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Utilization of sildenafil (Fildena) in patients with coronary disease. Cardiac evaluation using treadmill test for ED patients before treatment with sildenafil citrate. Time dependent patient satisfaction with sildenafil for erection dysfunction (ED) after nerve-sparing radical retropubic prostatectomy (RRP)
Because first effective oral answer to ED, sildenafil clearly interests those patients seeking initial treatment. Physicians must take into account the cardiovascular status of ‘at risk' patients with vasculogenic ED and significant vascular risk factors prior to initiating any strategy for ED including sildenafil. 21 Therefore, the function of high dose salvage treatment therapy is restricted to patient acceptance of a better incidence of uncomfortable side effects.
Adverse effects reflect the pharmacological action of sildenafil like a PDE-5 inhibitor along with a weak PDE-6 inhibitor. Uncomfortable side effects were reported with greater frequency by participants with this study when compared with participants in the earlier studies although adverse effect severity profile was similar. This parallels the experience of the Sildenafil Study Group who reported that only 43% of patients who had had RRP taken care of immediately sildenafil and suggested surgical damage to the cavernous nerves, with subsequent failure to activate the NO-cGMP pathway because the probable mechanism.
In 67 patients who didn't respond satisfactorily to sildenafil, alprostadil ICI ended in significant improvement in questions 3 and 4 with the IIEF inventory erection health domain in 60 (89.6%) and 57 (85.1%) patients, respectively. 15 Shabsigh reported that although responses to questions 3 or 4 from the IIEF in patients addressed with sildenafil were superior to placebo, responses didn't differ in patients with organic, psychogenic or mixed ED. 13 McMahon et al have reported that sildenafil is less efficient in patients with CVOD rather than patients with arteriogenic ED. They demonstrated an inverse relationship between your seriousness of CVOD as dependant on the DICC parameter, flow-to-maintain (FTM), and the response to sildenafil, as judged by patient scores to IIEF erections domain questions 3 and 4. They figured only patients with mild CVOD plus a FTM ?30 ml/min will probably reply to sildenafil or combined sildenafil/ICI.
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