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

Soler, J.-M.; Prévinaire, J G; Denys, Pierre; Chartier‐Kastler, Emmanuel

doi:10.1038/sj.sc.3101950

Cited by 61 publications

(54 citation statements)

References 18 publications

(34 reference statements)

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“…The type of method used depends on the patient's comfort, preferences, and type of dysfunction. Studies have demonstrated PDE5 inhibitors to be safe in men with SCI (12,13). In this present study, 44.7% of the patients used PDE5 inhibitors and 17% used papaverine injections.…”

Section: Discussionmentioning

confidence: 87%

Sexuality and sexual dysfunction in spinal cord-injured men in Turkey

Akman¹,

Çelik²,

Karataş³

2015

Turk J Med Sci

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Background/aim: To provide a comprehensive evaluation of sexual function and dysfunction in spinal cord-injured men based on self-reports of patients.Materials and methods: Forty-seven spinal cord-injured men who completed the spinal shock and rehabilitation period were included.Patients were asked to complete a questionnaire developed to assess social status, sexual activities, abilities, and sexuality education after injury. Neurologic levels of patients were classified according to American Spinal Cord Injury Association protocol. Erectile function was evaluated by International Index of Erectile Function-5 (IIEF-5) questionnaire. Results:Patients were aged between 20 and 62 years (mean: 35.2). Twenty-eight patients had T10 and above, 15 between T11 and L2, and 4 cauda conus injury. While 61.7% of the patients declared sexual activity, 93.6% declared some degree of erection. Mean IIEF-5 score was 5.3 and 87.3% of the patients had moderate to severe erectile dysfunction. Conclusion:Continuation of sexual activity after injury is very important and has a great impact on quality of life and interpersonal relationships for spinal cord-injured men. More attention must be given to sexuality after spinal cord injury. A very high rate of sexual dysfunction in spinal cord-injured patients was found and the importance of sexual education was emphasized in this study.

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Section: Discussionmentioning

confidence: 87%

Sexuality and sexual dysfunction in spinal cord-injured men in Turkey

Akman¹,

Çelik²,

Karataş³

2015

Turk J Med Sci

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“…33 However, therapies for ED caused by SCI remain challenging, and PDE5 inhibitors, vacuum devices, penile implants, intraurethral prostaglandins, percutaneous perineal electrostimulation, transdermal nitroglycerin, intracavernous injection of papaverine and some other therapies are still under debate. [33][34][35][36][37][38][39] The aim of this systematic review focused on comprehensively appraising efficacy and safety of PDE5 inhibitors in patients with SCI. In the present review, a large portion of ED patients secondary to SCI greatly benefited from PDE5 inhibitors (sildenafil, vardenafil or tadalafil).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of phosphodieterase-5 inhibitors for treatment of erectile dysfunction secondary to spinal cord injury: a systemic review and meta-analysis

Cheng

et al. 2016

Spinal Cord

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Objective: We carried out a systematic review and meta-analysis to assess the efficacy and safety of phosphodieterase-5 (PDE5) inhibitors on erectile dysfunction (ED) secondary to spinal cord injury (SCI). Methods: A literature review was performed to identify all published randomized, double-blind, placebo-controlled trials of PDE5 inhibitors for treatment of ED secondary to SCI. The search included the following database: MEDLINE, EMBASE and the Cochrane Library. The outcomes and complications analyzed involved the Global Efficacy Question (GEQ), sexual encounter profile diary question 2 and 3 (SEP2 and SEP3) and adverse events. All statistical analysis was performed using Stata 12.0 software (Stata Corp., College Station, TX, USA). Results: Six publications were used in analysis, including six randomized controlled trials that compared PDE5 inhibitors with placebo. Compared with placebo, PDE5 inhibitors were associated with significant improvements in GEQ (OR 11.997, 95% CI 8.073-17.830, Po0.0001), SEP2 (RR 1.847, 95% CI 1.561-2.185, Po0.0001) and SEP3 (RR 2.738, 95% CI 2.084-3.598, Po0.0001). Despite significant greater incidences of some adverse events observed (headache: RR 3.717, 95% CI 2.309-5.982, Po0.0001; flushing: RR 9.281, 95% CI 2.858-30.147, Po0.0001; gastrointestinal discomfort: RR 9.064, 95% CI 2.116-38.827, P = 0.003), most adverse events were mild to moderate and transient. Conclusions: This systematic review and meta-analysis indicate that PDE5 inhibitors are effective and well tolerated to treat ED secondary to SCI compared with placebo, as measured by response to GEQ, SEP2, SEP3 and incidence of adverse events. PDE5 inhibitors could be considered as the first choice in the treatment of ED patients with SCI. INTRODUCTIONApproximately 11 000 new cases are estimated to suffer from spinal cord injury (SCI) in America each year and 60% of them are between 16 and 30 years of age. Moreover, men account for 82% of all patients with SCI. 1,2 Erectile dysfunction (ED) is a common condition in individuals with SCI. 3 A high prevalence of ED is reported in about 80% of SCI patients. 4 It is an especially bothersome condition in young men who usually had an active sexual activity before their accident. 5 ED is defined as the persistent inability to achieve or maintain a penile erection for satisfactory sexual performance. 6 Most men with SCI have some type of penile erection, but it is usually not hard enough or does not last long enough for sexual life. 1 ED not only often results in disorder of self-esteem but also deteriorates partner relationship. Hence, ED has a negative effect on the life of men and their sexual partner. 7 Health-care providers deem sex life significant in the process of rehabilitation after SCI and give high priority to improving sexual activity for subjects with SCI. 8,9 Nitric oxide (NO) released by nonadrenergic-noncholinergic nerves in the penis has an important role in initiating and maintaining of the

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“…Because of the broad and fluid nature of these sexual terms, they may be interpreted very differently, by subjects and researchers alike, hence altering the meaning of the data collected. Many tools are commonly used in sexual assessment SCI studies today, including the International Index of Erectile Function (IIEF) [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] and the Female Sexual Function Index (FSFI), 32,40,41 however, neither of these have been validated specifically for SCI. As with the reviewed outcome measures, the tools currently used also lack defined nomenclature to describe sexual aspects of functioning after SCI.…”

Section: Discussionmentioning

confidence: 99%

Sexual health outcome measures for individuals with a spinal cord injury: a systematic review

et al. 2007

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Study Design: A systematic review of all sexual health outcome measures reporting psychometric properties for a spinal cord injury (SCI) population. Objectives: To evaluate the psychometric evidence for sexual health outcome measures used in a SCI population in order to (1) determine the clinical relevance of current tools and (2) suggest recommendations for future tool development. Setting: Vancouver, British Columbia, Canada. Methods: Electronic databases were searched for articles reporting psychometric properties of sexual health outcome measures used in a SCI population. The search was

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

Cited by 61 publications

References 18 publications

Sexuality and sexual dysfunction in spinal cord-injured men in Turkey

Sexuality and sexual dysfunction in spinal cord-injured men in Turkey

Efficacy and safety of phosphodieterase-5 inhibitors for treatment of erectile dysfunction secondary to spinal cord injury: a systemic review and meta-analysis

Sexual health outcome measures for individuals with a spinal cord injury: a systematic review

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