The therapeutic efficacy of sildenafil for the treatment of erectile dysfunction is correlative with the pharmacokinetics of the drug and the time of sexual behavior. More and more researches on the time effect window of sildenafil for the treatment of erectile dysfunction have elucidated the least time to achieve sufficient penile hardness for intercourse and to reach the best erectile state after the drug administration, as well as the therapeutic effect of the long-term treatment with the drug.
Erectile Dysfunction ; drug therapy ; Humans ; Male ; Phosphodiesterase Inhibitors ; pharmacokinetics ; therapeutic use ; Piperazines ; pharmacokinetics ; therapeutic use ; Purines ; pharmacokinetics ; therapeutic use ; Sildenafil Citrate ; Sulfones ; pharmacokinetics ; therapeutic use ; Time Factors

Child ; Humans ; Hypertension, Pulmonary ; drug therapy ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; administration & dosage ; therapeutic use ; Purines ; administration & dosage ; therapeutic use ; Sildenafil Citrate ; Sulfones ; administration & dosage ; therapeutic use

OBJECTIVETo evaluate the efficacy and safety of sildenafil citrate in man kidney transplant recipients with erectile dysfunction.

METHODSOne hundred and seventy married males, aged 26 approximately 50 years, who had received kidney transplantations at least half a year before and whose serum creatinine was under 133 umol/l, were selected randomly in the study. Their sexual function was investigated according to the International Index of Erectile Function-5 (IIEF-5), and those with erectile dysfunction (ED) were treated with oral sildenafil citrate for 6 months. The efficacy was assessed by IIEF-5.

RESULTSFifty-three men with ED received oral sildenafil citrate for 6 months. At the end of the treatment, each index in IIEF-5 increased significantly. There were no interactions between sildenafil and cyclosporine and there was no significant adverse effect of sildenafil on the graft function.

CONCLUSIONSildenafil is an effective and safe agent for the treatment of ED in kidney transplant recipients.

Adult ; Erectile Dysfunction ; drug therapy ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Piperazines ; adverse effects ; therapeutic use ; Purines ; Sildenafil Citrate ; Sulfones

Sildenafil (Viagra) citrate has been well accepted by physicians and patients for its reliable efficacy and safety in the treatment of erectile dysfunction (ED) ever since its introduction into clinical andrology in China 10 years ago. It has been proved effective for various ED subgroups, regardless of causes, severity and age. Recent studies show that sildenafil also benefits patients with premature ejaculation, either used alone or in combination with other therapies.
China ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Piperazines ; therapeutic use ; Premature Ejaculation ; drug therapy ; Purines ; therapeutic use ; Sildenafil Citrate ; Sulfones ; therapeutic use

OBJECTIVETo evaluate phosphodiesterase type 5 (PDE5) inhibitors in the management of temporary penile erectile dysfunction (ED) in patients undergoing assisted reproductive technology (ART).

METHODSThis study included 75 male patients that experienced ejaculation failure due to temporary ED during ART treatment. We treated the patients with PDE5 inhibitors sildenafil, tadanafil and vardenafil, and then evaluated the hardness of penile erection using Erection Hardness Score (EHS) and analyzed the end-point efficacy.

RESULTSSildenafil was administered to 28 of the patients, tadanafil to 25, and vardenafil to 22. Of the total number of patients, 61 (81.3%) achieved effective erection, but no significant differences were observed in the rate of effectiveness among the sildenafil (24 cases, 85.7%), tadanafil (20 cases, 80.0%) and vardenafil (17 cases, 77.3%) groups (P > 0.05). After medication, 53 (70.7%) of the patients successfully ejaculated, but there were no remarkable differences in the success rate among the sildenafil (21 cases, 75.0%), tadanafil (17 cases, 68.0%) and vardenafil (15 cases, 68.2%) groups (P > 0.05). Of the 75 patients, 37 received the recommended initial dose and 38 the maximum recommended dose of PDE5 inhibitors, but no significant differences were found in the rate of successful sperm retrieval between the former (28 cases, 75.7%) and the latter group (25 cases, 65.8%) (P > 0.05). Mild adverse events, including transient flush and dizziness, occurred in 5 cases (6.7%).

CONCLUSIONPDE5 inhibitors can help temporary ED patients to achieve penile erection and ejaculation during ART treatment.

Ejaculation ; Erectile Dysfunction ; drug therapy ; Humans ; Imidazoles ; therapeutic use ; Male ; Phosphodiesterase 5 Inhibitors ; therapeutic use ; Piperazines ; therapeutic use ; Purines ; therapeutic use ; Reproductive Techniques, Assisted ; Sildenafil Citrate ; Sulfonamides ; therapeutic use ; Sulfones ; therapeutic use ; Triazines ; therapeutic use ; Vardenafil Dihydrochloride

AIMTo determine if there are different penile hemodynamic patterns between sildenafil non-responders and responders by using color Doppler ultrasonography.

METHODSA total of 69 erectile dysfunction (ED) patients aged 22-79 years were enrolled into the present study. Thirty-eight (55.1%) men with ED who did not respond to four attempts of treatment with 100 mg sildenafil after re-education were classified as sildenafil non-responders. A combination of three vasodilator drugs, 1.25 mg papaverine, 0.4 mg phentolamine and 5 mg prostaglandin E1, was given by intracavernous injection before penile Doppler ultrasonography was carried out. The erectile response to intracavernous injection and vascular parameters including peak systolic velocity (PSV), resistance index (RI), end diastolic velocity (EDV) and cavernosa artery diameter (CD) were measured and the results between sildenafil non-responders and responders were compared.

