Cases that Matter Posters
P-03-075 Recovey from Pde5i failure with testestorene replacement and dayly cialis in patient with metabolic syndrome

https://doi.org/10.1016/j.jsxm.2016.03.291Get rights and content

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Objective

Abraham Dor (pseudonym) 64 YO man. Married to Eva (52 YO) healthy + 3 grown up children. Morbidity: Diabetes mellitus for 8 years moderately balanced, and hypertension. Treated with Xatral due to benign Prostatic Hypertrophy for the past 1 year. Obesity BMI =30 Medications: Metformin 850 mg X 2 / d, Glibenclamid 5 mg X 2 / d , Lossartan 50 mg X 1/ d. Xatral 10 mg X 1/d.

Methods

Complains on first visit: Came to SM clinic due to erectile dysfunction for 4 years. For the first two years successfully treated with daily 5 mg Cialis by his family physician. After 1 year the effect deteriorated and the GP switched to Sildenafil 100 mg and latter to Levitra 20 mg. He was referred to SM clinic by his GP for intracorporeal injections due to fail of the oral drugs and deterioration of his marriage and general mood and wellbeing. Laboratory: HBAIC 8.2, Total Testosterone 6

Results

Three weeks after educate testosterone eplacement Cialis 20 mg was successfully introduced and later switched to 5 mg daily, Xatral for BPH was stopped. Follow Up: The patient reported a tremendous satisfaction from the treatment and full satisfaction from his sexual life. The relationships with Eva came to normal, he lost 5 kg , started jogging again and HBAIC reduced to 7.1. No BPH complains.

Conclusion

The relative risk for Testosterone deficiency is f2.5 in metabolic syndrome and might be the cause for Pde5i failure. Test. replacement might improve the components of metabolic syndrome and reactivate pde5i influence.Cialis eficient both for ED and BPH symptoms Take home message: 1. When PDE5I stop acting, in particular with metabolic syndrome, before moving to invasive therapy check testosterone levels. 2. Daily Cialis 5 mg can safely cover ED and BPH symptoms in the same patient. I did not

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