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High dose sildenafil citrate as a salvage therapy for severe erectile dysfunction


Abstract
The aims of this study were to help assess the efficacy plus tolerability of high dose sildenafil to be a salvage therapy for patient’s refractory to be able to the maximum suggested amount of sildenafil. 60 three fully evaluated sufferers along with chronic erectile failure (ED) who had previously failed to respond to the residence trial of sildenafil (100 mg) with erections suited to sexual sex have been examined. Each man was taken care of at home along with sildenafil at escalating dosage of up to 250 mg until possibly maximal reply or Indies culpable unfavorable effects occurred. Lovemaking feature was quantified using the particular erectile function area regarding the International Index regarding Erectile Function (IIEF) before treatment, with sildenafil 75 mg and with optimum dose of sildenafil and even a world-wide efficaciousness problem after five several weeks connected with treatment.



Typically the mean age of the study collection was 59. 6±11 two y. 13/54 (24%) experienced artery organic ED, 16/54 (30%) had mixed vasculogenic education, 9/54 (17%) acquired cavernously venom-occlusive dysfunction, 11/54 (20%) had post radical retro pubic prostatectomy ED and 5/54 (9%) had psychogenic drew. 13/54 (24. 1%) taken care of immediately sildenafil at a typical maximal dose of 250 mg, 4/13 required a hundred and fifty mg and 9/13 required 200 mg. 41/54 (76%) failed to respond to help sildenafil. Mean IIEF question 3 and even 4 results were 1 .5 and 1. Four at base line, only two and a 1.9 having sildenafil one hundred mg, installment payments on your 8 together with 2.5 with sildenafil 150 mg and three or more 0 together with 2.9 with sildenafil 200 mg, respectively. Immediately after 4 several weeks, treatment was considered to be obtaining improved their erections by means of 37%, 46. 3% together with 68% of individuals with sildenafil 100 magnesium, a hundred and fifty mg and 250 magnesium, respectively. 34/54 (63%) noted undesirable effects using högsta dose sildenafil composed of frustration (19), facial flushing (32), fatigue (14), nasal over-crowding (11), dizziness (5) and visual disturbances (5). 4/13 (31%) responders declined to continue treatment caused by undesirable effects.

In conclusion, sildenafil at doses of right up to 190 mg is usually an effective salvage treatment for 24. 1% connected with previous sildenafil non-responders yet is limited by an appreciably higher incidence connected with side effects and a new 31% treatment method discontinuation rate.
Impotence problems (ED) are often the inability to attain and sustain a good erection of enough solidity for reasonable intimate sex. 1 Group based epidemiological studies suggest that sexual dysfunction, particularly impotence, is usually a common disorder inside patients and is associated with reduced total well being. 2, 3, 4, you’re five



Often the maximum dose of sildenafil recommended by means of the supplier will be 100 mg. A good study was designed to prospectively examine a group of clients with chronic ED, unresponsive to sildenafil 100 magnesium, who were treated within a home setting together with doses of sildenafil in excess of the encouraged utmost dose (150 mg plus 200 mg). Treatment usefulness, safety and ceiling seemed to be evaluated using melodrama physician interviews and typically the patient self applied administered IIEF questionnaire.


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