Acetyl-l-carnitine plus propionyl-l-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy

Cavallini, Giorgio; Modenini, Fabio; Vitali, Giuseppe; Koverech, Aleardo

doi:10.1016/j.urology.2005.05.014

Cited by 45 publications

(46 citation statements)

References 19 publications

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“…Using the database search strategy, a total of 77 records were retrieved from Cochrane Library, PubMed, Embase, AMED, CINAHL and the National Health Service Research Register, of which eight RCTs [25]–[32] finally met full inclusion criteria for this review. There were no original clinical trials studied the new generation of PDE5-Is (lodenafil or mirodenafil or udenafil) for post-RP ED.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of the Use of Phosphodiesterase Type 5 Inhibitors for Treatment of Erectile Dysfunction following Bilateral Nerve-Sparing Radical Prostatectomy

Wang

Liu

et al. 2014

PLoS ONE

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Prostate cancer is relatively common cancer occurring in males. Radical prostatectomy (RP) is the most effective treatment for a localized tumor but erectile dysfunction (ED) is common complication, even when bilateral nerve-sparing RP (BNSRP) is performed. Clinical trials have shown varied effectiveness of phosphodiesterase type-5 inhibitors (PDE5-Is) for treatment of post-BNSRP ED, but there remains controversy over the application of this treatment and no formal systematic review and meta-analysis for the use of PDE5-Is for this condition has been conducted. This review was to systematically assess the efficacy and safety of oral PDE5-Is for post-BNSRP ED. A database search was conducted to identify randomized controlled trials (RCTs). The comparative efficacy of treatments was analyzed by fixed or random effect modeling. Erectile function was measured using the International Index of Erectile Function (IIEF), Sexual Encounter Profile (SEP) question-2, 3 and the Global Assessment Question (GAQ). The rate and incidence of adverse events (AEs) were determined. The quality of included studies was appraised using the Cochrane Collaboration bias appraisal tool. Eight RCTs were included in the analyses. PDE5-Is were effective for treating post-BNSRP ED compared to placebo when erectile function was determined using the IIEF score [mean difference (MD) 5.63, 95% confidence interval (CI) (4.26–6.99)], SEP-2 [relative risk (RR) 1.63, 95% CI (1.18–2.25) ], SEP-3 [RR 2.00, 95% CI (1.27–3.15) ] and GAQ [RR 3.35, 95% CI (2.68–4.67) ]. The subgroup analysis could find a trend that longer treatment duration, higher dosage, on-demand dosing, sildenafil and mild ED are associated with more responsiveness to PDE5-Is. PDE5-Is were overall well tolerated with headache being the most commonly reported AE. Our data provides compelling evidence for the use of PDE5-Is as a primary treatment for post-BNSRP ED. However, further studies are required to optomize usage parameters (such as dosage and duration of treatment).

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Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of the Use of Phosphodiesterase Type 5 Inhibitors for Treatment of Erectile Dysfunction following Bilateral Nerve-Sparing Radical Prostatectomy

Wang

Liu

et al. 2014

PLoS ONE

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“…A follow-up study showed significantly higher IIEF scores in men using combination PDE5I plus PLC and acetyl-L-carnitine when compared with PDE5I monotherapy in patients undergoing bilateral nervesparing radical prostatectomy for prostate cancer. 38 It is currently thought that both PLC and acetyl-L-carnitine function as antifibrotic and antioxidative compounds.…”

