Rapid communicationSildenafil citrate for penile hemodynamic determination: an alternative to intracavernosal agents in Doppler ultrasound evaluation of erectile dysfunction
Section snippets
Material and methods
All patients admitted with erectile dysfunction underwent a pretreatment evaluation with a detailed history and physical examination followed by the short form of the International Index of Erectile Function (IIEF).11 A total of 20 patients who had a likelihood of having an organic etiology and with an IIEF score below 25 were included in the study group. A hormonal profile and serum multiple analysis-12 (SMA-12) were obtained from all patients. Patients older than 50 years or with a history of
Results
The study group consisted of 20 patients between 41 and 64 years of age (average 51.88 ± 2.59). The average IIEF score recorded was 12.47 ± 2.64. The distribution of our patients according to their IIEF score is shown in Table I.
The mean PSV, EDV, and RI values are shown in Table II. The differences between the PSV (P = 0.000), EDV (P = 0.004), and RI (P = 0.0013) values were statistically significant according to the Wilcoxon test. The Mann-Whitney U test was used to discover the source of
Comment
Currently, penile vascular pathologic features can best be detected with pharmacodynamic PDU investigation. However, false-negative results occur when the vasoactive agent injections cause adrenergic tonus changes.3 To avoid the adrenergic effect, PDU with repeated doses of vasoactive agents has been described.12
However, intracavernosal vasoactive agents, namely papaverine, PGE1, and phentolamine, have not been free of complications. The main complications have been prolonged erection and
Conclusions
Since the PDU measurements obtained with oral sildenafil citrate plus VSS were not statistically different from those obtained after penile injections of papaverine and PGE1 on the same patients, we believe that oral sildenafil citrate induces a sufficient erection for obtaining the penile hemodynamic parameters and is a noninvasive test. Our findings suggest that sildenafil citrate when combined with VSS may be used as a first-line diagnostic test in the evaluation of erectile dysfunction,
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