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Zippe C D, Kedia A W, Kedia K et al. Treatment of erectiledysfunction after radical prostatectomy with sildenafil citrate(Viagra). Urology 1998;52(6):963-966.Zippe C D, Kedia S, Kedia A W et al. Sildenafil citrate (Viagra)after radical retropubic prostatectomy: pro. Urology1999;54(4):583-586.Zlotta A R, Teillac P, Raynaud J P et al. Evaluation of malesexual function in patients with Lower Urinary Tract Symptoms(LUTS) associated with Benign Prostatic Hyperplasia (BPH)treated with a phytotherapeutic agent (Permixon), Tamsulosin orFinasteride. Eur Urol 2005;48(2):269-276.Zorgniotti A. '''On demand'' oral drug for erection in impotentmen'. Br J Urol 1992;147308Zorgniotti A W. Experience with buccal phentolamine mesylatefor impotence. Int J Impot Res 1994;6(1):37-41.Zusman R M, Morales A, Glasser D B et al. Overallcardiovascular profile of sildenafil citrate. [Review] [33 refs].Am J Cardiol 1999;83(5A):35C-44C.Not applicable.Annual update 2004/2005 - Treatment of genitourinarydisorders. Drugs of the Future 2005;30(9):931-934.Abrams J. Time course of the interaction between tadalafil andnitrates.[comment]. J Am Coll Cardiol 2004;43(11):2150-2151.Adaikan P G, Chong Y S, Chew S S L et al. Male sexualdysfunction. Curr Obstet Gynaecol 2000;10(1):23-28.Ahl J, Kinon B J, Liu-Seifert H. Sexual dysfunction associatedwith neuroleptic-induced hyperprolactinemia improves withreduction in prolactin levels. Ann N Y Acad Sci 2004;1032(pp289-290):-290.Ahuja S K, Krane N K, Hellstrom W J. Penile prostheses in themanagement of impotence in patients with end-stage renaldisease. J La State Med Soc 1998;150(1):32-34.Akbari F, Alavi M, Esteghamati A et al. Effect of renaltransplantation on sperm quality and sex hormone levels. BJUInt 2003;92(3):281-283.Akkus E, Kadioglu A, Esen A et al. Prevalence and correlates oferectile dysfunction in Turkey: a population-based study. EurUrol 2002;41(3):298-304.Alexandre B, Lemaire A, Desvaux P et al. Intracavernousinjections of prostaglandin E1 for erectile dysfunction: patientsatisfaction and quality of sex life on long-term treatment. Br JSex Med 2007;4(2):426-431.Alfonso A, Rieniets K I, Vigersky R A. Incidence and clinicalsignificance of elevated macroprolactin levels in patients withhyperprolactinemia. Endocr Pract 2006;12(3):275-280.Alivizatos G, Skolarikos A, Laguna P. Recent dataupon impotence, incontinence and quality of lifeissues concerning radical prostatectomy. [Review] [74refs]. Arch Esp Urol 2003;56(3):321-330.Althof S E. Quality of life and erectile dysfunction.Urology 2002;59(6):803-810.Althof S E, Corty E W, Levine S B et al. EDITS:development of questionnaires for evaluatingsatisfaction with treatments for erectile dysfunction.Urology 1999;53(4):793-799.Althof Stanley E, Turner Louisa A. Self-injectiontherapy and external vacuum devices in the treatmentof erectile dysfunction: Methods and outcome. Rosen,Raymond C (Ed); Leiblum, Sandra Risa (Ed)1992;(1992):378Anderson R A, Bancroft J, Wu F C. The effects ofexogenous testosterone on sexuality and mood ofnormal men. Journal of Clinical Endocrinology &Metabolism 1992;75(6):1503-1507.Anderson R A, Martin C W, Kung A W et al. 7Alphamethyl-19-nortestosteronemaintains sexual behaviorand mood in hypogonadal men. Journal of ClinicalEndocrinology & Metabolism 1999;84(10):35563562.Anderson R A, Wallace A M, Sattar N et al. Evidencefor tissue selectivity of the synthetic androgen 7 alphamethyl-19-nortestosteronein hypogonadal men.Journal of Clinical Endocrinology & Metabolism2003;88(6):2784-2793.Andersson K-E. Pharmacology of penile erection.Pharmacol Rev 2001;53(3):417-450.Andolsek K M. Alprostadil for the treatment oferectile dysfunction. Am Fam Physician1997;55(5):1902-1903.Andriole G, Bruchovsky N, Chung L W K et al.Dihydrotestosterone and the prostate: The scientificrationale for 5a-reductase inhibitors in the treatment ofbenign prostatic hyperplasia. Br J Urol 2004;172(4I):1399-1403.Anonymous. Tadalafil: new preparation. Slightly moreconvenient, but poorly assessed in organic disorders.Prescrire Int 2003;12(68):213-215.Anonymous. Tadalafil (cialis) for erectile dysfunction.Medical Letter on Drugs & Therapeutics2003;45(1172):101-102.Anonymous. First study of Viagra in black mendemonstrates effective, well-tolerated treatment. UrolNurs 2002;22(4):285-286.D-186
