Positive effect of counseling and dose adjustment in patients with erectile dysfunction who failed treatment with sildenafil

被引:47
作者
Gruenwald, Ilan
Shenfeld, Ofer
Chen, Juza
Raviv, Gil
Richter, Santiago
Cohen, Ayala
Vardi, Yoram
机构
[1] Rambam Med Ctr, Dept Neuro Urol, IL-31096 Haifa, Israel
[2] Shaare Zedek Med Ctr, Dept Urol, Jerusalem, Israel
[3] Tel Aviv Sourasky Med Ctr, Dept Urol, Tel Aviv, Israel
[4] Sheba Med Ctr, Dept Urol, Tel Hashomer, Israel
[5] Meir Med Ctr, Dept Urol, Kefar Sava, Israel
[6] Technion, Dept Stat, Haifa, Israel
关键词
erectile dysfunction; counseling; dosage; IIEF;
D O I
10.1016/j.eururo.2006.01.042
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 [临床医学]; 100201 [内科学];
摘要
Objective: Many patients with erectile dysfunction (ED) stop using sildenafil due to subjective failure. This study examined whether counseling and maximal dosing (100 mg) could achieve better treatment compliance and could possibly improve treatment outcome. Material and methods: Patients were recruited by newspaper advertisements and referred to 5 ED centers throughout the country. Details about their previous experiences with sildenafil were recorded and following an explicit explanation about the nature and action of the drug, were offered to enter the study. Instructions on drug use were provided during each visit in which four 100 mg Sildenafil tablets were provided. Treatment outcomes were assessed by the international index of erectile function (IIEF) questionnaire after taking 4 and 8 tablets. In 2 ED centers a short video with sexual counseling content was added in between visits. Results: The study cohort was comprised of 220 patients aged 27-88 years. The majority reported having received limited or no instructions on drug use when sildenafil was first prescribed. A significant increase in IIEF erectile function domain scores (EFDS) between visits 1,2 and 3 was observed (10.96 +/- 0.40, 16.73 +/- 0.51 and 17.82 +/- 0.55 mean +/- SE, respectively), with 23.6% of the study patients achieving normal erectile function at the end of the study. The parameters of age and initial severity of ED most influenced treatment success. Conclusions: Counseling and dose adjustment were directly influential in achieving an excellent response to a second trial of sildenafil in patients with ED who had previously failed treatment with the drug, and obviated their needing to seek more invasive measures. (c) 2006 European Association of Urology. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:134 / 140
页数:7
相关论文
共 16 条
[1]
Salvage of sildenafil failures referred from primary care physicians [J].
Atiemo, HO ;
Szostak, MJ ;
Sklar, GN .
JOURNAL OF UROLOGY, 2003, 170 (06) :2356-2358
[2]
Sildenafil for male erectile dysfunction - A systematic review and meta-analysis [J].
Fink, HA ;
Mac Donald, R ;
Rutks, IR ;
Nelson, DB ;
Wilt, TJ .
ARCHIVES OF INTERNAL MEDICINE, 2002, 162 (12) :1349-1360
[3]
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
[4]
Clinical efficacy of sildenafil citrate and predictors of long-term response [J].
Gonzalgo, ML ;
Brotzman, M ;
Trock, BJ ;
Geringer, AM ;
Burnett, AL ;
Jarow, JP .
JOURNAL OF UROLOGY, 2003, 170 (02) :503-506
[5]
Sildenafil failures may be due to inadequate patient instructions and follow-up: A study on 100 non-responders [J].
Hatzichristou, D ;
Moysidis, K ;
Apostolidis, A ;
Bekos, A ;
Tzortzis, V ;
Hatzimouratidis, K ;
Ioannidis, E .
EUROPEAN UROLOGY, 2005, 47 (04) :518-523
[6]
Compliance of sildenafil treatment for erectile dysfunction and factors affecting it [J].
Jiann, BP ;
Yu, CC ;
Su, CC ;
Tsai, JY .
INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH, 2006, 18 (02) :146-149
[7]
Rechallenge prior sildenafil nonresponders [J].
Jiann, BP ;
Yu, CC ;
Su, CC ;
Huang, JK .
INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH, 2004, 16 (01) :64-68
[8]
McCullough Andrew R., 2001, Journal of Urology, V165, P170
[9]
Achieving treatment optimization with sildenafil citrate (Viagra®) in patients with erectile dysfunction [J].
McCullough, AR ;
Barada, JH ;
Fawzy, A ;
Guay, AT ;
Hatzichristou, D .
UROLOGY, 2002, 60 (2B) :28-38
[10]
Side-effect profile of sildenafil citrate (Viagra) in clinical practice [J].
Moreira, SG ;
Brannigan, RE ;
Spitz, A ;
Orejuela, FJ ;
Lipshultz, LI ;
Kim, ED .
UROLOGY, 2000, 56 (03) :474-476