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The efficacy of sildenafil in different etiologies of erectile dysfunction

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Abstract

Purpose: The aim of this study was to evaluate the efficacy of sildenafil and success of treatment in particular etiological causes in erectile dysfunction lasting more than 3 months. Material and methods: A total of 141 patients between 27 and 78 years old without any cardiac compromise, despite controversial, which precludes sildenafil (Viagra®) treatment, were included in this study. All patients had only International Index of Erectile Capacity Form (IIEF) for pre-treatment evaluation and 50 mg sildenafil was started. Patients were assessed monthly for 6 months thereafter. Erectile capacity changes were questioned by IIEF on each follow-up and 100 mg sildenafil was given in patients without a response and monthly follow-up was scheduled. All patients had SMA-12, hormonal analyses and penile colour Doppler ultrasonography during the treatment course. The difference between IIEF score of each patient was displayed by Paired-ttest and p-values less than 0.05 was applied as significant. Results: The average beginning IIEF score of 141 patients was11.80 ± 0.47 [6–22], and increased to 20.70 ± 0.62[6–30] after a month of 50 mg sildenafil treatment. The mean increase was 75.4% and found to be significant (p= 0.000, p < 0.05). The average IIEF scores were recorded as 22.57 ± 0.69 after 3, and 22.12 ± 0.24 after 6 months. There was no difference between these values and 2nd month controls (p 3 month = 0.5675,p 6 month = 0.6138, p > 0.05). A positive response was recorded in 102 patients (72.3%) and 39(27.7%) patients were unresponsive. Doubled doses of sildenafil (100 mg) was effective in additional 17 patients. After overall treatment, 119 (84.4%) patients had benefit from sildenafil. Penile Doppler ultrasonography displayed arterial insufficiency in 79 (56.03%), veno-occlusive dysfunction in 14 (9.93%), mixt vascular pathology in 14 (9.93%) patients. Normal ultrasonographic findings in 32 patients (22.7%) were classified as psychogenic dysfunction. Among the organic causes, sildenafil was found to be most effective in arterial insufficiency group. Conclusion: Sildenafil is a successful management modality in erectile dysfunction with minimal pre-treatment evaluation. As far as etiological causes concerned, sildenafil was found to be most effective in arterial insufficiency group and psychogenic group. The efficacy of sildenafil treatment has not been changed with the treatment time, since IIEF scores were stable during follow-up controls.

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References

  1. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinley JB. Impotence and its medical and psychological correlates: Results of the Massechussets male aging study. J Urol 1994; 151: 54–61.

    PubMed  CAS  Google Scholar 

  2. Bennet EA, Melman A. The epidemiology of erectile dysfunction. Urol Clin North Am 1995; 222: 699–710.

    Google Scholar 

  3. Teifer L, Schuetz-Mueller D. Psychological issues in diagnosis and treatment of erectile disorders. Urol Clin North Am 1995; 22: 767–773.

    Google Scholar 

  4. Lewis RW. Long-term results of penile prosthetic implants. Urol Clin North Am 1995; 22: 849–856.

    Google Scholar 

  5. Sharby JS, Benet EA, Melman A. Penile revascularization. Urol Clin North Am 1995; 22: 821–832.

    Google Scholar 

  6. Derouet H, Caspari D, Rohde V, Rommel G, Ziegler M. Treatment of erectile dysfunction with external vacuum devices. Andrologia 1999; 31(suppl. 1): 89–94.

    PubMed  Google Scholar 

  7. Fallon B. Intracavernous injection therapy for male erectile dysfunction. Urol Clin North Am 1995; 22: 833–847.

    PubMed  CAS  Google Scholar 

  8. Rowland DL, Boelhoe HB, Dohle G, Slob AK. Intracavernosal self-injection therapy in men with erectile dysfunction and attrition in 119 patients. Int J Impotence Res 1999; 11: 145–151.

    Article  CAS  Google Scholar 

  9. McVary KT, Polepalle S, Riggi S, Pelham RW. Topical prostaglandine-E1 SERA gel for the treatment of erectile dysfunction. J Urol 1999; 163(3 Pt l): 726–730.