Anonymous. Study shows patients taking vardenafil consistentlycompleted sexual intercourse. Urol Nurs 2001;21(6):413-414.Anonymous. Apomorphine (TAP holdings). 6a beta-aporphine10,11-diol hydrochloride hemihydrate, apomorphinehydrochloride, spontane, Uprima. Drugs in R & D1999;2(6):415-416.Anonymous. Intraurethral alprostadil for impotence. MedicalLetter on Drugs & Therapeutics 1997;39(997):32Anonymous. Treatment for impotence gains FDA approval. AmJ Health Syst Pharm 1995;52(19):2078-2079.Anonymous. Intracavernous injection of alprostadil for erectiledysfunction. Medical Letter on Drugs & Therapeutics1995;37(958):83-84.Anonymous. Vardenafil works for 10 hours. Can Pharm J2005;275(7360):133Anonymous. Treatment duration of action is important in ED.Can Pharm J 2004;273(7330):878Anonymous. Dutaseride. Prescrire Int 2004;13(73):183Anonymous. Erratum: Efficacy and tolerability of sildenafil inIndian males with erectile dysfunction: A double-blind,randomized, placebo controlled, crossover study (Indian Journalof Pharmacology (2004) vol. 37 (5) (317)). Indian J Pharmacol2004;36(6):391Anonymous. Partnership struck between Bayer and Schering.Nat Rev Genet 2004;3(10):819Anonymous. Erectile dysfunction drugs may reduce fertility buthelp depression. Can Pharm J 2004;272(7294):439Anonymous. Sildenafil appears safe and effective for some heartfailure patients. Can Pharm J 2004;272(7290):310Anonymous. What to do when oral treatment fails?. Int J ImpotRes 2003;15(SUPPL. 7):S30-S32.Anonymous. Oral drug treatment of erectile dysfunction. Int JImpot Res 2003;15(SUPPL. 7):S27-S29.Anonymous. Counselling and increased dose of sildenafilimproves response in ED. British Journal of Diabetes &Vascular Disease 2003;3(6):445Anonymous. Improve erectile function early afterprostatectomy. Med Today 2003;4(11):8-9.Anonymous. Recent FDA approval of new erectile dysfunctiondrug provides first challenge to sildenafil. Geriatrics and Aging2003;6(8):11Anonymous. New PDE 5 inhibitor efficacious for erectiledysfunction in diabetics. Cardiology Review 2003;20(10):Anonymous. Inhaled apomorphine promising forerectile dysfunction treatment. Can Pharm J2003;271(7261):170Anonymous. Transurethral alprostadil. Prescrire Int2002;11(61):144Anonymous. IDdb News focus. Current DrugDiscovery 2003;(pp 10-13):-13.Anonymous. Sildenafil effective for sexualdysfunction associated with use of antidepressants.Can Pharm J 2003;270(7231):41Anonymous. Vardenafil prolongs improved erectilefunction in diabetics. Cardiology Review2002;19(10):38-39.Anonymous. Erectile dysfunction treated effectivelywith tadalafil. Economics of Neuroscience2001;3(11):19Anonymous. New erectile dysfunction drug useful indiabetes. Can Pharm J 2001;267(7173):669Anonymous. Erectile dysfunction - Alprostadil. ManufChem Aerosol News 2001;72(11):21Anonymous. Erectile dysfunction - Vardenafil. ManufChem Aerosol News 2001;72(6):25Anonymous. FDA approves oral therapy for erectiledysfunction. Am J Health Syst Pharm1998;55(10):981-984.Anonymous. Sildenafil Viagra(R) UK-92480:Treatment of erectile dysfunction phosphodiesterase Vinhibitor. Drugs of the Future 1998;23(2):242-243.Anonymous. Intracavernosal alprostadil for erectiledysfunction. Hospital Practice (Office Edition)1996;31(8):136-137.Anonymous. Intracavernous alprostadil: Effectivetherapy for erectile dysfunction. Drugs & TherapyPerspectives 1996;7(6):1-5.Anonymous. Heart drug with 'viagra side-effect'.Indian J Med Sci 1999;53(5):236Anonymous. What to do if Viagra won't do. HarvardMens Health Watch 2005;9(10):4-8.Anonymous. Diagnostic and therapeutic technologyassessment. Vasoactive intracavernouspharmacotherapy for impotence: intracavernousinjection of prostaglandin E1. JAMA1991;265(24):3321-3323.D-187
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This report is based on research co
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This document is in the public doma
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AcknowledgmentsThe authors would li
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ContentsExecutive Summary..........
