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Organo Oficial de la Sociedad Mexicana de Urología

2009, Number 4

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Rev Mex Urol 2009; 69 (4)

Erection hardness and satisfaction with rapid sildenafil dose escalation from 50 to 100 mg in men with erectile dysfunction

Dehesa-Dávila M

Language: Spanish
References: 25
Page: 135-142
PDF size: 285.11 Kb.


ABSTRACT

Objective: To evaluate tolerance to sildenafil and erection hardness and satisfaction with rapid dose escalation from 50 to 100 mg in men presenting with erectile dysfunction (ED).
Materials and methods: An open multicenter study was carried out over a period of 8 weeks. Initial monitoring and wash-out phase lasted for 2 weeks, followed by 2 weeks of introductory treatment with 50 mg of sildenafil, followed by a 4-week phase of 100 mg. All patients were over 18 years of age and had been diagnosed with ED (score ≤ 25 on the International Index of Erectile Function) (IIEF) and met with administration criteria for 50 and 100 mg of sildenafil.
Results: Of the 125 patients included in the study (mean age 53 years ± 11.0), 117 (94%) participated in the tolerance analysis and 114 (97%) in the efficacy analysis. A total of 110 patients completed the study. IIEF-EF scores improved from 14.5 to 21.7 (49%) (P‹0.001) in patients who received initial 50 mg dose. When dose was increased to 100 mg, scores improved from 21.7 to 25.2 (P‹0.001) and improvement was 75% at the end of the study. In the Quality of Erection Questionnaire (QEQ), there was 91 and 128% improvement with 50 and 100 mg, respectively. In the Sexual Experience Questionnaire (Sex-Q) erection improved from 36 to 60%. There was a 38 to 64% increase in sexual intercourse and overall intercourse satisfaction increased from 50 to 79%.
In the Sexual Encounter Profile (SEP) with the Erection Hardness Grading Scale (EHGS), efficacy was 75% with 50 mg and 89% with 100 mg. All patients whose dose was increased to 100 mg had a better response than those with 50 mg. SEP and EHGS correlation was r=0.97. The most common adverse effects were headache (15%), red face (8%) and nasal congestion (3%) at the beginning of treatment, and they did not become more pronounced when dose was increased to 100 mg.
Conclusions: After initial treatment with 50 mg of sildenafil, patients whose dose was increased to 100 mg showed greater improvement in erection hardness and satisfaction with no increase in side effects or their severity. A positive correlation between successful sexual intercourse with dose escalation to 100 mg and Grade 4 erection hardness was demonstrated.


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