    Article  Google Scholar 

  10. Tam PY, Keller T, Poppiti R, Gesundheit N, Padma-Nathan H. Hemodynamic effects of transurethral alprostadil measured by color duplex ultrasonography in men with erectile dysfunction. J Urol 1998; 160: 1321–1324.

    Article  PubMed  CAS  Google Scholar 

  11. Meinhardt W, Schimitz PI, Kropman RF, de la Fuente RB, Lycklama A, Nijeholt AA, Zwatendlijk LJ. Trazodone, A double blind trial for treatment of erectile dysfunction. Int J Impotence Res 1997; 9: 163–165.

    Article  CAS  Google Scholar 

  12. Kim N, Azadzoi KM, Goldstein I, Saenz de Tejada I. A nitric oxide-like factor mediates nonadrenergic noncholinergic neurogenic relaxation of penile corpus cavernosum smooth muscle. J Clin Invest 1991; 88: 112–118.

    Article  PubMed  CAS  Google Scholar 

  13. Burnett AL, Lowenstein CJ, Bredt DS, Chang TS, Snyder SH. Nitirc oxide: A physiologic mediator of penile erection. Science 1992; 257: 401–403.

    PubMed  CAS  Google Scholar 

  14. Carrier S, Zvara P, Nunes L, Kour NW, Rehman J, Lue TF. Regeneration of nitric oxide synthase-containing nerves after cavernous nerve anatomy in the rat. J Urol 1995; 1722–1727.

  15. Raymond C, Rosen AR, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A the international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology 1997; 49: 822–830.

    Article  Google Scholar 

  16. Morales A, Heaton JPW, Jonhston B, Adams M. Oral and topical treatment of erectile dysfunction. Urol Clin North Am 1995; 22: 879–886.

    PubMed  CAS  Google Scholar 

  17. Kurt U, Ozkardeş H, Altug U, Germiyanoğlu C, Gürdal M, Erol D. The efficacy of anti-serotoninergic agents in the treatment of erectile dysfunction. J Urol 1994; 152: 407–409.

    PubMed  CAS  Google Scholar 

  18. Lance R, Albo M, Constabile RA, Steers WD. Oral trazodone as empirical therapy for erectile dysfunction a retrospective study. Urology 1995; 46: 117–120.

    Article  PubMed  CAS  Google Scholar 

  19. Morales A, Johnston B, Heaton JWP, Clark A. Oral androgens in the treatment of hypogonadal men J Urol 1994; 152: 1115–1117.

    PubMed  CAS  Google Scholar 

  20. Zorginotti AW, Lizza AF. Effect of large doses of nitric oxide precursor L-arginine on erectile failure. Int J Impotence Res 1994; 6: 33–34.

    Google Scholar 

  21. Padma-Nathan H. Oral sildenafil (Viagra) in the treatment of erectile dysfunction: Assessment of erections hard enough for sexual intercourse. Int J Impotence Res 1998; 10(suppl. 3): A300.

    Google Scholar 

  22. Morales A, Gingell C, Collins M, Wicker PA, Osterloh IH. Clinical safety of oral sildenafil citrate (Viagra) in the treatment of erectile dysfunction. Int J Impotence Res 1998; 10: 69–73.

    Article  CAS  Google Scholar 

  23. Virag R. Indications and early results of sildenafil (Viagra) in erectile dysfunction. Urology 1999; 54: 1073–1077.

    Article  PubMed  CAS  Google Scholar 

  24. Shabsigh R. Efficacy of sildenafil (Viagra) is not affected by etiology of erectile dysfunction. In J Clin Pract Suppl 1999; 102: 19–20.

    CAS  Google Scholar 

  25. Price D. Sildenafil (Viagra) efficacy in the treatment of erectile dysfunction in patients with common concomitant conditations. Int J Clin Pract Suppl 1999; 102: 21–23.

    CAS  Google Scholar 

  26. Jarow JP, Burnett EA, Geringer AM. Clinical efficacy of sildenafil citrate based on etiology and response to prior treatment. J Urol 1999; 162: 722–725.