RESULTSNo statistical difference in vascular parameters measured by Doppler ultrasonography studies between non-responders and responders was noted. Sildenafil non-responders had a poorer penile rigidity response to intracavernous injection than responders (P < 0.05). Among patients with adequate PSV (>or=30 cm/s) and abnormal EDV (> 5 cm/s), individuals in the non-responder group had fewer positive responses to intracavernous vasodilator injection than in the responder group (35.3% vs. 72.2%, P < 0.05). Advanced age and comorbidity with diabetes mellitus were significantly associated with sildenafil non-response (P < 0.05).

CONCLUSIONSildenafil non-responders were characterized by a poorer penile rigidity response to intracavernous injection and had an associated impaired veno-occlusive mechanism. Advanced age and comorbidity with diabetes mellitus were two common factors associated with non-response.

Adult ; Aged ; Alprostadil ; therapeutic use ; Erectile Dysfunction ; diagnostic imaging ; drug therapy ; Humans ; Male ; Middle Aged ; Papaverine ; therapeutic use ; Phentolamine ; therapeutic use ; Piperazines ; therapeutic use ; Purines ; therapeutic use ; Sildenafil Citrate ; Sulfones ; therapeutic use ; Ultrasonography, Doppler, Color ; Vasodilator Agents ; therapeutic use

The rate of erectile dysfunction after radical retropubic prostatectomy is from 10% to 100%. The prevalence of erectile dysfunction after nerve-sparing radical prostatectomy is more than one third. In the patients who had undergone bilateral NS, 72% responded to sildenafil, 71.7% and 59.7% responded to 20 mg and 10 mg of vardenafil respectively. For all randomized patients who received tadalafil, the mean percentage of successful penetration attempts was 54% and the mean percentage of successful intercourse attempts was 41%. For the subgroup with evidence of postoperative tumescence these values were 69% and 52%, respectively. No head-to-head trials have been performed with sildenafil, vardenafil and tadalafil in treatment of erectile dysfunction after radical prostatectomy.
Carbolines ; therapeutic use ; Erectile Dysfunction ; drug therapy ; etiology ; Humans ; Imidazoles ; therapeutic use ; Male ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; therapeutic use ; Prostatectomy ; adverse effects ; Purines ; therapeutic use ; Sildenafil Citrate ; Sulfones ; therapeutic use ; Tadalafil ; Triazines ; therapeutic use ; Vardenafil Dihydrochloride

In the recent few years, especially since the introduction of phosphodiesterase-5 inhibitor, sildenafil, most researchers have focused their researches on biochemistry and physiology of erectile function. New progress has been made made in basic and clinic researches on pharmacotherapy for ED. In this article, the putative molecular or cellular mechanism of actions of the available centrally and peripherally acting drugs are reviewed, providing details about the current and most explosive area of drug research and development in erectile dysfunction.
Animals ; Apomorphine ; pharmacology ; therapeutic use ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Phosphodiesterase Inhibitors ; pharmacology ; therapeutic use ; Piperazines ; pharmacology ; therapeutic use ; Purines ; pharmacology ; therapeutic use ; Rats ; Sildenafil Citrate ; Sulfones ; pharmacology ; therapeutic use ; Yohimbine ; pharmacology ; therapeutic use

Phosphodiesterase type 5 (PDE5) inhibitors effectively enhance the erectile function of the patients with erectile dysfunction (ED). The use of sildenafil citrate is expanding to a broader extent. Pulmonary artery hypertension has become a new indication of sildenafil. Sildenafil could improve the epithelial function in several vascular conditions in clinical trials. This article reviews the recent advances on basic and clinical studies of ED and sildenafil. On animal models, sildenafil could resume the cavernous epithelial function, up-regulate the protein expression of phosphorylated endothelial NO synthase (eNOS), reverse the decreased intracavernosal pressure (ICP) induced by pudendal artery blood flow restriction or hypoxia. In clinical studies, over 50% of ED patients receiving sildenafil got a fully rigid erection (grade 4 erection). And the same percentage of post-nerve-sparing radical prostatectomy patients receiving sildenafil obtained penile rehabilitation and spontaneously resumed erection sufficient for sexual intercourse. Sildenafil treatment has contributed to the normalization of self-esteem, confidence and sexual harmony in men with ED. All this suggests that a whole rehabilitation from erectile to psychosocial function may become a new goal of ED therapy.
Animals ; Erectile Dysfunction ; drug therapy ; physiopathology ; rehabilitation ; Humans ; Male ; Mice ; Penis ; drug effects ; physiopathology ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; therapeutic use ; Purines ; Rats ; Sildenafil Citrate ; Sulfones

OBJECTIVESTo evaluate the outcome of treatment in patients with erectile dysfunction (ED) using sildenafil or intracavernosal injection of prostaglandin E1(PGE1).

METHODS54 patients with ED were randomly classified into two groups and received either oral sildenafil (group A) or intracavernosal injection of PGE1(group B) for 4-9 months with an average of 6 months.

RESULTSThe percentages of efficacy in the two groups were 80.0% and 83.3%, respectively. There was no statistical difference between group A and B (P > 0.05). Two of six patients who did not respond to sildenafal in group A achieved erections sufficient for sexual intercourse when the six patients received intracavernous injection of PGE1. None of the four patients who did not respond to intracavernous injection of PEG1 in group B achieved erection sufficient for sexual intercourse when they received oral sildenafil.

CONCLUSIONSBoth oral sildenafil and intracavernous injection of PGE1 are effective for patients with ED of various etiologies. The patients who do not respond to sildenafil can receive intracavernous injection therapy. The satisfactory results can probably achieved.

Administration, Oral ; Adult ; Aged ; Alprostadil ; therapeutic use ; Drug Administration Routes ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Purines ; Sildenafil Citrate ; Sulfones ; Treatment Outcome