Adult urologyEfficacy, safety, and use of sildenafil in urologic practice
Section snippets
Material and methods
Male patients with ED treated with sildenafil from April 1998 to April 1999 by one urologist (R.S.) were included in the study. A diagnosis of ED was made based on the history and physical examination in all patients, with additional testing in some patients using nocturnal penile tumescence testing, duplex ultrasound scanning, and/or other diagnostic methods as indicated. Excluded were patients who had a contraindication to sildenafil (eg, concomitant use of nitrates, unstable heart disease,
First follow-up visit
One hundred sixty-four patients filled out the questionnaire and were subsequently interviewed at the first follow-up visit. The youngest patient was 22 years old and the oldest was 85 years old (mean age 54.1). The duration of ED before starting sildenafil ranged from 6 months to 30 years (mean 3.8). The mean number of tablets used per week was 1.4 (range 0.13 to 6.7) (Table I). One hundred twelve patients (68.2%) noted an improvement in their ED. Ninety-three patients (56.7%) were able to
Comment
The results of our study demonstrate that sildenafil improves ED in most patients. However, not all patients who noted improvement were able to sustain an erection adequate for intercourse in one half or more of their attempts. Those patients who had undergone radical retropubic prostatectomy responded least favorably to sildenafil. Approximately 62% of patients renewed sildenafil at their first follow-up visit and 78% at the second follow-up visit. However, only 82 of the original 164 patients
References (10)
- et al.
The International Index of Erectile Functiona multidimensional scale for assessment of erectile dysfunction
Urology
(1997) - et al.
Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction
N Engl J Med
(1996) - et al.
Treatment of men with erectile dysfunction with transurethral alprostadil
N Engl J Med
(1997) - et al.
Sildenafil, a novel effective oral therapy for male erectile dysfunction
Br J Urol
(1996) - et al.
Nitric oxide as a mediator of relaxation of the corpus cavernosum response to nonadrenergic, noncholinergic neurotransmission
N Engl J Med
(1992)
Cited by (53)
A Small Group Randomized Double-Blind Placebo-Controlled Study to Evaluate the Efficacy of Daily Pentoxifylline in the Management of Patients With Erectile Dysfunction with Suboptimal Treatment Response to Sildenafil
2020, Sexual MedicineCitation Excerpt :The Global Study of Sexual Attitudes and Behaviours showed that, in a population of 13,618 men aged between 40 and 80 years, 10% of them has erectile dysfunction.2 Although large multicenter clinical trials have shown fair efficacy and tolerability of oral phosphodiesterase-5 (PDE-5) inhibitors in ED with various etiologies and a broad range of severity,3−5 30−35% of patients fail to respond.6 Patients who fail to respond to PDE-5 will require more invasive second or third-line treatments, such as intracavernosal injection of vasodilators and surgical implantation of penile prostheses.7
Preference for erectile dysfunction treatments: Assessment by means of consumers preference analysis techniques
2014, Actas Urologicas EspanolasIn Vivo and in Vitro Animal Investigation of the Effect of a Mixture of Herbal Extracts from Tribulus terrestris and Cornus officinalis on Penile Erection
2012, Journal of Sexual MedicineCitation Excerpt :Although large multicenter clinical trials have demonstrated the efficacy and tolerability of these drugs in ED with various etiologies and a broad range of severity, 30–35% of patients fail to respond. The reported 62% prescription renewal rate at 3–4 months of follow‐up, which drops to approximately 30% by 6–12 months, suggests that patients stop taking the drug for reasons other than treatment failure [19,20]. Use of PDE‐5 inhibitors may result in side effects such as visual disturbance, headache, facial flushing, rhinitis, and indigestion [7].
Erectile dysfunction (ED) is a shared sexual concern of couples II: Association of female partner characteristics with male partner ED treatment seeking and phosphodiesterase type 5 inhibitor utilization
2009, Journal of Sexual MedicineCitation Excerpt :The MALES study revealed a dramatic treatment falloff cascade such that while approximately 60% of men with ED had spoken to their physician about the problem, only 16% of men were currently using PDE5 inhibitor therapy [19]. Other studies have demonstrated rates of discontinuation of PDE5 inhibitor therapy of up to 47% [43–46]. The current study showed that in a number of cases, women's attitudes and beliefs about ED treatment were correlated with the likelihood of their male partner mentioning his sexual dysfunction to a doctor, but not with the likelihood of him trying PDE5 inhibitors.
Erectile dysfunction (ED) is a shared sexual concern of couples I: Couple conceptions of ED
2009, Journal of Sexual MedicineCitation Excerpt :The MALES study revealed a negative treatment cascade such that, although approximately 60% of men with ED had spoken to their physician about the problem, only 16% of men with ED were currently using phosphodiesterase type 5 (PDE-5) inhibitor therapy [21]. Other studies suggest that rates of discontinuation of PDE-5 inhibitor therapy are as high as 19.5–47.3% [29–32]. It appears highly likely that discordant couple views about functional impairment, safety of treatment.
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R. Shabsigh is a paid consultant to Pfizer, Pentech, and Lilly-ICOS; is an investigator with Pfizer, Pentech, Bayer, and Lilly-ICOS; and is on the speaker’s bureau of Pfizer and Lilly-ICOS.