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PDE-5 inhibitors in monotherapy versus combination therapy in a sample of 1200 patients with erectile dysfunction

Luis Labairu-Huerta, Bárbara Padilla-Fernández, José Luis Arrondo-Arrondo, Lauro Sebastián Valverde-Martínez, Agustín Martín-Rodríguez, Juan Miguel Silva-Abuín, María Begoña García-Cenador, José Antonio Mirón-Canelo, María Fernanda Lorenzo-Gómez
  • Bárbara Padilla-Fernández
    Department of Urology, University Hospital of the Canary Islands, Tenerife, Spain
  • José Luis Arrondo-Arrondo
    Department of Urology, Hospital of Navarra, Spain
  • Lauro Sebastián Valverde-Martínez
    Department of Urology, University Hospital of Salamanca, Spain
  • Agustín Martín-Rodríguez
    Department of Urology, University Hospital of Salamanca, Spain
  • Juan Miguel Silva-Abuín
    Department of Urology, University Hospital of San Pedro, Logroño, Spain
  • María Begoña García-Cenador
    Department of Surgery, University of Salamanca, Spain
  • José Antonio Mirón-Canelo
    Department of Preventive Medicine and Public Health, University of Salamanca, Spain
  • María Fernanda Lorenzo-Gómez
    Department of Urology, University Hospital of Salamanca; Department of Surgery, University of Salamanca; Urological Renal Multidisciplinary Research Group of the Biomedical Research Institute of Salamanca (IBSAL), Spain

Abstract

Objectives: To compare the effectiveness in the treatment of erectile dysfunction when using PDE-5 inhibitors (PDE5i), alprostadil (PG-E1) and testosterone (TES) in monotherapy or combination therapy. Material and Methods: Observational multicentre retrospective study of men diagnosed and treated for ED between January 2008 and January 2014. Age, social and employment situation, pathological medical history, risk factors, usual treatments, IIEF-5 at the first consultation and at first and each 6 months follow-ups, physical examination, calculated total and free testosterone and received treatment were analysed. Descriptive statistics, one-way ANOVA analysis, Chi2 for qualitative data, t-test, Fisher's exact test and Pearson's correlation coefficient were used; p < 0.05 is considered significant. Results: Average age was 58.61 years, SD5.02, average follow- up time 48.21 months, SD 6.21, range 6-174 months. Out of the patients 76.12% were married, 9.81% divorced/separated, 10.04% single, 4.03% widowed; 85.14% of the total in stable partnership but 66.16% were not accompanied by their partners. In total 844 patients received monotherapy (597 PDE5i; 62 PG-E1; 36 TES; 27 penile prosthesis; 121 psychotherapy/alternative therapies) and 357 combination therapy (167 PDE5i+TES; 124 PDE5i+PGE1; 66 PG-E1+TES). There was a homogeneous distribution between risk factors and medical history groups. Satisfactory response according to IIEF-5 was achieved for 72.33% of patients on PDE5i monotherapy, 46.65% of patients on PDE5i+PG-E1 combination therapy and 83.41% of patients on PDE5i+TES. Conclusions: The best therapeutic success for ED in this series was achieved through a combination of testosterone+PDE-5 inhibitors without increasing morbidity and maintaining the response over time. Larger studies with longer follow-up will corroborate these findings.

Keywords

Erectile dysfunction; Combination therapy; PDE-5 inhibitors; Testosterone

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Submitted: 2015-09-28 16:32:49
Published: 2015-09-30 11:12:49
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Copyright (c) 2015 Luis Labairu-Huerta, Bárbara Padilla-Fernández, José Luis Arrondo-Arrondo, Lauro Sebastián Valverde-Martínez, Agustín Martín-Rodríguez, Juan Miguel Silva-Abuín, María Begoña García-Cenador, José Antonio Mirón-Canelo, María Fernanda Lorenzo-Gómez

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