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

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

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

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

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

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

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

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

The major role of treatment for impotence is played by vasoactive intracavernous pharmacotherapy or penile prosthesis during last decades. However, the former has a high risk of cavernosal fibrosis-and priapism, and the latter, also infection. We applied the Vacuum Constrictor Device to fifty of organic, 2 of old age, and 2 of unknown. Of 53 cases, 47 encountered the desirable erection were able to secure the vaginal penetration. Of 5 failed cases, 4 were because of maladjustment due to slim body and 1 was of pain on the pubic area due to previous old pelvic bone fracture. Of 17 cases with poor erection by vasoactive intracavernous pharmacotherapy 15 encountered good erection by means of Vacuum Constrictor Device and no significant complications were observed. Of 14 self-acquired Vacuum Constrictor Davicl which were used in which frequency of 10 to 17 times, 10 cases were shown to be satisfactory and the rest were not. Of 4 unsatisfactory cases, 2 were leakage of congested blood during intercourse, 1 was difficulty in intercourse due to pivot and the other one was of mild suprapubic pain due to previous pelvic bone fracture. Although Vacuum Temescence Enhancement Therapy is cumbersome in manipulation prior to sexual intercourse and has time limitation, it is easy to learn and has less complications than vasoactive intracavernous pharmacotherapy. Therefore Vacuum Tumescence Enhancement Therapy is thought to a preferable therapeutic alternative prior to vasoactive intracavernous pharmacotherapy and surgical treatment in impotence in spite of these disadvantages.
Coitus ; Drug Therapy ; Erectile Dysfunction* ; Estrogens, Conjugated (USP) ; Male ; Pelvic Bones ; Penile Prosthesis ; Priapism ; Vacuum*