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Quality of Erections in Men Treated with Flexible-Dose Sildenafil for Erectile Dysfunction: Multicenter Trial with a Double-Blind, Randomized, Placebo-Controlled Phase and an Open-Label Phase

2008; Elsevier BV; Volume: 5; Issue: 3 Linguagem: Inglês

10.1111/j.1743-6109.2007.00701.x

1743-6109

Ateş Kadıoğlu, Walther Grohmann, Andrzej Depko, Ivan P. Levinson, Franklin Sun, Suzanne Collins,

Hormonal and reproductive studies

ABSTRACT Introduction Erectile dysfunction (ED) impacts erection hardness and compromises quality of life. Aim Assess erection hardness and its correlation with sexual function, emotional well-being, and satisfaction (erection quality, intercourse, sex life, sexual relationship, and treatment). Methods Men with ED were randomized to double-blind, flexible-dose sildenafil (25, 50, or 100 mg) or placebo (6 weeks) with open-label extension (6 weeks). Main Outcome Measures Erection Hardness Score (EHS), Quality of Erection Questionnaire (QEQ), International Index of Erectile Function (IIEF), Self-Esteem And Relationship (SEAR) questionnaire, and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS). Results A total of 307 men (mean [range] age, 45 [18–55] years) were randomized to sildenafil (N=154) or placebo (N=153). At the end of double-blind treatment, occasions with EHS 3 (hard enough for penetration but not completely hard) or 4 (completely hard) had increased by 40% ± 3% for sildenafil vs. 11% ± 3% for placebo (least squares mean ± standard error; P <0.0001); the estimated percentage of occasions with EHS 4 was 58% (95% CI, 52–65%) vs. 14% (95% CI, 10–19%) (odds ratio, 8.5; P <0.0001). There was greater improvement in mean QEQ, IIEF, and SEAR scores (P <0.0001), and more men were satisfied with sildenafil treatment (EDITS Index score >50: 90% vs. 49%). QEQ, IIEF, SEAR, and EDITS outcomes correlated positively with EHS 3 or 4, and with EHS 4 alone and were highest (no overlap of 95% CI vs. other EHS subgroups) in the subgroup with most frequent EHS of 4. Conclusions In the group of men with ED treated with sildenafil, it was estimated that completely hard erections were achieved on 58% (95% CI, 52–65%) of occasions. Improvement in function, emotional well-being, and satisfaction was greatest in men with completely hard erections and correlated positively with other measures of hardness.