Use of intraurethral alprostadil in patients not responding to sildenafil citrate

Jaffe, Jamison S.; Antell, Mara R; Greenstein, Marc; Ginsberg, Phillip C.; Mydlo, Jack H.; Harkaway, Richard C.

doi:10.1016/j.urology.2003.11.039

Cited by 30 publications

(10 citation statements)

References 9 publications

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“…Prostaglandin E 1 . Although PDE5 inhibitor remains the most common initial therapy in men with erectile dysfunction, intraurethral alprostadil may be a reasonable treatment option for sildenafil nonresponders (Jaffe et al, 2004), particularly in men having undergone prior radical retropubic prostatectomy (McCullough, 2001;McCullough et al, 2010). Vasoactive agents can be administered topically to the urethral mucosa and can apparently be absorbed into the corpus spongiosum and transferred to the CC.…”

Section: Drugs For Nonintracavernosal Administrationmentioning

confidence: 99%

Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction

2011

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Section: Drugs For Nonintracavernosal Administrationmentioning

confidence: 99%

Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction

2011

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“…32 In seven (30%) of the 23 studies, the active interventions included sildenafil for patients with ED, 5,33 sildenafil plus patient education for patients with ED, [34][35][36] sildenafil for patients with ED and arterial hypertension, 37 and, in one study, sildenafil in young healthy men. 38 Five (22%) of the 23 studies featured the evaluation of other oral agents: Butea superba for patients with ED, 39 alpha-blockers or finasteride for patients at high risk for ED, 40 intraurethral alprostadil for patients with ED who were nonresponders to sildenafil, 41 atorvastatin for patients with hypercholesterolemia as the only risk factor for ED, 42 and herbal and vitamin supplements for men who visited a prostate cancer screening clinic. 43 Six (26%) intervention studies involved surgery followed by sildenafil.…”

Section: Intervention Studiesmentioning

confidence: 99%

The Sexual Health Inventory for Men (SHIM): a 5-year review of research and clinical experience

2005

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The Sexual Health Inventory for Men (SHIM) is a widely used scale for screening and diagnosis of erectile dysfunction (ED) and severity of ED in clinical practice and research. In reviewing the SHIM-related literature, we sought to provide a compendium of studies in which the SHIM was used, to provide a systematic framework for organizing and evaluating the studies, and to provide a status report on the SHIM and its impact on the management of male sexual dysfunction. Using a Medline search, we found that the SHIM was an integral measure in at least 21 studies on the prevalence of ED, 23 studies on the efficacy of ED interventions, and eight other (mainly correlational) studies. The quantity of research and quality of scholarship on the SHIM provide testimony to its positive impact on understanding and improving male sexual function. These scientific contributions are likely to remain influential in coming years.

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“…The response to sildenafil after RP is strongly influenced by nerve status at the time of surgery. Several reports show a significantly lower response to sildenafil monotherapy in patients undergoing RP than in controls [20–25]. Combined therapy may have a role in these patients.…”

Section: Discussionmentioning

confidence: 99%

Use of combined intracorporal injection and a phosphodiesterase‐5 inhibitor therapy for men with a suboptimal response to sildenafil and/or vardenafil monotherapy after radical retropubic prostatectomy

2005

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Associate Editor Michael G. Wyllie Editorial Board Ian Eardley, UK Jean Fourcroy, USA Sidney Glina, Brazil Julia Heiman, USA Chris McMahon, Australia Bob Millar, UK Alvaro Morales, Canada Michael Perelman, USA Marcel Waldinger, Netherlands OBJECTIVE To report experience with combined therapy using intracorporal injection (ICI) of alprostadil and oral phosphodiesterase 5 (PDE‐5) inhibitors for the minimally invasive treatment of erectile dysfunction (ED) after radical prostatectomy (RP), as PDE‐5 inhibitors are effective but a few patients may have a suboptimal response. PATIENTS AND METHODS In a retrospective study, 34 men (aged 46–66 years) had a nerve‐sparing retropubic RP and subsequent ED. Patients were titrated on sildenafil citrate or vardenafil to maximum doses. All had a suboptimal response after a maximum of eight doses of oral therapy and were then treated with ICI therapy using 15 or 20 µg alprostadil. Erectile function was assessed with the Sexual Health Inventory for Men (SHIM). RESULTS Of the 32 patients who continued combined therapy, 22 (68%) had an improvement in erectile function after ICI therapy, as assessed by the SHIM score. On follow‐up, 36% of these patients used ICI therapy only intermittently, instead of regularly, as they felt that this was adequate enough for good results. CONCLUSIONS PDE‐5 oral pharmacotherapy is the most commonly used effective therapy for ED but may not be as effective in patients who have radical surgery; the addition of testosterone patches may have side‐effects or be considered a risk in patients with a history of prostate cancer. The use of ICI therapy as an adjunct or maintenance therapy to their oral medication may be another alternative in these patients.

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Use of intraurethral alprostadil in patients not responding to sildenafil citrate

Cited by 30 publications

References 9 publications

Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction

Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction

The Sexual Health Inventory for Men (SHIM): a 5-year review of research and clinical experience

Use of combined intracorporal injection and a phosphodiesterase‐5 inhibitor therapy for men with a suboptimal response to sildenafil and/or vardenafil monotherapy after radical retropubic prostatectomy

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