    Article  PubMed  CAS  Google Scholar 

  27. Goldtstein I. A 36–week, open label, non-comparative study to asses the long-term safety of sildenafil (Viagra) in patients with erectile dysfunction. In J Clin Pract Suppl 1999; 102: 8–9.

    Google Scholar 

  28. Boolell M, Gepi-Attee S, Gingell JC, Allen MJ. Sildenafil, a novel effective oral therapy for male erectile dysfunction. Br J Urol 1996; 78: 257–261.

    PubMed  CAS  Google Scholar 

  29. Manecke RG, Mulhall JP. Medical treatment of erectile dysfunction. Ann Med 1999; 31: 388–398.

    Article  PubMed  CAS  Google Scholar 

  30. Herrmann HC, Chang G, Klugherz BD, Mahoney PD. Hemodynamic effects of sildenafil in men with severe coronary artery disease. N Eng J Med 2000; 342: 1622–1626.

    Article  CAS  Google Scholar 

  31. Langtry HD, Markham A. Sildenafil: A review of its use in erectile dysfunction. Drugs 1999; 57: 967–989.

    Article  PubMed  CAS  Google Scholar 

  32. Muller JE. Triggering of cardiac events: Findings from a casecrossover analysis. Ann J Cardiol 2000; 86: 14–18.

    Article  Google Scholar 

  33. Cheitlin MD, Hutter AM, Brindis RG et al Use of sildenafil (Viagra) in patients with cardiovascular disease. J Am Coll Cardiol 1999; 33: 273–282.

    Article  PubMed  CAS  Google Scholar 

  34. Cohen JS: Sildenafil and nonnitrate antihypertansive medications. JAMA 2000; 283: 201–202.

    Article  PubMed  CAS  Google Scholar 

  35. Kloner RA, Zausman RM: Cardiovascular effects of sildenafil citrate and recommendations for its use. Am J Cardiol 1999; 84: 11N–17N.

    Article  PubMed  CAS  Google Scholar 

  36. Noss MB, Christ GJ, Melman A. Sildenafil: A new oral therapy for erectile dysfunction. Drugs of Today 1999; 35: 211–217.

    PubMed  CAS  Google Scholar 

  37. Padma-Nathan H, Steers WD, Wicker PA. Efficacy and safety of oral sildenafil in the treatment of erectile dysfunction: A double-blind, placebo-controlled study of 329 patients. Sildenafil Study Group. Int Clin J Pract 1998; 52: 375–379.

    CAS  Google Scholar 

  38. Feldman R, Mueleman EJH, Steers W. Sildenafil (Viagra) in the treatment of erectile dysfunction: analysis of two flexible dose-escalation studies. Int J Impotence Res 1998; 10(suppl. 3): A250.

    Google Scholar 

  39. Hartmann U, Mueleman EJH, Cuzin B, Emrich HM, Deslercq GA, Bailey MJ, Maytom MC, Smith MD, Osterloh IH and Multicenter Study Group. Sildenafil (Viagra): Analysis of preferred dose in a European, 6–month, double-blind, placebocontrolled, flexible dose-escalation study in patients with erectile dysfunction. Int J impotence Res 1998; 10(suppl. 3): A255.

    Google Scholar 

  40. Osterloh IH, Collins M, Wicker P, Wagner G. Sildenafil (Viagra) overall safety profile in 18 double-blind, placebocontrolled, clinical trials of erectile dysfunction. Int J Impotence Res 1998; 10(suppl. 30): A243.

    Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Kırıkkale University, Faculty of Medicine, Ankara Numune Hospital, Turkey

    Murat Başar, Erdal Yılmaz, Halil Başar & Ertan Batislam

  2. Department of Urology, Ankara Numune Hospital, Turkey

    Ümit Y. Tekdoğan & Ali Atan

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  1. Murat Başar
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Başar, M., Tekdoğan, Ü.Y., Yılmaz, E. et al. The efficacy of sildenafil in different etiologies of erectile dysfunction. Int Urol Nephrol 32, 403–407 (2001). https://doi.org/10.1023/A:1017554300171

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