1
|
Mulhall JP, Giraldi A, Hackett G, Hellstrom WJ, Jannini EA, Rubio-Aurioles E, Trost L, Hassan TA. The 2018 Revision to the Process of Care Model for Management of Erectile Dysfunction. J Sex Med 2018; 15:1434-1445. [DOI: 10.1016/j.jsxm.2018.05.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 01/29/2023]
|
2
|
Taylor DG, Giuliano F, Hackett G, Hermes-DeSantis E, Kirby MG, Kloner RA, Maguire T, Stecher V, Goggin P. The pharmacist's role in improving the treatment of erectile dysfunction and its underlying causes. Res Social Adm Pharm 2018; 15:591-599. [PMID: 30057329 DOI: 10.1016/j.sapharm.2018.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 01/07/2023]
Abstract
Erectile dysfunction (ED), which worldwide is likely to affect in excess of 300 million men by 2025, is often either untreated or insufficiently treated. It can be a prelude to other serious illnesses and may be a cause or consequence of depression in affected individuals. Among men younger than 60 years of age, ED can be a robust early-stage indicator of vascular disease and type 2 diabetes. Untreated or inadequately treated ED can also be a sign of poor communication between health professionals and service users of all ages. Improved treatment of ED could cost-effectively prevent premature deaths and avoidable morbidity. The extension of community pharmacy‒based health care would enable more men living with ED to safely access effective medications, along with appropriate diagnostic services and support for beneficial lifestyle changes such as smoking cessation in conveniently accessible settings. The task of introducing improved methods of affordably addressing problems linked to ED exemplifies the strategic challenges now facing health care systems globally. Promoting professionally supported self-care in pharmacies has the potential to meet the needs of aging populations in progressively more effective ways.
Collapse
Affiliation(s)
- David G Taylor
- The UCL School of Pharmacy, 29-39 Brunswick Square, Bloomsbury, London, WC1N 1AX, UK.
| | - Francois Giuliano
- Neurourology R. Poincaré Hal Garches, Versailles Saint-Quentin University, 104 Boulevard Raymond Poincaré, Garches, 92380, France.
| | - Geoff Hackett
- Good Hope Hospital, Rectory Road, Sutton Coldfield, Birmingham, B75 7RR, UK.
| | - Evelyn Hermes-DeSantis
- Ernest Mario School of Pharmacy, Rutgers University, 160 Frelinghuysen Road, New Brunswick, NJ, 08854, USA.
| | - Michael G Kirby
- The Prostate Centre, 32 Wimpole St, Marylebone, London W1G 8GT, UK; University of Hertfordshire, Centre for Research in Primary and Community Care, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK.
| | - Robert A Kloner
- Huntington Medical Research Institutes, 686 S Fair Oaks Ave, Pasadena, CA 91105, USA; Division of Cardiovascular Medicine, Dept. of Medicine, Keck School of Medicine at University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA.
| | - Terry Maguire
- Queens University Belfast, University Road, Belfast, BT7 1NN, UK, Ireland.
| | - Vera Stecher
- Pfizer Inc, 235 E 42nd St, New York, NY, 10017, USA.
| | - Paul Goggin
- Pfizer Ltd, Discovery Park, Ramsgate Rd, Sandwich, CT13 9ND, UK.