Section: Pde5i Plus Other Medicationsmentioning

confidence: 99%

Combination therapy for erectile dysfunction: an update review

Dhir¹,

Lin

Canfield³

et al. 2011

Asian J Androl

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The introduction of oral phosphodiesterase-5 inhibitors (PDE5Is) in the late 1990s and early 2000s revolutionized the field of sexual medicine and PDE5Is are currently first-line monotherapy for erectile dysfunction (ED). However, a significant proportion of patients with complex ED will be therapeutic non-responders to PDE5I monotherapy. Combination therapy has recently been adopted for more refractory cases of ED, but a critical evaluation of current combination therapies is lacking. A thorough PubMed and Cochrane Library search was conducted focusing on the effectiveness of combination therapies for ED in therapeutic non-responders to PDE5I therapy. Journal articles spanning the time period between January 1990 and December 2010 were reviewed. Criteria included all pertinent review articles, randomized controlled trials, cohort studies and retrospective analyses. References from retrieved articles were also manually scanned for additional relevant publications. Published combination therapies include PDE5I plus vacuum erectile device (VED), intraurethral medication, intracavernosal injection (ICI), androgen supplement, a-blocker or miscellaneous combinations. Based on this review, some of these combination treatments appeared to be quite effective in preliminary testing. Caution must be advised, however, as the majority of combination therapy articles in the last decade have numerous limitations including study biases and small subject size. Regardless of limitations, present combination therapy research provides a solid foundation for future studies in complex ED management. 1 Current projections indicate an increase in the prevalence of ED due to aging as well as the continued abundance of comorbidities such as coronary artery disease, hypertension and diabetes in industrialized nations. Over 320 million people in Westernized nations will be affected by 2025, more than double the prevalence seen 15 years ago, indicating a growing need to reevaluate ED therapeutic strategies.2 Over the past four decades, the treatment of ED has evolved rapidly and is still changing with new discovery. Before the 1970s, psychotherapy was the primary means of treatment and undoubtedly was limited in its success. During the 1970s, penile prostheses combined with psychotherapy remained popular but relatively inaccessible. The 1980s was dominated by intracavernous injection (ICI) and followed by intraurethral therapy in the mid-1990s. Despite this transition towards non-surgical management, available treatment modalities were not patient-friendly. The introduction of oral phosphodiesterase-5 inhibitors (PDE5Is) in the late 1990s and early 2000s revolutionized the field of sexual medicine and PDE5Is are currently first-line monotherapy.

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“…Recentemente uma meta-análise envolvendo os oito subtipos dos inibidores do PDE5 disponíveis no mercado farmacêutico mundial demonstrou que o principal efeito colateral é a cefaléia 8 . Dependendo destes estudos a prevalência da cefaléia variou entre 4,6 à 30,4% dos pacientes utilizando esta classe de medicamento [9][10][11][12][13][14] . Os mecanismos fisiopatológicos desta cefaléia parecem estar diretamente relacionados com o potencial inibidor sobre o PDE5.…”

Section: Discussionunclassified

Cefaléia Induzida Pela Tadalafila - Relato De Caso E Revisão Da Literatura

Piovesan

2014

Rev. Med. UFPR

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RESUMOCefaléia secundária ao uso de medicamentos é freqüente e subdiagnosticada na prática médica. Relatamos o caso de um paciente que após o uso de tadalafila desenvolveu uma cefaléia relacionada com atividade sexual. Discutimos os aspectos semiológicos das cefaléias relacionadas com o uso de drogas, com atividade sexual e finalmente comentamos aspectos relacionados com a cefaléia thunderclap primárias e secundárias.Palavras-chave: Cefaléia Thunderclap; Cefaléia Induzida por Drogas; Cefaléia Relacionada com Atividade Sexual; Tadalafila. ABSTRACTHeadache secondary to drug use are frequent and underdiagnosed in daily clinical practice. We report the case of a patient that developed headache related to sexual activity after the use of tadalafil. We discuss the semiologic aspects of the drug induced headache, headaches related with sexual activity, and finally the primary and secondary thunderclap headaches.

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Acetyl-l-carnitine plus propionyl-l-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy

Cited by 45 publications

References 19 publications

Systematic Review and Meta-Analysis of the Use of Phosphodiesterase Type 5 Inhibitors for Treatment of Erectile Dysfunction following Bilateral Nerve-Sparing Radical Prostatectomy

Systematic Review and Meta-Analysis of the Use of Phosphodiesterase Type 5 Inhibitors for Treatment of Erectile Dysfunction following Bilateral Nerve-Sparing Radical Prostatectomy

Combination therapy for erectile dysfunction: an update review

Cefaléia Induzida Pela Tadalafila - Relato De Caso E Revisão Da Literatura

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