Examining Endothelial Dysfunction and The Effect of Topical Treatment with Prostaglandin E1 In Diabetics Suffering from Erectile Dysfunction

Abstract

Aims: Erectile and endothelial dysfunctions are the most common complications of diabetes. We studied the endothelial function and response to treatment of a topical alprostadil in diabetics with erectile dysfunction.Sample and Methods: 30 patients were enrolled in the non-intervention, postregistration, prospective study with 300 µg alprostadil cream. We examined vascular endothelial function using an ENDO-PAT 2000 device. We used International Index of Erectile Function (IIEF-5), Erectile Hardness Score (EHS), Global Assessment Questionnaire (GAQ) and Sexual Encounter Profile Q 2 and 3 (SEP 2, SEP 3) to assess erectile function. The primary outcome measures were the proportion of patients with an optimal treatment response at baseline and at 6 and 12 weeks after treatment and the evaluation of patients and their partner's subjective satisfaction.Results: We diagnosed endothelial dysfunction in 15 diabetics. After 12 weeks of treatment with alprostadil 53.3% of the sample, reached normal erectile function. We found a significant increase in IIEF-5 scores with a median of 6 points (range 0-19, p<0.001) after 6 weeks compared to baseline, and of 7 points (range 0-20, p<0.001) after 12 weeks of treatment compared to baseline; a significant increase occurred both after 6 and 12 weeks of treatment (p=0.002). After both 6 and 12 weeks we found a significant increase in erection rigidity, EHS, compared to baseline (p< 0.001, p = 0.014). After 12 weeks of treatment, GAQ, improving erectile function was reached in 76.7% patients. Conclusion:We have demonstrated that topical alprostadil is efficient in diabetic men with erectile-endothelial dysfunction.