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Table 17: Intra-urethral Treatment:
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Figure 63. Absolute Mean Change Fro
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associated with ED treatments. Two
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ED as a main complaint. In only one
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different formulations/modes of app
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Evidence Report
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flaccidity are no less important th
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prostatectomy, antipsychotic agents
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disease). Furthermore, there is ins
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Analytic FrameworkFigure 1. Analyti
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KQ 3. Harms of pharmaceutical treat
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Figure 2. Modified QUOROM Flow Char
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that included intervention characte
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Prevalence of Hypogonadism (Total S
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stimulation and a challenge test wi
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Overview of Trials79-84,86-88,90,91
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131,137,138,142,143,147,151,155,156
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pectoris occurred in a participant
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statistical test results for the ob
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individual Q1-Q15 items, 104,106,15
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Proportion of participants with hea
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erectile maintenance frequency, IIE
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Oral Treatments — Phosphodiestera
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Patients were instructed to take th
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Results obtained from two trials 19
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improved erections was higher in pa
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Clinically homogenous groups of pat
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Oral Treatments — Phosphodiestera
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The approximate proportion of smoke
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value was not reported). Even thoug
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Tadalafil (20 mg) versus tadalafil
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scheduled dosing regimen (90 percen
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Proportion of patients with improve
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Sublingual Treatments - Apomorphine
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been taking over the past two or fo
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apomorphine (5 and 6 mg: 38 and 49
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heterogeneity with respect to popul
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Finally, two studies reported on wh
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the second study, prolonged erectio
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Moxisylate versus placebo. One tria
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Quantitative SynthesisThere was a l
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erection” versus one placebo trea
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methods of allocation concealment.
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Prazosin (IU) versus placebo. One t
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reported adequate allocation concea
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Hormonal Treatments Literature Sear
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Harms. In the first trial, the diff
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sex with partner (scale 1-6, with =
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daily for 4 weeks followed by concu
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(MEDQoL) score (range 0-100) compar
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group (16.7, 12.5, and 8.3 percent,
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Question 3a. What Are the harms of
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Chapter 4. DiscussionThis evidence
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Question 1: What is the Clinical Ut
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Questions 2-3: What are the Benefit
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Harms. There were no obvious differ
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alone. Compared with trimix alone,
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PhentolamineEfficacy. The results i
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Question 2a-b: Do Specific Patient
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Methodological and Logistic Limitat
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Tables and Figures.Summary TablesTa
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123Study details 1 Study Design Set
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125Table 2: Prevalence of Hypogonad
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127Study Details 2 Study Design Set
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129Table 4: Prevalence of Hypogonad
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131Study Details 5 Study Design Set
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Table 7: Prevalence of Hyperprolact
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135StudyEDDetails 8 Study Design Se
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Table 10: Serious Adverse Events in
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Table 11: Efficacy Results of Tadal
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Treatment Control Relative RiskStud
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Treatment Control Relative RiskStud
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Table 14: Intracavernosal Injection
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StudyAdverse EventsTreatmentGroup%
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StudyAdverse EventsTreatment Contro
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Study / Typeof PatientsOutcome Defi
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Study ED Etiology OutcomeWilliams*1
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Physiologic:60.0 (18/30) 90.0 (27/3
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StudyAdverse EventTreatmentGroup% (
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TreatmentStudy ED Etiology Group% (
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StudyAdverse EventCavallini 1991 Pa
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Study/patient CharacteristicsGooma
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Aversa 2003Men witharteriogenicEDYa
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Study/patientCharacteristicsClopper
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Study/patientCharacteristicsOutcome
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Table 26: Testosterone Treatment: P
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McNicholas2002Patients reporting
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175Table 27: Miscellaneous Treatmen
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177Table 28: Nonarteritic Anterior
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Table 29: Penile Fibrosis in Studie
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StudyStudyDesignPatientsage range 4
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Figure 6. Improved erection (GEQ-Q1
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Figure 11. Visual disturbances (all
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Figure 16. Any adverse events (trea
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Figure 23. The mean IIEF-Q4 score:
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Figure 30. Improved erection (GEQ-Q
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Figure 37. Visual disturbances (all
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Figure 43. IIEF-EF ≥ 26 at follow
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Figure 49. Dyspepsia (all cause)Fig
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Figure 55. Serious adverse events (
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Figure 61. Mean per-patient percent
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Figure 67. Any adverse events (all-
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Figure 73. Any adverse events (all-
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in men with erectile dysfunction. J
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parameters in obese men with erecti
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comparative crossover study. Androl
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153. Shabsigh R. Efficacy of silden
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190.191.Stief C, Porst H, Saenz dT,
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treatment of men with erectile dysf
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randomized trial. J Urol 1997 Oct;1
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moderate and severe ED. Int J Impot
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349.350.351.randomized, placebo-con
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395. Moher D, Schulz KF, Altman DG.
