Is There a Link between Erectile Dysfunction and Coronary Artery Disease?

[Why and how to explore erectile function in patient with cardiovascular risk?]

Erectile dysfunction (ED) is a frequent disorder, which can be the first symptom of an underlying pathology such as cardiovascular diseases. Doctors should have a good understanding of erectile dysfunction and must be aware of the importance of detecting and investigating any erectile disorders. Detection of an erectile dysfunction induces to search underlying cardiovascular diseases, but also urinary symptoms, hormonal deprivation, mood and relational alterations and iatrogenous complications. Determination of erectile disorders therefore represents an excellent opportunity to conduct a work-up of this symptom, as an integral part of health policy.

Vardenafil for the Treatment of Erectile Dysfunction: A Critical Review of the Literature Based on Personal Clinical Experience

OBJECTIVE

To critically review the literature on vardenafil in the treatment of erectile dysfunction while integrating the clinical findings with the personal experience of the authors.

METHODS

Analysis of published full-length papers that were identified through Medline search from January 2000 through May 2004. Abstracts published in peer-reviewed journals from the same period were also considered.

RESULTS

Efficacy, tolerability and safety, as reported in the peer-reviewed literature compares well with the authors' personal experience. Authors' personal observations include discussions on potency, selectivity, selection of initial dose, counselling for patients characteristically considered difficult-to-treat (diabetes, prostatectomy, depression), including the determination of the maximal efficacious dose and the possible role of daily dosing, optimisation of the use of vardenafil according to its pharmacokinetic and pharmacodynamic profiles (onset and reliability), and management of ED patients with or at risk for cardiovascular disease.

CONCLUSIONS

Extensive experience with vardenafil as reported in peer reviewed literature confirms the important role of vardenafil in the management of patients with ED. The development of each physician's own experience with vardenafil is key to optimise overall satisfaction of this therapy by the patient and his partner.

Retention and migration of alprostadil cream applied topically to the glans meatus for erectile dysfunction

Retention and migration of a specially designed alprostadil transdermal cream was assessed after single-dose administration to the glans meatus of the penis. Seven men were enrolled in this two-way crossover study. Three subjects self-administered the radio-labeled alprostadil transdermal cream (approximately 100 mg of cream containing 300 microg alprostadil) by inserting the tip of the dispenser into the meatus. In three others, the dose was administered by dispensing the cream dropwise into the metal opening without touching the penis (the preferred and directed method). Retention and migration of the cream mass was measured in the penis with a gamma scintillation camera. The alprostadil transdermal cream was retained in the fossa navicularis at or near 99% in five of six subjects regardless of the method of dosing, thus indicating that the cream formulation performed as designed. A mild, transient burning sensation in the penis was the most common adverse event.