Efficacy, safety and predictive factors of therapeutic success with sildenafil for erectile dysfunction in patients with different spinal cord injuries

Ramos, Ancelmo; Vidal, Joan; Jáuregui, M Luisa; Barrera, Manuel Pastor; Recio, Clara Sonia Alayón; Giner, Miguel Angel; Toribio, L; Salvador, Sebastián; Sanmartín, Abel Pallarés; Fuente, Macarena De La; Santos, JF; Juan, FJ de; Moraleda, Susana; Mendez, J Molina; Ramírez, Leonardo Gutiérrez; Casado, RM

doi:10.1038/sj.sc.3101210

Cited by 65 publications

(50 citation statements)

References 10 publications

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“…These results are in line with other randomized or placebo-controlled studies. 8,[10][11][12][14][15][16] The adverse effects of PDE5 inhibitors were mild in 6-15% of the patients. No episode of severe hypotension was experienced, probably because patients prone to blood pressure instability were excluded from this study.…”

Section: Discussionmentioning

confidence: 99%

“…In these cases, PDE5 inhibitors amplify the physiological NO/cGMP mechanism and reinforce the existing mechanical erection. 8,15 Home-based assessments showed that PDE5 inhibitors significantly improve the sexual life of SCI patients, particularly in the IIEF domains of erectile function, intercourse satisfaction and overall satisfaction for the three drugs. These results are in line with other randomized or placebo-controlled studies.…”

Section: Discussionmentioning

confidence: 99%

“…5,19 Orgasm feeling is poor in most SCI patients, as reflected by clinical studies using the IIEF questionnaire. 8,11,15 Although the issue of orgasm in SCI men has been rarely addressed, it seems that orgasm is often accompanied by ejaculation, 20 as in normal men. The reason why the improvement of orgasmic function is obtained with Sildenafil only is not clear.…”

Section: Discussionmentioning

confidence: 99%

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Phosphodiesterase inhibitors in the treatment of erectile dysfunction in spinal cord-injured men

Soler¹,

Prévinaire

Denys

et al. 2006

Spinal Cord

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Phosphodiesterase inhibitors in the treatment of erectile dysfunction in spinal cord-injured men

Soler¹,

Prévinaire

Denys

et al. 2006

Spinal Cord

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“…2,[6][7][8][13][14][15][16] In all these studies, sildenafil was reported to have notable efficacy for obtaining and maintaining an erection in patients with SCI. However, in many of these studies, 2,6,7 patients with neurological levels of SCI above T5 were systematically excluded due to the potential risk of autonomic dysreflexia and, especially, of hypotension. Similarly, many of the studies excluded individuals with hypotension (systolic/diastolic blood pressure o90/50 mmHg, respectively).…”

Section: Introductionmentioning

confidence: 98%

“…In total, 80% of these patients have some type of erection, either reflex, psychogenic or mixed. 2 However, most of these erections are inadequate to engage in satisfactory sexual contacts and usually require some type of therapeutic intervention.…”

Section: Introductionmentioning

confidence: 99%

Determination of changes in blood pressure during administration of sildenafil (Viagra®) in patients with spinal cord injury and erectile dysfunction

et al. 2005

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Study design:Prospective, open-label, comparative study, to assess the effects of sildenafil on blood pressure in a population of patients with spinal cord injury (SCI). Objectives: To determine the effect of sildenafil on blood pressure in patients with erectile dysfunction secondary to SCI by comparing changes in blood pressure in SCI patients with a neurologic level below T5 versus higher levels. To establish a relationship between the potential hypotensive effect and protective muscle spasm against blood pressure reduction. To assess the effects of age, complexity and duration of SCI on changes in blood pressure. To record any adverse effects occurring during the study. Setting: Spinal Cord Injury Unit, Insular University Hospital of Gran Canaria, Canary Islands, Spain. Subjects: In total, 22 male SCI patients aged 18 years or older with a history of SCI greater than 3 months in duration. Methods: Patients with erectile dysfunction secondary to SCI were induded in the study, without excluding patients with a neurologic level above 75 or asymptomatic low blood pressure. Patients with specific contraindications for use of the drug were excluded. A personal history was obtained, and the level of injury (ASIA/IMSOP scales of international standards), impairment grade (ASIA impairment scale), spasticity grade (modified Ashworth scale) and baseline sitting and supine blood pressure values were determined. A single dose of 50 mg of sildenafil was administered, and patients remained sitting at 451. Blood pressure was monitored every 10 min for 4 h and whenever the patient reported symptoms. Any relevant signs and symptoms manifested during the study period were also recorded. Analysis of the changes in blood pressure values was performed using a paired t-test in each group of patients according to neurologic level and spasticity grade. Results: A decrease in blood pressure was observed in all patients, although patients with a level of injury at T5 or above and those with a complete SCI showed a less intense decrease (Po0.05). The spasticity grade of the patients was protective against the fall in blood pressure, as it was less significant in patients with grade 3 (P40.1) than in those with grade 0. Adverse effects were few and transient. None were related to hypotension. Conclusion: Sildenafil caused a decrease in blood pressure in SCI patients with a neurologic level of injury above T5 and complete injuries (grade A), but did not have clinical implications in the patients studied. A higher spasticity grade tends to protect the patient from the fall in blood pressure. Age and duration of injury do not appear to influence this decrease.

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Current Awareness

2002

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 19 sections: 1 Books, Reviews & Symposia; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Efficacy, safety and predictive factors of therapeutic success with sildenafil for erectile dysfunction in patients with different spinal cord injuries

Abstract: Spanish Society of Paraplegia.

Cited by 65 publications

References 10 publications

Phosphodiesterase inhibitors in the treatment of erectile dysfunction in spinal cord-injured men

Phosphodiesterase inhibitors in the treatment of erectile dysfunction in spinal cord-injured men

Determination of changes in blood pressure during administration of sildenafil (Viagra®) in patients with spinal cord injury and erectile dysfunction

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