No abstract available.
Drug Therapy* ; Erectile Dysfunction* ; Male

There has been remarkable progress in the treatment of erectile dysfunction during last decade. We have analyzed 2,000 patients with erectile dysfunction who had been treated with a variety of treatment modalities during last 10 years to identify the annual changes in the proportion of the respective treatment modality. The most remarkable change was seen in the proportion of patients treated by vasoactive pharmacotherapy The proportion was 12.0% on 1984, which was gradually increased in time, and reached to 82.1% on 1994. Another remarkable change was found in the proportion of patients treated by surgery, especially vascular surgery : The proportion of patients treated by penile prosthesis implantation on 1985 and vein ligation on 1986 was 64.0% and 14.3%, respectively ; whereas, it was decreased to 1.8 % and 0% on 1994, respectively. In conclusion, we could find remarkable change of trend in the primary treatment modality for erectile dysfunction from invasive and costly surgical treatment to less invasive and cheap vasoactive pharmacotherapy. Nowadays, intracavernous self-injection of vasoactive agents plays a primary role in the treatment of impotence. Penile prosthesis implantation remains as the last treatment modality for erectile dysfunction. However, vascular surgery is rarely being performed nowadays because of its poor long-term outcome.
Drug Therapy ; Erectile Dysfunction* ; Humans ; Ligation ; Male ; Penile Implantation ; Veins

Currently intracavernous pharmacotherapy is the second common therapeutic modality for erectile dysfunction after the introduction of Viagra. Nevertheless, intracavernous pharmacotherapy has increased in popularity for the past 15 years. While having an overwhelming safety after complete training in injection method, this treatment option can reveal unexpected complications related to self-injection. We report two cases of intracavernous needle breakage associated with alprostadil (Caverject , Pharmacia-Upjohn) and trimix self-injection therapy with a brief review of the literature.
Alprostadil ; Drug Therapy ; Erectile Dysfunction ; Male ; Needles* ; Sildenafil Citrate

PURPOSE: To compare the efficacy of Bimix solution (27.3 mg/ml papaverine and 0.9 mg/ml phentolamine) versus Trimix solution (18.8 mg/ml papaverine, 0.6 mg/ml phentolamine and 6.3ug/ml prostaglandin El) in terms of erectile response and complications. MATERIALS AND METHODS: We comparatively analyzed the erectile response and the incidence of pain, prolonged erection (>4 hours), and corporal fibrosis of either medication in the 155 impotent patients who used Bimix solution for intracavernous pharmacotherapy (mean duration: 15 months) and thereafter used Trimix solution (mean 12 months). RESULTS: Erectile response to Trimix solution was significantly better than Bimix solution (p<0.01). The mean dose of Bimix solution was higher than Trimix solution (0.43 ml. vs. 0.34 ml, p<0.05). The severe pain enough for impediment to ntercourse occurred in 6.5% of the Trimix group, while no patient of the Bimix group experienced (p<0.01). The corporal fibrosis was noted in 8.4% of the Trimix group and 16.1% of the Bimix group. However, there was no significant difference between the two groups (p=0.08). The incidence of prolonged erection was significantly lower (p<0.05) in the Trimix group (2.6%) than in the Bimix group (12.3%). A total of 139 patients (89.7%) finally selected Trimix solution. CONCLUSIONS: The Trimix solution was more effective and safer than Bimix solution for the treatment of erectile dysfunction.
Drug Therapy ; Erectile Dysfunction* ; Fibrosis ; Humans ; Incidence ; Male ; Papaverine ; Phentolamine

Tadalafil is an effective drug in treating erectile dysfunction (ED), and its clinical efficacy has been confirmed by a great many researches. Tadalafil is distinguished from sildenafil and vardenafil by its prolonged action lasting 36 hours for a sigle dose, compared with about 4 hours for sildenafil. Furthermore, this drug is effective in improving the erectile function of ED patients including those with various comorbid conditions. Tadalafil can help ED patients to regain morning erection and recover the confidence as a man. More and more ED patients choose tadalafil as the first line therapy because of its long efficacy and its conformability to the therapeutic requirement by restoring ED patients to normal, natural and pleasurable sexual life.
Carbolines ; therapeutic use ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Tadalafil

