrasound and cavernometry, cavernometry is still indicated in highly selected cases such as preoperative work-up.

Humans↗

PubMed2003

Current and future trends in the oral pharmacotherapy of male erectile dysfunction.

The promising clinical data on the use of the first orally active phosphodiesterase inhibitor sildenafil citrate (Viagra) for treatment of male erectile dysfunction have been accompanied by an increase in research activities on the physiology of the male erectile mechanism. This included both peripheral intracellular signal transduction in the corpus cavernosum as well as central brain and spinal cord pathways that control penile erection. This work provided the basis for the development and introduction of several new therapeutic modalities into the management of erectile dysfunction that is now offered to the patients. Since the concept of 'taking a pill' as a cure for an illness or the relief of symptoms of a disease has become widely accepted by consumers, the pharmacological treatment of erectile dysfunction has primarily focused on selective, orally available drugs that act via influencing intracellular or central regulatory mechanisms, combining a high response rate and the advantage of an 'on-demand' intake. These agents are regarded as more efficacious, have a faster onset of drug action in the target tissue and an improved effect-to-side effect ratio than sildenafil. The purpose of this review is to describe the major novel and evolving pharmacological advances in the field of oral pharmacotherapy for the treatment of male erectile dysfunction.

Administration, Oral↗

PubMed2005

A surgical algorithm for men with combined Peyronie's disease and erectile dysfunction: functional and satisfaction outcomes.

INTRODUCTION: Men with Peyronie's disease who also have erectile dysfunction represent a challenge to the urologist. Historically, penile prosthesis surgery has been the management strategy of choice for this population. This study was undertaken to define the outcomes of a penile reconstructive surgery algorithm in men with Peyronie's disease and concomitant erectile dysfunction (ED). METHODS: Patients presenting with combined Peyronie's disease and erectile dysfunction were treated with vasoactive therapy initially. All patients underwent dynamic infusion cavernosometry and cavernosography. Nonresponders to erectogenic pharmacotherapy were advised to undergo penile prosthetic surgery. Responders to erectogenic therapy were considered candidates for either corporoplasty or plaque incision and grafting. The International Index of Erectile Function (IIEF) questionnaire was used to compare erectile function and satisfaction profiles serially pre- and postoperatively between the patients in the three groups. RESULTS: Sixty-two patients constituted the study population. Eighty-one percent of the patients responded to erectogenic pharmacotherapy. Postoperative IIEF erectile function domain scores were statistically higher for implant patients and lower for plaque incision and grafting patients compared to preoperative scores. Postoperative IIEF satisfaction domain scores were higher for corporoplasty and implant patients and lower for plaque incision and grafting patients compared to preoperative scores. CONCLUSIONS: The surgical algorithm used in this study leads to excellent IIEF erectile function and satisfaction scores for corporoplasty and implant patients; however, plaque incision and grafting patients had poor functional and satisfaction outcomes. These data support the concept that not all men with combined ED and Peyronie's disease require penile prosthetic surgery, and furthermore, plaque incision and grafting surgery is a poor option for men with combined disease.

Adult↗

PubMed2006

Predictors of tadalafil efficacy in men with erectile dysfunction: the SURE study comparing two dosing regimens.

INTRODUCTION: The efficacy of phosphodiesterase-5 inhibitors in the treatment of erectile dysfunction may depend on patient characteristics. AIM: To determine whether patient characteristics influence the efficacy of two tadalafil dosage regimens and to identify prognostic factors predictive of tadalafil efficacy. METHODS: This was a multicenter, open-label study in which men with erectile dysfunction were randomized to tadalafil 20 mg either on demand or three times per week for a period of 5-6 weeks. After a 1-week washout period, patients were crossed over to the alternate regimen for another 5-6 weeks. MAIN OUTCOME MEASURES: Score of the Erectile Function (EF) domain of the International Index of Erectile Function Questionnaire (IIEF) and percentage of positive responses to questions 3 and 5 of the Sexual Encounter Profile (SEP) diary. RESULTS: A total of 4,262 patients were randomized. A normal EF domain score (> or =26) at the end of on-demand and three-times-per-week treatment was reported by 60.2% and 62.3% of patients, respectively. The percentage of patients who achieved a normal EF domain score and the percentages reporting positive responses to SEP3 and SEP5 depended on the severity of erectile dysfunction and the presence of certain comorbidities, irrespective of the tadalafil dosage regimen. On regression analysis, the two best predictors of tadalafil efficacy were the baseline score of the IIEF-EF domain and the baseline percentage of "Yes" responses to SEP2. CONCLUSIONS: On-demand and three-times-per-week dosage regimens of tadalafil 20 mg were equally efficacious in men with erectile dysfunction. Among the possible prognostic factors tested in this study, baseline disease severity scores were the strongest predictors of efficacy endpoint scores.

Adult↗

PubMed2001

Use of sildenafil citrate in treatment of Taiwanese men with erectile dysfunction: a single center experience.

BACKGROUND: We evaluated the efficacy and safety of sildenafil citrate in the treatment of Taiwanese men with erectile dysfunction in the post-marketing era. METHODS: From March 24, 1999 to September 30, 1999, we evaluated the efficacy and safety of Sildenafil in patients with erectile dysfunction. We used questions 3 and 4 of the International Index of Erectile Function (IIEF) as objective efficacy end-points. The patients used a home medication diary to record the subjective efficacy and side effects of sildenafil and their satisfaction with this drug as well as that of their sexual partners. RESULTS: There were 415 patients with erectile dysfunction in our survey. Their ages ranged from 29 to 85 years old with a mean of 60 years. Of these, 212 patients (51.1%) returned their home medication diaries. The satisfaction rate of these patients was 81.6% and the satisfaction rate of their sexual partners was 71.2%. About 71% of these patients achieved more than 60% rigidity. The most common side effect was facial flushing (45.8%), followed by dizziness (13.7%), visual disturbances (10.8%), headache (8%), nasal congestion (8%) and dyspepsia (4.7%). CONCLUSION: Sildenafil citrate is an effective oral medication for the treatment of erectile dysfunction in Taiwanese men. Our study noted more facial flushing and visual disturbances than other studies. These side effects were transient and well tolerated by most of the patients.

Adult↗