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Efficiency of intracavernosal alprostadil and oral clomiphene citrate combination treatment in penile vasculogenic erectile dysfunction patients accompanied by late‐onset hypogonadism
Author(s) -
Taşkapu Hakan Hakkı,
Sönmez Mehmet Giray,
Kılınç Muzaffer Tansel,
Altınkaya Nurullah,
Aydın Arif,
Balasar Mehmet
Publication year - 2020
Publication title -
andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.633
H-Index - 59
eISSN - 1439-0272
pISSN - 0303-4569
DOI - 10.1111/and.13759
Subject(s) - medicine , erectile dysfunction , urology , testosterone (patch) , cgmp specific phosphodiesterase type 5 , erectile function , gynecology , endocrinology
In this study, the efficiency of intracavernosal alprostadil + oral clomiphene citrate (CC) treatment in late‐onset hypogonadism (LOH) accompanied by penile vasculogenic erectile dysfunction (PVED) in patients irresponsive to phosphodiesterase type 5 inhibitor treatment was evaluated. A total of 31 patients with concurrent PVED and LOH were included in the study. The patients were given intracavernosal alprostadil (10–20 μg) and oral CC (50 mg) every day for 12 weeks. Before and after treatment, a 15‐question International Index of Erectile Function (IIEF‐15) questionnaire, Erection Hardness Score (EHS), Sexual Encounter Profile (SEP)2 and SEP3 levels were analysed, and follicle stimulating hormone (FSH), luteinising hormone (LH), total testosterone and prostate‐specific antigen (PSA) levels were measured. In all, 41.9% of patients had pure arterial deficiency, 19.3% had pure venous deficiency, and 38.7% had arterial + venous (mixed) deficiency. A significant increase was detected in total testosterone, FSH, LH and PSA values after treatment when compared to values before treatment ( p < .001, p < .001, p < .001 and p = .034 respectively). A significant recovery was observed in IIEF‐15 subscores, EHS and SEP2‐SEP3 results. In PVED patients accompanied by LOH, intracavernosal alprostadil and oral CC combination is an efficient, low cost, safely applicable and tolerable treatment.