Effect of sildenafil in cavernous arteries of patients with erectile dysfunction

Abstract

Introduction: Sildenafil citrate is a type 5 phosphodiesterase inhibitor, which has demonstrated excellent results in the treatment of erectile dysfunction. The effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction has not been established yet. The objective of this study was to assess the effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction, following an intracavernous injection of alprostadil.Materials and Methods: 29 male patients, with mean age of 53.8 years (32 to 75 years), were prospectively evaluated. The mean time with complaint of erectile dysfunction was 50.5 months (6 to 168 months). Each patient was his own control. Patients underwent a measurement of peak systolic velocity before and after use of sildenafil citrate associated with 5 micrograms of alprostadil, through ultrasonic velocitometry Knoll/MIDUS® system. In the interval between measurements, approximately 15 days, patients used 3 tablets of sildenafil at home with their partners.Results: Using only 5 mcg of alprostadil, average peak systolic velocity was 23.9 cm/s, and when associated to 50 mg of sildenafil it was 24.8 cm/s. Despite the increase in the flow rate caused by sildenafil, the difference was not statistically significant, Z calculated = -0.695 NS (Wilcoxon test). Twenty one of the 29 patients (72.4%) showed global improvement in sexual performance with the use of sildenafil citrate at home. There was not a statistically significant correlation between the global response to sildenafil citrate and the increase in the peak systolic velocity.Conclusion: We concluded that, even though the use of 50 mg of sildenafil citrate associated with 5 mcg of alprostadil provides an increase in the peak systolic velocity of the cavernous arteries, there was no statistic difference in relation to alprostadil alone. There was no correlation between the global response to sildenafil and the increase in the peak systolic velocity.

Pathophysiology, evaluation and treatment of erectile dysfunction: review article

“…Diversos estudos clínicos demonstraram uma taxa de sucesso no uso de Sildenafil entre 70% a 90% 3,72 . A ação do Sildenafil foi demonstrada através de pletismografia peniana, com uma duração da rigidez 60% maior em relação ao placebo 73 . Foi realizado um estudo prospectivo, comparativo, tipo caso-controle, no qual cada paciente era seu próprio controle, com 29 pacientes, com idades entre 32 e 75 anos e com queixa de DE 72,73 .…”

“…A ação do Sildenafil foi demonstrada através de pletismografia peniana, com uma duração da rigidez 60% maior em relação ao placebo 73 . Foi realizado um estudo prospectivo, comparativo, tipo caso-controle, no qual cada paciente era seu próprio controle, com 29 pacientes, com idades entre 32 e 75 anos e com queixa de DE 72,73 . Os pacientes utilizaram três comprimidos de Sildenafil 50mg antes de relações sexuais em casa por 15 dias e um comprimido 1h antes do acompanhamento com os pesquisadores.…”