Carnitine, an important compound in the beta-oxidative process of mitochondrial fatty acid, plays a significant role in the cardiovascular, nervous, and reproductive system. Recently, carnitine has been used as a therapeutic in the treatment of male infertility, erectile dysfunction, Peyronie's disease, etc. Accordingly, the objective of this review is to summarize the progress in researches on carnitine as a clinical therapy in andrology.
Carnitine ; therapeutic use ; Erectile Dysfunction ; drug therapy ; Humans ; Infertility, Male ; drug therapy ; Male

With the approaching of an aging society, the number of patients with late-onset hypogonadism (LOH) is increasing. There are various methods for the treatment of LOH. And testosterone undecanoate is an effective and safe supplementary therapy for LOH. This paper gives an overview of the advances in the studies of testosterone undecanoate in the treatment of LOH.
Erectile Dysfunction ; drug therapy ; Humans ; Hypogonadism ; drug therapy ; Male ; Testosterone ; analogs & derivatives ; therapeutic use

The benefit of tadalafil should be justified by its safety and tolerance in the chronic treatment of erectile dysfunction (ED) in general and high-risk population. The main treatment-emergent adverse events, chiefly induced by the interactions of tadalafil with PDE5 and isoforms, are mild or moderate in severity, transient and reversible, which may disappear without drug withdrawal. Tadalafil does not add to the risk and severity of cardiovascular problems, and can be safely co-administered with antihypertensives and selective a-receptor blockers.
Carbolines ; adverse effects ; therapeutic use ; Drug Tolerance ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Tadalafil ; Treatment Outcome

OBJECTIVETo explore the correlation between the results of the nocturnal penile tumescence (NPT) test and the efficacy of tadalafil in the treatment of ED.

METHODSA total of 188 ED patients were divided into a normal NPT group (n = 136) and an abnormal NPT group (n = 52) according to the results of the NPT test. All of them were treated with tadalafil at 20 mg 3 times a week. The IIEF-5 score, SEP2, SEP3 and GAQ score were compared between the two groups before and 1 month after the treatment.

RESULTSTadalafil treatment significantly improved IIEF-5 score, SEP2 and SEP3 of both groups of the patients (P < 0.01). Compared with the abnormal NPT group, the normal NPT group showed a remarkable increase in the IIEF-5 score, SEP2, SEP3 (P < 0.05) and GAQ score (P < 0.01).

CONCLUSIONAfter 1 month of tadalafil treatment, the normal NPT group achieved a more significant improvement of erectile function and sexual satisfaction than the abnormal NPT group, suggesting that tadalafil has a better therapeutic effect for ED patients with normal NPT.

Carbolines ; pharmacology ; therapeutic use ; Erectile Dysfunction ; drug therapy ; physiopathology ; Humans ; Male ; Penile Erection ; drug effects ; Tadalafil

Oral pharmacotherapy has become the first-line therapy for the majority of patients with erectile dysfunction (ED) of broad-spectrum etiology since the introduction of oral sildenafil, a potent, selective inhibitor of phosphodiesterase type 5 (PDE5). More than 3 years following the launch of sildenafil have made us informed fully about the mechanism of sildenafil, its clinical efficacy and safety, and appropriate use of the drug. Recently, the efficacy and tolerability of another potent, selective inhibitors of PDE5, vardenafil and tadalafil have been reported one after another and their phase 3 clinical studies worldwide have just finished. The PDE5 inhibitors are contraindicated in patients taking nitrates and may be restricted in others. The recent introduction of sublingual (SL) apomorphine, a centrally acting dopaminergic agonist with known erectogenic effects, could provide patients and clinicians with an additional option in the treatment of ED, although its efficacy and safety need to be verified further by worldwide clinical studies. We are in face of the era of multiple oral agents available for the treatment of ED. Due to the complex nature of individual patient-oriented goals and the multifactorial nature of ED, choices are needed that can be adapted to the requirements and responses of the individual patients. In this review, an overview of the pharmacokinetics, efficacy and safety of the oral PDE5 inhibitors, sildenafil, vardenafil and tadalafil, and sublingual apomorphine are provided.
Apomorphine* ; Dopamine Agonists ; Drug Therapy ; Erectile Dysfunction* ; Humans ; Male ; Nitrates ; Pharmacokinetics* ; Phosphodiesterase 5 Inhibitors