Systematic Review of Oral Combination Therapy for Erectile Dysfunction When Phosphodiesterase Type 5 Inhibitor Monotherapy Fails

2019 ◽  
Vol 7 (3) ◽  
pp. 430-441 ◽  
Author(s):  
Nicolai Egholt Munk ◽  
Jakob Schöllhammer Knudsen ◽  
Simon Comerma-Steffensen ◽  
Ulf Simonsen
Keyword(s):  
Systematic Review ◽  
Erectile Dysfunction ◽  
Combination Therapy ◽  
Phosphodiesterase Type 5 Inhibitor ◽  
Phosphodiesterase Type

scholarly journals PDE-5i Management of Erectile Dysfunction After Rectal Surgery: A Systematic Review Focusing on Treatment Efficacy

2020 ◽  
Vol 14 (5) ◽  
pp. 155798832096906
Author(s):  
Margherita Notarnicola ◽  
Valerio Celentano ◽  
Paschalis Gavriilidis ◽  
Bilal Abdi ◽  
Nassiba Beghdadi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Erectile Dysfunction ◽  
Management Strategies ◽  
Rectal Surgery ◽  
Treatment Strategies ◽  
Case Series ◽  
Case Control Studies ◽  
Phosphodiesterase Type 5 Inhibitor ◽  
Rectal Cancers ◽  
Phosphodiesterase Type

Erectile dysfunction (ED) is one of the main functional complications of surgical resections of the rectum due to rectal cancers or inflammatory bowel disease (IBD). The present systematic review aimed at revising ED management strategies applied after rectal resections and their efficacy in terms of improvement of the International Index of Erectile Function (IIEF) score. A literature search was conducted on Medline, EMBASE, Scopus, and Cochrane databases by two independent reviewers following the PRISMA guidelines. Randomized and nonrandomized controlled trials (RCTs, NRCTs), case-control studies, and case series evaluating medical or surgical therapies for ED diagnosed after rectal surgery for both benign and malignant pathologies were eligible for inclusion. Out of 1028 articles initially identified, only five met the inclusion criteria: two RCTs comparing oral phosphodiesterase type-5 inhibitor (PDE-5i) versus placebo; one NRCT comparing PDE-5i versus PDE-5i + vacuum erection devices (VEDs) versus control; and two before-after studies on PDE-5i. A total of 253 (82.7%) rectal cancer patients and 53 (17.3%) IBD patients were included. Based on two RCTs, PDE-5i significantly improved IIEF compared to placebo at 3 months (SMD = 1.07; 95% CI [0.65, 1.48]; p < .00001; I2 = 39%). Improved IIEF was also reported with PDE-5i + VED at 12 months. There is a paucity of articles in the literature that specifically assess efficacy of ED treatments after rectal surgery. Many alternative treatment strategies to PDE-5is remain to be investigated. Future studies should implement standardized preoperative, postoperative, and follow-up sexual function assessment in patients undergoing rectal resections.

scholarly journals The blue pill (sildenafil) and its descendants: an overview

2017 ◽  
Vol 30 (3) ◽  
pp. 129-133
Author(s):  
Tomasz Krzanowski ◽  
Lila Dabkowska ◽  
Monika Wujec ◽  
Ewa Kedzierska
Keyword(s):  
Erectile Dysfunction ◽  
Current Medical ◽  
Medication Treatment ◽  
Phosphodiesterase Type 5 Inhibitor ◽  
Sexuality Study ◽  
The World ◽  
Severity Of The Disease ◽  
Phosphodiesterase Type ◽  
Medical Guidelines ◽  
Active Substances

AbstractAn increasing number of men around the world suffer from erectile dysfunction (ED). Indeed, according to the sexuality study conducted by Professor Izdebski, 1 out of 10 men in Poland suffers from ED. The problem is found among men of any age, however, 60% of all patients are between 40 and 60 years old, thus in their prime, and who still want to fully enjoy life. Not only do the effects of ED affect a man, but they have influence on his relationship and partner as well. In spite of a growing awareness within society, the problem remains perceived as embarrassing, which leads patients to treat themselves on their own, delaying a visit to their doctors. Meanwhile, in many cases, ED may be the first symptom of more serious diseases, such as diabetes, or result from the sideeffects of applied drugs. A breakthrough in the oral medication treatment of ED was observed when a new phosphodiesterase type 5 inhibitor (PDE-5-inhibitor) - sildenafil citrate (Viagra®) - was introduced. Nowadays, 5 active substances from this group are being applied. The current medical guidelines recommend PDE-5 inhibitors as the firstline therapy for most men with ED, irrespective of the cause and severity of the disease. Recently, sildenafil at the dose of 25 mg came into the market without prescription. This paper presents an overview and update of the PDE-5 inhibitors.

scholarly journals Audiometry Results and TEOAE and DPOAE Amplitudes in Men Taking a Phosphodiesterase Type 5 Inhibitor for Erectile Dysfunction

2017 ◽  
Vol 96 (7) ◽  
pp. E34-E39 ◽  
Author(s):  
Sertan Öntepeli ◽  
Nuray Bayar Muluk ◽  
Devrim Tuğlu ◽  
Timuçin Şipal
Keyword(s):  
Erectile Dysfunction ◽  
Otoacoustic Emissions ◽  
Pde5 Inhibitor ◽  
Post Treatment ◽  
Guanosine Monophosphate ◽  
Pde5 Inhibitors ◽  
Cochlear Blood Flow ◽  
Distortion Product ◽  
Phosphodiesterase Type 5 Inhibitor ◽  
Phosphodiesterase Type

We conducted a prospective study of transient evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs) in men who were taking an oral phosphodiesterase type 5 (PDE5) inhibitor for erectile dysfunction. Our study group was made up of 30 men (60 ears), aged 34 to 60 years (mean: 50.9). They were randomly divided into three groups; 10 men were given sildenafil (Viagra) at 50 mg twice a week, 10 were given tadalafil (Cialis) at 20 mg twice a week, and 10 were given vardenafil (Levitra) at 20 mg twice a week. All patients took their drug for 3 weeks, for a total of 6 tablets for each patient. Audiometric tests and TEOAE and DPOAE measurements were performed before and after treatment. Post-treatment audiometry demonstrated improvement in hearing in all three groups. However, post-treatment TEOAE amplitudes and DPOAE amplitudes differed among the three groups; they were significantly higher in the sildenafil group at 1.0 kHz and the same in the tadalafil group; in the vardenafil group, the DPOAE amplitude was significantly lower at 3.0 kHz while there was no change in the TEOAE amplitude. We speculate that the possible mechanism for these findings is that PDE5 inhibitors block degradation of cyclic guanosine monophosphate (cGMP) and induce dilation of the cochlear microcirculation, resulting in an increase in cochlear blood flow. We also believe that the decrease in DPOAE amplitudes at 3.0 kHz seen in the vardenafil group may be related to an accumulation of nitric oxide/cGMP complex, which is toxic to the cochlea; however, since there was no change in TEOAE amplitude in the vardenafil group, this influence may be minimal. Further studies are needed to obtain a more comprehensive assessment of the effects of PDE5 inhibitors on hearing with the use of higher doses and longer durations of therapy.

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