Prognostic Factors for Response to Sildenafil in Patients with Erectile  Dysfunction

Martínez-Jabaloyas, J.M.; Gil-Salom, Manuel; Villamón-Fort, Rafael; Pastor-Hernández, Francisco; Martínez‐García, Roberto; García-Sisamón, Francisco

doi:10.1159/000049850

Cited by 81 publications

(77 citation statements)

References 19 publications

(30 reference statements)

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“…4 The current results suggested that favorable NPT was an independent factor related to efficacy. This is similar to a previous report, 5 because high NPT results imply that baseline erectile function is favorable. Moreover, favorable NPT might be related to the possibility of a psychogenic cause for ED, for which the efficacy of sildenafil was also high in the current study group.…”

Section: Discussionsupporting

confidence: 92%

“…4 In this study, the current smokers were defined as 'smokers', and the patients with moderate or severe alcohol abuse, as suffering from 'alcoholism'. 5 The definition of the National Institutes of Health (NIH) Consensus on ED, which defined impotence as the consistent inability to attain and maintain a penile erection sufficient to permit satisfactory sexual intercourse, was used in this study. 6 Sildenafil was administered with doses from 25 to 50 mg.…”

Section: Methodsmentioning

confidence: 99%

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Outcome analysis of sildenafil citrate for erectile dysfunction of Japanese patients

et al. 2005

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The approved maximal dose of sildenafil is only 50 mg in Japan, but the impact of dose regulation on treatment outcomes has not been established. Moreover, the contributors to the efficacy in patients having an intact peripheral nervous system have not been fully elucidated. We assessed in Japanese patients the treatment outcomes of sildenafil for erectile dysfunction (ED) under regulation of the approved dose and identified factors contributing to its efficacy among those with various etiologies other than pelvic surgery. We retrospectively reviewed 196 ED patients treated with sildenafil. The overall efficacy was 70.9% (139/196), and patients with psychological problems and concomitant cardiovascular disease showed high response rates (82.4 and 87.0%, respectively). Of the 139 responders, 89.9% achieved efficacy with a dose of 25 or 50 mg. Logistic regression analysis revealed concomitant cardiovascular disease and a favorable nocturnal penile tumescence result to be independent contributors to the efficacy.

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Outcome analysis of sildenafil citrate for erectile dysfunction of Japanese patients

et al. 2005

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“…While the efficacy in hypertension patients was similar to or lower than that in patients with normal blood pressure, it was higher than that in hypertension patients on placebo. 14,17,18,20 The odds ratio showed that this decrease in efficacy was statistically significant in the present study.…”

Section: Discussionsupporting

confidence: 55%

“…Lower efficacy in patients suffering from diabetes was also found in Western studies. 17,18 Although lower efficacy was reported in diabetic patients compared to nondiabetic patients, sildenafil was found to increase erectile function in diabetic patients when compared to diabetic patients taking a placebo. 19 The meta-analysis by Fink et al 14 indicated that sildenafil was less efficacious in patients aged more than 65, compared to younger patients.…”

Section: Discussionmentioning

confidence: 99%

Post-marketing surveillance study of the safety and efficacy of sildenafil prescribed in primary care to erectile dysfunction patients

et al. 2004

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In order to investigate the safety and efficacy of sildenafil prescribed in primary care, a post-marketing surveillance study was undertaken. A total of 651 men with erectile dysfunction (ED) were enrolled from 31 family physicians in Korea from December 1999 to July 2002. Patients were regularly followed up to ascertain the safety and efficacy of sildenafil. Of the 651 patients enrolled, 572 (87.9%) returned for safety evaluation and efficacy assessment. In all, 458 (80.1%) of 572 patients reported improved erectile function with sildenafil. Hypertension, diabetes and low-dose sildenafil were associated with poor efficacy. A total of 71 adverse events were reported among 56 patients (8.6%), with the most frequent being hot flushes (5.6%), followed by headache (2.6%), palpitation (1.0%), anxiety (0.5%) and elevated ALT (0.5%). Only six patients (1.0%) discontinued sildenafil as a direct result of adverse events. These results suggest that sildenafil prescribed by primary care physicians was well tolerated and improved erectile function in patients with ED.

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“…All patients with erectile dysfunction should be offered PDE-5 inhibitor pharmacotherapy. 24,25 As there have been no studies into this therapy in relation to Peyronie's disease, 26 this area needs further assessment with double-blind placebo-controlled randomized controlled trials. 2.…”

Section: Discussionmentioning

confidence: 99%

Should assessment of penetrative sexual activity be used as the treatment arbiter in the management of Peyronie's disease?

et al. 2011

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Peyronie's disease is an inflammatory disorder, which causes thickening of the tunica albuginea of the penis. Peyronie's disease has a variable natural history and the assessment and management of the disease has yet to be standardised. The case notes of 97 patients with a diagnosis of Peyronie's disease were retrospectively reviewed at a single tertiary referral centre. Patients who were able to achieve sexual penetrative activity to the satisfaction of both partners were managed conservatively. Patients who were unable to achieve penetrative sexual activity were given intra-cavernosal prostaglandin, with those achieving a satisfactory erection being offered appropriate surgical intervention. The mean age at presentation was 50 years (range 18-82). A total of 59 (61%) men were able to have penetrative sex at the time of presentation. Following initial conservative management, only five (8%) of this group had disease progression, which stopped them from being able to penetrate. In all 38 (39%) men who were not able to penetrate at presentation were offered surgical intervention. In all 24 (63%) of these men chose to have surgical intervention. Tunical plication resulted in the ability to penetrate in 77% of men choosing this option whereas only 46% of men undergoing autologous saphenous vein grafting were able to have penetrative sex. Assessment of penetrative sexual function is an essential component of the management of patients with Peyronie's disease. This enables appropriate counselling with respect to possible conservative management or the most appropriate surgical intervention. The majority of patients with Peyronie's disease can achieve sexual penetrative activity, many without surgical intervention.

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Prognostic Factors for Response to Sildenafil in Patients with Erectile Dysfunction

Cited by 81 publications

References 19 publications

Outcome analysis of sildenafil citrate for erectile dysfunction of Japanese patients

Outcome analysis of sildenafil citrate for erectile dysfunction of Japanese patients

Post-marketing surveillance study of the safety and efficacy of sildenafil prescribed in primary care to erectile dysfunction patients

Should assessment of penetrative sexual activity be used as the treatment arbiter in the management of Peyronie's disease?

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