Elsevier

Urology

Volume 57, Issue 6, June 2001, Pages 1141-1144
Urology

Adult urology
Efficacy, safety, and use of sildenafil in urologic practice

https://doi.org/10.1016/S0090-4295(01)00984-0Get rights and content

Abstract

Objectives. To evaluate the efficacy, side effects, renewal patterns, and other relevant practice issues of the use of sildenafil in urologic practice after approval of this medication and release for public use.

Methods. Consecutive male patients with erectile dysfunction were evaluated by one urologist and sildenafil was prescribed when appropriate. Patients were monitored at two follow-up visits: at 3 to 4 months and then at 3 to 8 months (6 to 12 months after the initial prescription). At the follow-up visits, each patient was given a questionnaire assessing his improvement in erectile function, satisfaction with sildenafil, and expectations. Data were obtained on side effects, medical history, tablets taken, subsequent treatment in sildenafil failures, and renewal patterns.

Results. A total of 164 and 82 patients were evaluated at the first and second follow-up visits, respectively. Patients used a mean of 1.2 to 1.4 tablets per week. At the first follow-up visit, an improvement in erection was noted in 68.2% of patients. At the second follow-up visit, an improvement in erection was noted in 80.5% of patients. Sixty-two percent and 78% of patients renewed sildenafil at the first and second follow-up visits, respectively. In those patients who did not renew, a lack of efficacy was the most frequent reason. Intracavernous injection therapy was the most common treatment after sildenafil failure, followed by penile implants.

Conclusions. Sildenafil is an effective and safe drug in the treatment of erectile dysfunction. At the first and second follow-up visit, most patients requested and received renewal.

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

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1

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.

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