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脊柱裂患者的勃起功能障碍是可治的
PURPOSE: Now that individuals with spina bifida live
well into adulthood erectile dysfunction has become a recognized associated
medical disorder. To our knowledge no study has dealt specifically
with treatment of erectile dysfunction in men with spina bifida. Therefore,
we conducted a prospective, blinded, randomized, placebo controlled,
dose escalation, crossover study to determine the ability to treat
erectile dysfunction in men with spina bifida with sildenafil citrate.
MATERIALS AND METHODS: Erectile dysfunction was diagnosed in 15 men
19 to 35 years old with spina bifida who were assigned to take 4 sets
of tablets, 5 tablets per set, in a random order. All patients took
25 and 50 mg. sildenafil and 2 identical looking sets of corresponding
placebos 1 hour before planned sexual activity. Efficacy was assessed
by the effect of treatment compared to baseline, that is before treatment,
on rating of erections (scored from 0 to 10), duration of erections,
frequency of erections based on response to question 1 (scored from
0 to 5) of the International Index of Erectile Function and confidence
to obtain an erection based on response to question 15 (scored from
1 to 5) of the International Index of Erectile Function. RESULTS:
Improved erectile function was reported while on sildenafil by 12
(80%) men compared to baseline and placebos. There was a significant
dose dependent improvement of erectile function with both 25 and 50
mg. sildenafil compared to baseline (p <0.05), as mean erectile
score increased by 50% and 88%, mean duration of erections increased
by 192% and 266%, mean frequency of erections increased by 61% and
96%, and mean level of confidence increased by 33% and 63%, respectively.
Furthermore, 50 mg. sildenafil provided greater improvement in all
4 parameters compared to 25 mg. The placebo results were not significantly
different compared to baseline for any of the parameters. CONCLUSIONS:
Erectile dysfunction in patients with spina bifida is a medically
treatable condition. Sildenafil is effective in this patient population
and improves level of sexual confidence.
【引自J Urol 2000 Sep;164(3 Pt 2):958-61】 |
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