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PSVRCTRIRIASBPSCSDSETTGTRTWMDpeak s
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dDegDept.Ff/uFHxhrHxIGMmaxminmoNANI
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30. or/24-2931. (ANIMALS not HUMAN)
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27. limit 26 to yr="1990 - 2008"28.
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5. exp clinical trials/6. random$.m
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20. or/17-1921. 16 and 2022. limit
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A systematic review of harms associ
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B-4Summary Table- Randomized Contro
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The Quality Assessment of Studies o
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AuthorFundingN; study design; eligi
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C-10 AuthorFundingN; study design;
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C-146 C5-Intracavernousal Injection
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C-202 C8-Topical Treatments of ED A
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C-216 C9-Testosterone Treatment of
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men with erectile dysfunction and s
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symptoms associated with benign pro
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(84) Zinner N. Do food and dose tim
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(117) Carrier S, Brock GB, Pommervi
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(150) Hagemann JH, Berding G, Bergh
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(183) Moriel EZ, Rajfer J. Sodium b
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(255)(256)dysfunction. Psychopharma
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Anonymous. Surgery & watchful waiti
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Derouet H, Jost W H, Osterhage J et
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Doust J, Miller E, Duchesne G et al
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Elhilali M M. Alfuzosin: An a1-rece
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Ferri C, Giuggioli D, Cazzato M et
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Frucht S J. Parkinson disease: An u
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Ghofrani H A, Pepke-Zaba J, Barbera
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Baldwin D S. Sexual dysfunction ass
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Douglass M A, Lin J C. Update on th
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Hatch J P. Psychophysiological aspe
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Lau D H, Mumtaz F H, Thompson C S e
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Morales A, Heaton J P. Hormonal ere
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Roehrborn C G, McNicholas T. The Ma
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Uckert S, Stief C G, Jonas U. Curre
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Leungwattanakij S, Flynn V, Hellstr
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Musacchio Najah S, Hartrich Molly,
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Akkus E, Kadioglu A, Esen A et al.
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Ashok S, Sigman M. Bioavailable tes
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Briganti A, Salonia A, Gallina A et
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Chinegwundoh F, Anie K A. Treatment
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Dundar S O. Visual loss associated
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Hawton Keith, Catalan Jose, Fagg Jo
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Kell P. Cardiovascular safety of si
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Laumann Edward O, West Suzanne, Gla
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Mulhall J P. Deciphering erectile d
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Parsons J K, Marschke P, Maples P e
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Rojewski M T, Korper S, Schrezenmei
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Shabsigh R. Testosterone therapy in
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Tam S W, Worcel M, Wyllie M. Yohimb
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Webb D J, Freestone S, Allen M J et
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Katlowitz N M, Albano G J, Morales
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Sparwasser C, Treiber U, Bahren W e
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Cooper A J. Evaluation of I-C papav
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Page 1027: F-10STUDY IDQ1:SpectrumQ2.Selection
Page 1030 and 1031: Figure G-2. Sildenafil (any dose) v
Page 1036 and 1037: Figure G-8. Sildenafil (25 mg) vs.
Page 1038 and 1039:
Figure G-10. Vardenafil (any dose)
Page 1040 and 1041:
Tadalfil20 mg vs. PlaceboFigure G-1
Page 1042 and 1043:
Figure G-14. Tadalafil (20 mg) vs.
Page 1044 and 1045:
Figure G-16. Tadalafil (20mg) vs. T
Page 1046 and 1047:
5 = Eleven+ attempts Q7: When you a
Page 1048 and 1049:
The IIEF-5 score is the sum of ques
Page 1050:
El Malik EMA. Erectile dysfunction:
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