Sildenafil failures may be due to inadequate patient instructions and follow-up: A study on 100 non-responders

被引:63
作者
Hatzichristou, D [1 ]
Moysidis, K
Apostolidis, A
Bekos, A
Tzortzis, V
Hatzimouratidis, K
Ioannidis, E
机构
[1] Aristotle Univ Salonika, Dept Urol, Thessaloniki, Greece
[2] Aristotle Univ Salonika, Ctr Sexual & Reprod Hlth, Thessaloniki, Greece
关键词
erectile dysfunction; treatment; sildenafil; prescription;
D O I
10.1016/j.eururo.2004.12.005
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objective: The objective of this study was to identify factors that affect efficacy response rate to sildenafil in the clinical practice. Material and Method: The study comprised 100 consecutive sildenafil non-responders. Mean patient age was 59 +/- 14.4 years and mean duration of ED 5.5 +/- 6.4 years. All patients underwent detailed medical and sexual history and completed the IIEF and a questionnaire regarding the previous use of sildenafil. When inadequate instructions were reported, information on the appropriate use of sildenafil was given and patients were asked to use at least 4 tablets at home. Pharmacologic efficacy was re-evaluated in a scheduled follow-up visit. Results: Mean Erectile Function Domain (ED) of the IIEF score was 14 +/- 9.9. In 56 patients inappropriate use of sildenafil was recognized; 45 had never used the highest recommended dose (100 mg), 32 had taken the pill with a full stomach right after a meal, 22 had taken the pill just before the initiation of sexual activity and 12 were not aware that sexual stimulation was mandatory to achieve an erection. Furthermore, 8 patients had tried the 100 mg dose, despite the presence of factors associated with sildenafil clearance reduction (renal insufficiency, cimetidine treatment). Only 34 patients reported that their physician had scheduled a follow-up visit. Following adequate dose titration and time adjustment, 31 patients responded to sildenafil; 10 patients used the 50 mg dose and 21 the 100 mg. Second and third-line treatment options were offered to the rest of the patients. Conclusions: ED patients may receive inadequate instructions with their prescriptions. Response rate to sildenafil may be maximized after receiving appropriate dose titration and instructions on administration. ED should be treated in the same way as other chronic conditions; follow-up is necessary to evaluate the appropriate application and pharmacologic efficacy of the proposed treatment. (c) 2004 Elsevier B.V. All rights reserved.
引用
收藏
页码:518 / 523
页数:6
相关论文
共 17 条
[1]   When an erection alone is not enough: biopsychosocial obstacles to lovemaking [J].
Althof, SE .
INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH, 2002, 14 (Suppl 1) :S99-S103
[2]   Salvage of sildenafil failures referred from primary care physicians [J].
Atiemo, HO ;
Szostak, MJ ;
Sklar, GN .
JOURNAL OF UROLOGY, 2003, 170 (06) :2356-2358
[3]  
BARADA J, 2001, INT J IMPOT RES S4, V13, pS49
[4]   Long-term efficacy and safety of oral Viagra® (sildenafil citrate) in men with erectile dysfunction and the effect of randomised treatment withdrawal [J].
Christiansen, E ;
Guirguis, WR ;
Cox, D ;
Osterloh, IH .
INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH, 2000, 12 (03) :177-182
[5]   Oral sildenafil in the treatment of erectile dysfunction [J].
Goldstein, I ;
Lue, TF ;
Padma-Nathan, H ;
Rosen, RC ;
Steers, WD ;
Wicker, PA .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 338 (20) :1397-1404
[6]   Diagnostic steps in the evaluation of patients with erectile dysfunction [J].
Hatzichristou, D ;
Hatzimouratidis, K ;
Bekas, M ;
Apostolidis, A ;
Tzortzis, V ;
Yannakoyorgos, K .
JOURNAL OF UROLOGY, 2002, 168 (02) :615-620
[7]   Sildenafil citrate: lessons learned from 3 years of clinical experience [J].
Hatzichristou, DG .
INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH, 2002, 14 (Suppl 1) :S43-S52
[8]   Current treatments and emerging therapeutic approaches in male erectile dysfunction [J].
Hatzichristou, DG ;
Pescatori, ES .
BJU INTERNATIONAL, 2001, 88 :11-17
[9]   Patient and partner satisfaction with Viagra (sildenafil citrate) treatment as determined by the Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire [J].
Lewis, R ;
Bennett, CJ ;
Borkon, WD ;
Boykin, WH ;
Althof, SE ;
Stecher, VJ ;
Siegel, RL .
UROLOGY, 2001, 57 (05) :960-965
[10]   Prognostic factors for response to sildenafil in patients with erectile dysfunction [J].
Martínez-Jabaloyas, JM ;
Gil-Salom, M ;
Villamón-Fort, R ;
Pastor-Hernández, F ;
Martínez-García, R ;
García-Sisamón, F .
EUROPEAN UROLOGY, 2001, 40 (06) :641-646