Oral Phentolamine as Treatment for Erectile Dysfunction

Becker, Armin J.; Stief, Christian G.; Machtens, S.; Schultheiss, Dirk; Hartmann, Uwe; Truß, Michael C.; Jonas, Udo

doi:10.1016/s0022-5347(01)63559-6

Cited by 83 publications

(29 citation statements)

References 16 publications

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“…Zorgniotti reported a 42% rate of full spontaneous erections after buccal administration of 50 mg of phentolamine. 9 Becker has carried out a double-blind placebo-controlled study in 40 men with ED treated with varying doses of phentolamine: full erections were achieved by 20% of the placebo group, 30% in the group treated with 20 mg and 50% in the group with 50 mg. 10 Recently, Goldstein has reported the results of large multicenter, placebo-controlled pivotal phase III clinical trials: the mean change in the erectile function was significantly higher following use of phentolamine (40 mg or 80 mg) compared to placebo and there were no severe adverse events. 11 Doxazosin is an alpha 1 selective anti-adrenergic drug; there are few studies on its oral use for ED therapy.…”

Section: Discussionmentioning

confidence: 99%

Combined oral therapy with sildenafil and doxazosin for the treament of non-organic erectile dysfunction refractory to sildenafil monotherapy

et al. 2002

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The purpose of this work was to investigate the efficacy and safety of sildenafil in combination with doxazosin for the treatment of non-organic erectile dysfunction in patients who did not respond to sildenafil. We enrolled 28 patients with non-organic erectile dysfunction, for whom 3 months of sildenafil monotherapy had failed. They were divided in two random and homogeneous groups: 14 were treated with doxazosin (4 mg daily) and sildenafil (100 mg 1 h before sexual intercourse); the other 14 patients received sildenafil and placebo. The results were assessed by means of the IIEF questionnaire before the beginning of the study, after 30 days of therapy and after 60 days. Of the 14 patients treated with doxazosin and sildenafil, 11 (78.6%) showed a statistically significant increase of IIEF; in the placebo group, only one patient (7.1%) recorded a significant IIEF increase. The differences observed in the two groups were statistically very significant (P ¼ 0.0016). Blood pressure did not show significant alterations. Side effects were minimal and even present during sildenafil monotherapy. The combination therapy with sildenafil and doxazosin resulted in the safe and effective treatment of men with non-organic erectile dysfunction for whom sildenafil alone had failed.

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Section: Discussionmentioning

confidence: 99%

Combined oral therapy with sildenafil and doxazosin for the treament of non-organic erectile dysfunction refractory to sildenafil monotherapy

et al. 2002

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“…Combinations of vasoactive intestinal peptide (VIP) and phentolamine have been tested in pilot studies as intracavernosal therapeutics. 68,69 In a recent clinical trial, Becker et al 70 evaluated the ef®cacy of oral phentolamine mesylate in treatment of men with erectile dysfunction. The authors concluded that oral phentolamine may be of bene®t for the treatment of erectile dysfunction.…”

Section: Alpha Adrenergic Receptor Blockade In Erectile Dysfunctionmentioning

confidence: 99%

Role of alpha adrenergic receptors in erectile function

et al. 2000

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Penile erection is a complex physiological process in which the regulation of penile hemodynamics depends on signal input from central and peripheral nervous systems, and on the balance and interplay between several local physiological mediators (neurotransmitters, vasoactive agents and endocrine factors). A role for the sympathetic nervous system in attaining or maintaining penile¯accidity and detumescence is well recognized. However, the exact mechanisms of alpha-adrenergic receptor mediated erectile function remain poorly de®ned. The objective of this review is to summarize data presented in the literature and from our laboratory on alpha-adrenergic receptors, and to discuss the conceptual framework by which the alphaadrenergic receptor pathway modulates penile corpus cavernosum smooth muscle contractility. We will integrate the current state of knowledge of penile erection into one framework encompassing the biochemical and physiological pathways responsible for trabecular smooth muscle relaxation (erection) and contraction (detumescence). We will focus our discussion on local control mechanisms of alpha-adrenergic receptors and explore the following topics: (1) functional activity of alpha-1 and alpha-2 adrenergic receptors in the physiology of human penile erection; (2) identi®cation, classi®cation and characterization of alpha-1 and alpha-2 adrenergic receptor subtypes in human penile erectile tissue; (3) molecular mechanism of action of alpha-1 and alpha-2 adrenergic receptors in human penile erectile tissue; (4) blockade of alpha-1 and alpha-2 adrenergic receptor action by selective and non-selective alpha-1 and alpha-2 adrenergic receptor antagonists (blockers); (5) physiologic (functional) antagonism of alpha-1 and alpha-2 adrenergic receptor activity by vasodilators mediating smooth muscle relaxation; and (6) key areas of consensus, as well as critical gaps in the existing scienti®c knowledge concerning the rationale and the potential use of alpha-blockers in erectile function.

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“…Good response was found with psychogenic or mild vascular ED but very poor responses were reported in those with serious vascular involvement. 22,24 Clinical trials may soon resume with this product.…”

Section: Oral Therapymentioning

confidence: 99%

Medical and surgical advances in the radical prostatectomy patient

Nehra

2000

Int J Impot Res

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Maintaining the quality of life after surgery in the radical prostatectomy patient is of paramount importance. One of the major dilemmas in surgical management of radical retropubic prostatectomy (RRP) is preservation of the neurovascular bundle and, hence, erectile function and the continence mechanism. This manuscript addresses anatomical considerations for the surgeon and discusses the following issues with regard to medical and surgical therapies: (1) incidence of erectile dysfunction solely due to complications during RRP; (2) nerve damage during RRP; (3) vascular damage during RRP; (4) current medical and surgical therapies for restoring or maintaining potency; and (5) new advances on the horizon for management of the prostatectomy patient.

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Oral Phentolamine as Treatment for Erectile Dysfunction

Abstract: Our results indicate that oral phentolamine may be of benefit for the treatment of erectile dysfunction. Further studies are required to corroborate our findings.

Cited by 83 publications

References 16 publications

Combined oral therapy with sildenafil and doxazosin for the treament of non-organic erectile dysfunction refractory to sildenafil monotherapy

Combined oral therapy with sildenafil and doxazosin for the treament of non-organic erectile dysfunction refractory to sildenafil monotherapy

Role of alpha adrenergic receptors in erectile function

Medical and surgical advances in the radical prostatectomy patient

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