Combination of Vacuum Erection Device and PDE5 Inhibitors as Salvage Therapy in PDE5 Inhibitor Nonresponders with Erectile Dysfunction |
| |
| Authors: | Onder Canguven James Bailen William Fredriksson David Bock Arthur L. Burnett |
| |
| Affiliation: | 2. Metropolitan Urology, PSC, Jeffersonville, IN, USA;;3. Idaho Urologic Institute, Meridian, ID, USA;;4. Kansas City Urology Care, Overland Park, KS, USA;;5. Department of Urology, Johns Hopkins Medical Institutions, Baltimore, MD, USA;2. The James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD, USA;3. Division of Urology, University of Western, ON, Canada;4. Sexology & STDs, Cairo University, Cairo, Egypt;5. Neuro-Urology-Andrology Unit, Department of Physical Medicine and Rehabilitation, Raymond Poincaré Hospital, Garches, France;6. Instituto H.Ellis, São Paulo, Brazil;7. Department of Urology, Section of Andrology and Male Infertility, Tulane University School of Medicine, New Orleans, LA, USA;8. Unidad Andrología, Servicio Urología Hospital, Regional Universitario Carlos Haya, Málaga, Spain;9. Department of Urology & Urological Reseach Institute (URI), Universiti Vita Saluta San Raffaele, Milan, Italy;10. University of California at San Francisco, San Francisco, CA, USA;2. Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA;3. Evans Department of Medicine, Whitaker Cardiovascular Institute, Boston University, Boston, MA, USA;4. Division of Cardiology, University of California San Francisco, San Francisco, CA, USA;2. Department of Urology, University of South Florida, Tampa, FL, USA;3. Vascular and Interventional Imaging, University of South Florida, Tampa, FL, USA;4. Department of Urology, Center for Sexual Medicine, Boston University School of Medicine, Boston, MA, USA;2. Sexual & Reproductive Medicine Program, Urology Service, Department of Surgery, Memorial Sloan‐Kettering Cancer Center, New York, NY, USA;1. Department of UrologyUrology Research CenterGuilan University of Medical SciencesRashtIran |
| |
| Abstract: | IntroductionOral phosphodiesterase type 5 inhibitors (PDE5i) have improved treatment options for erectile dysfunction (ED). In case of unresponsiveness to PDE5i, alternative therapies are considered.AimTo evaluate whether combination of vacuum erection device (VED) and PDE5i is effective as salvage therapy in subjects with ED in whom PDE5i alone failed.MethodsFrom September 2007 to May 2008, we evaluated 69 men (aged 36–82 years) in whom PDE5i treatment at the highest recommended dose, with at least 4–6 attempts at intercourse during a 3 months period, had failed. The clinical efficacy of combination therapy was evaluated using the International Index of Erectile Function-5 (IIEF-5) questionnaire, Sexual Encounter Profile (SEP)-2, SEP-3, and Global Patient Assessment Scale (GPAS).Main Outcome MeasuresScores on IIEF-5, SEP-2, SEP-3, and GPAS before and after combination therapy were measured.ResultsAfter 4 weeks of combination therapy, the mean IIEF-5 score increased significantly over baseline from 9.0 to 17.6 (P < 0.001). Of the 34 subjects with a SEP-2 response of “no” at baseline, 27 (79%) responded “yes” after combination therapy (P < 0.001). Of the 50 subjects with a SEP-3 response of “no” at baseline, 35 (70%) responded “yes” after combination therapy (P < 0.001). Furthermore, of the 42 subjects with a GPAS response of “not at all” or “slightly” improved at baseline, 31 (74%) responded “moderately” or “greatly” improved after combination therapy (P < 0.001). One subject (1.5%) experienced device-related intermittent penile pain, which resolved after 4 days without any action.ConclusionsStatistically significant improvements over baseline were seen in IIEF-5, SEP-2, SEP-3, and GPAS measures following 4 weeks of combination therapy of PDE5i and VED. This study supports the use of PDE5i with VED in men in whom PDE5i alone failed. This combination therapy may be offered to patients not satisfied with PDE5i alone before being switched to more invasive alternatives. Canguven O, Bailen J, Fredriksson W, Bock D, and Burnett AL. Combination of vacuum erection device and PDE5 inhibitors as salvage therapy in PDE5 inhibitor nonresponders with erectile dysfunction. J Sex Med 2009;6:2561–2567. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
