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The utility of sildenafil citrate for infertile men with sexual dysfunction: a pilot study
Author(s) -
Boorjian Stephen,
Hopps Carin V.,
Ghaly Sameh W.,
Parker Marilyn,
Mulhall John P.
Publication year - 2007
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2007.07038.x
Subject(s) - erectile dysfunction , medicine , psychogenic disease , sildenafil , sexual dysfunction , placebo , gynecology , premature ejaculation , sexual function , infertility , population , randomization , randomized controlled trial , psychiatry , pregnancy , psychology , alternative medicine , environmental health , pathology , biology , psychoanalysis , genetics
Associate Editor Michael G. Wyllie Editorial Board Ian Eardley, UK Jean Fourcroy, USA Sidney Glina, Brazil Julia Heiman, USA Chris McMahon, Australia Bob Millar, UK Alvaro Morales, Canada Michael Perelman, USA Marcel Waldinger, Netherlands OBJECTIVE To investigate the use the sildenafil citrate, recognized as a first‐line therapy for men with erectile dysfunction (ED), and which is safe and effective in men with various causes and severity of ED, including psychogenic ED, in a population of infertile men with sexual dysfunction. PATIENTS AND METHODS Infertility is a major source of life stress and might be associated with sexual dysfunction through the erosion of self‐esteem and self‐confidence, and in stimulating discord in a relationship. Men presenting for evaluation of fertility who on questioning by the physician reported the recent onset of sexual dysfunction, had a history taken, a physical examination, hormonal profile, and completed the International Index of Erectile Function (IIEF), a validated inventory for assessing sexual dysfunction. Thirty men with a score of <26 on the erectile function domain of the IIEF, or who complained of new onset rapid or delayed ejaculation, were treated with sildenafil with no randomization or placebo control. The evaluation was repeated and the IIEF completed again ≥3 months after starting treatment. RESULTS For men complaining of ED, subjective erectile rigidity, duration of erection, and the percentage of successful penetration attempts significantly improved with sildenafil. The mean ( sd ) IIEF domain scores for erection and satisfaction, at 18 (4) vs 27 (3), and 12 (2) vs 16 (3) (both P = 0.01), and orgasm, at 4 (1) vs 6 (3) ( P = 0.001), respectively, significantly improved after treatment. In patients with ejaculatory dysfunction, the function improved in 64% after sildenafil therapy. CONCLUSIONS We identified the nature of sexual dysfunction associated with male‐factor infertility, and showed the efficacy of sildenafil therapy in men with this condition.