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OBJECTIVE: Depressed men commonly have erectile dysfunction, and men with erectile dysfunction are frequently depressed. Since the etiologic and modulatory relationships between depression and erectile dysfunction have been poorly characterized, a 12-week, randomized, double-blind, placebo-controlled trial was conducted at 20 urologic clinics to evaluate the effects of sildenafil treatment in men with erectile dysfunction and mild-to-moderate comorbid depressive illness. METHOD: Men (N=152, mean age=56 years) with erectile dysfunction for =" src="/math/ge.gif"6 months (mean=5.7 years), a DSM-IV diagnosis of depressive disorder not otherwise specified, and a Hamilton Depression Rating Scale score =" src="/math/ge.gif"12 (mean at baseline=16.9) were randomly assigned to flexible-dose treatment with sildenafil citrate or matching placebo. Interviewer-rated and self-report instruments were used to assess changes in sexual function, depressive symptoms, and quality of life. Conservative criteria were used to classify erectile dysfunction treatment response and nonresponse. RESULTS: Sildenafil was strongly associated with erectile dysfunction treatment response. Fifty-eight men met the conservative criteria for response (48 given sildenafil, 10 given placebo), and 78 men did not respond (18 given sildenafil, 60 given placebo). Mean decreases of 10.6 and 2.3 in Hamilton depression scale scores were seen in treatment responders and nonresponders, respectively; 76% of treatment responders showed a =" src="/math/ge.gif"50% decline in Hamilton depression scale score versus 14% of nonresponders. Quality of life was similarly improved in treatment responders. CONCLUSIONS: Sildenafil is efficacious for erectile dysfunction in men with mild-to-moderate depressive illness. Improvement of erectile dysfunction is associated with marked improvement in depressive symptoms and quality of life.
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Men with erectile dysfunction should be watched closely for coronary artery disease, the authors stated. Others agreed.
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Possible blindness due to nonarteritic anterior ischemic optic neuropathy and cilioretinal artery occlusion caused by PDE-5 inhibitors has been a concern. This is an extremely rare event, with only a handful of reported cases from the tens of millions of patients using PDE-5 inhibitor medications. This risk may be increased if the PDE-5 medication is misused or overdosed.
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FRIDAY, July 21 (HealthDay News) -- The erectile dysfunction drug Uprima did not work for two-thirds of the over 11,000 patients who tried it, according to a U.K. study in the July issue of the urology journal BJU International.
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Vasoactive injection–When injected into the penis, certain solutions cause erection by dilating blood vessels in erectile tissue. Normally, these injections produce an erection lasting about 20 minutes. During this procedure, penile pressure is measured and x-rays may be taken of the penile blood vessels using a special dye (contrast agent).
Talk to your health care provider if your erection problems are related to fear of recurring heart problems. Sexual intercourse is usually safe in these circumstances.
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Also important, say experts, is to use this discussion to let him know that you have enjoyed the physical part of your relationship together, and that you miss it -- and that together you can work to find a solution.
A. While the devices are simple to install and use, infection occurs in about two percent of cases. In this case, the implants have to be removed. Depending on the degree of infection, another implant may be reinserted immediately or after sufficient healing. But in rare cases, scarring may be so severe that subsequent reimplant is impossible and leaves the patient without any hope of intercourse.
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