Objective To assess the ef®cacy and safety of sildena®l citrate (Viagra 1 , P®zer Inc., USA) in a double-blind, placebo-controlled, dose-escalation study over a period of 26 weeks in men with erectile dysfunction of a broad spectrum of aetiology. Patients and methods In all, 315 patients from ®ve countries were randomized to receive treatment with placebo (156 men) or sildena®l (159 men). Signi®cant concomitant medical conditions were hypertension (20%), a history of pelvic surgery (19%), diabetes mellitus (15%), and ischaemic heart disease (10%). Patients randomized to treatment received a starting dose of 25 mg of sildena®l or matching placebo, which could be increased to 50 mg and then to 100 mg of sildena®l, based on ef®cacy and tolerability. Assessments of ef®cacy comprised the 15-item International Index of Erectile Function (IIEF), including question three (ability to achieve an erection) and question four (ability to maintain an erection), a partner questionnaire, an overall ef®cacy question, and event-log data. Results After 12 weeks of treatment, 26%, 32% and 42% of patients were taking 25, 50 and 100 mg of sildena®l, respectively. A similar distribution of doses was reported after 26 weeks of treatment. Treatment with sildena®l signi®cantly improved the patients' abilities to achieve and maintain an erection compared with treatment with placebo (P <0.001).Scores for four of the ®ve sexual function domains of the IIEF (erectile function, orgasmic function, intercourse satisfaction and overall satisfaction) also improved signi®cantly (P<0.001). There was a signi®cant improvement in the mean score for the erectile function domain, regardless of the aetiology of erectile dysfunction (P<0.001). After 12 weeks and 26 weeks of treatment, 82% and 79% of patients receiving sildena®l reported improved erections, compared with 24% and 23% of patients receiving placebo, respectively (P<0.001). Treatment-related adverse events were mild to moderate and occurred in 27% of patients receiving sildena®l, compared with 8% of patients receiving placebo. Conclusion Sildena®l is an effective and well-tolerated treatment for men with erectile dysfunction of a broad spectrum of aetiology.
Among the 911 cases of carcinoma of the breast treated between 1969 and 1978 there were 39 cases of bilateral primary cancer. Of these, 17 were synchronous tumours defined as cancers diagnosed and treated during the same primary hospital admission. The remaining 22 patients had tumours that were diagnosed separately (metachronous tumours), with a mean time interval of 5 years and 8 months between presentation of first and second primaries (range 6 months to 20 years). Of the metachronous tumours, 20 had presented within 7 years of the diagnosis of the first primary (2.2 per cent of all patients). The patients with synchronous disease fared badly, but patients in the metachronous group had a good prognosis. This is due, at least in part, to the inherent selection of patients in the metachronous group who have to survive the first primary tumour in order to develop the second. However, careful follow-up after the first primary may also account for the relatively good prognosis of this group. We therefore recommend continuing regular out-patient follow-up, with careful examination of the second breast, for all patients having undergone treatment for cancer of the breast.
Approximately 10% of patients with Peyronie's disease require surgery for penile angulation or erectile failure severe enough to make coitus difficult or impossible. The results of three different operations performed on 200 patients over the period 1975 to 1984 have been reviewed. The results of plaque excision and dermal grafting in nine patients were disappointing and since 1977, Nesbit's procedure has been performed in 179 patients with excellent results in 53% and moderate results in 19%. Poor results (28%) were usually due to erectile failure and this was usually present pre-operatively. Such patients are better treated by the implantation of penile prostheses and excellent (8) or moderate (2) results were seen in 12 patients so treated. The number of patients with poor results after a Nesbit's procedure increased from 14% at 3 months to 28% at 36 months, but then remained fairly constant. Prolonged follow-up is therefore needed to allow valid conclusions about the ultimate outcome of surgery.
Approximately 10% of patients with Peyronie's disease require surgery for penile angulation or erectile failure severe enough to make coitus difficult or impossible. The results of three different operations performed on 200 patients over the period 1975 to 1984 have been reviewed. The results of plaque excision and dermal grafting in nine patients were disappointing and since 1977, Nesbit's procedure has been performed in 179 patients with excellent results in 53% and moderate results in 19%. Poor results (28%) were usually due to erectile failure and this was usually present pre-operatively. Such patients are better treated by the implantation of penile prostheses and excellent (8) or moderate (2) results were seen in 1 2 patients so treated. The number of patients with poor results after a Nesbit's procedure increased from 14% at 3 months to 28% at 36 months, but then remained fairly constant. Prolonged follow-up is therefore needed t o allow valid conclusions about the ultimate outcome of surgery
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.