| |
Collapse
|
3
|
Shah GR, Chaudhari MV, Patankar SB, Pensalwar SV, Sabale VP, Sonawane NA. Evaluation of a multi-herb supplement for erectile dysfunction: a randomized double-blind, placebo-controlled study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 12:155. [PMID: 22978405 PMCID: PMC3478157 DOI: 10.1186/1472-6882-12-155] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 08/16/2012] [Indexed: 11/16/2022]
Abstract
Background Evidence is lacking for multi-ingredient herbal supplements claiming therapeutic effect in sexual dysfunction in men. We examined the safety and efficacy of VigRX Plus (VXP) – a proprietary polyherbal preparation for improving male sexual function, in a double blind, randomized placebo-controlled, parallel groups, multi-centre study. Methods 78 men aged 25–50 years of age; suffering from mild to moderate erectile dysfunction (ED), participated in this study. Subjects were randomized to receive VXP or placebo at a dose of two capsules twice daily for 12 weeks. The international index of erectile function (IIEF) was the primary outcome measure of efficacy. Other efficacy measures were: Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Serum testosterone, Semen analysis, Investigator’s Global assessment and Subjects’ opinion. Results In subjects receiving VXP, the IIEF-Erectile Function (EF) scores improved significantly as compared to placebo. After 12 weeks of treatment, the mean (sd) IIEF-EF score at baseline increased from 16.08 (2.87) to 25.08 (4.56) in the VXP group versus 15.86 (3.24) to 16.47 (4.25) in the placebo group (P < 0.0001). Similar results were observed in each of the remaining four domains of the IIEF (orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction).There was a significant difference for VXP versus placebo comparison of mean (sd) EDITS scores of patients: 82.31(20.23) vs 36.78(22.53) and partners :(82.75(9.8) vs 18.50(9.44);P < 0.001. Thirty-five out of 39 (90%) subjects from the VXP group and one (3%) from the placebo group wished to continue with the treatment they received. Investigator’s global assessment rated VXP therapy as very good to excellent in more than 50% patients and placebo therapy as fair to good in about 25% of patients. Incidence of side effects and subject’s rating for tolerability of treatment was similar in both groups. Conclusions VigRX Plus was well tolerated and more effective than placebo in improving sexual function in men. Trial Registration Clinical Trial Registry India, CTRI/2009/091/000099, 31-03-2009
Collapse
|
4
|
An open label, randomized, fixed-dose, crossover study comparing efficacy and safety of sildenafil citrate and saffron (Crocus sativus Linn.) for treating erectile dysfunction in men naïve to treatment. Int J Impot Res 2010; 22:240-50. [PMID: 20520621 DOI: 10.1038/ijir.2010.10] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Saffron (Crocus sativus Linn.) have been perceived by the public as a strong aphrodisiac herbal product. However, studies addressing the potential beneficial effects of saffron on erectile function (EF) in men with ED are lacking. Our aim was to evaluate the efficacy and safety of saffron administration on EF in men with ED. After a 4-week baseline assessment, 346 men with ED (mean age 46.6+/-8.4 years) were randomized to receive on-demand sildenafil for 12 weeks followed by 30 mg saffron twice daily for another 12 weeks or vice versa, separated by a 2-week washout period. To determine the type of ED, penile color duplex Doppler ultrasonography before and after intracavernosal injection with 20 microg prostaglandin E(1), pudendal nerve conduction tests and impaired sensory-evoked potential studies were performed. Subjects were assessed with an International Index of Erectile Function (IIEF) questionnaire, Sexual Encounter Profile (SEP) diary questions, patient and partner versions of the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire and the Global Efficacy Question (GEQ) 'Has the medication you have been taking improved your erections?' No significant improvements were observed with regard to the IIEF sexual function domains, SEP questions and EDITS scores with saffron administration. The mean changes from baseline values in IIEF-EF domain were +87.6% and +9.8% in sildenafil and placebo groups, respectively (P=0.08). We did not observe any improvement in 15 individual IIEF questions in patients while taking saffron. Treatment satisfaction as assessed by partner versions of EDITS was found to be very low in saffron patients (72.4 vs 25.4, P=0.001). Mean per patient 'yes' responses to GEQ was 91.2 and 4.2% for sildenafil and saffron, respectively (P=0.0001). These findings do not support a beneficial effect of saffron administration in men with ED.
Collapse
|
5
|
Wentzell E, Salmerón J. You'll "get viagraed:" Mexican men's preference for alternative erectile dysfunction treatment. Soc Sci Med 2009; 68:1759-65. [PMID: 19362402 DOI: 10.1016/j.socscimed.2009.03.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Indexed: 10/20/2022]
Abstract
The pharmaceutically focused clinical and epidemiological literature on erectile dysfunction (ED) treatment has paid little attention to men's non-medical responses to changing erectile function. This study explores the relationship of erectile function change, resulting use of medical or alternative treatments, and Mexican men's understandings of masculinity and aging, through a mixed method approach utilizing both quantitative survey and ethnographic interview data. A survey of 750 men undertaken at the Instituto Méxicano del Seguro Social hospital in Cuernavaca, Mexico in April to June 2008 showed that only about half of those who experienced erectile function changes sought treatment for these changes; treatment users were far more likely to seek alternative treatment than medical treatment, especially preferring lifestyle change and vitamins. Ethnographic data from interviews with 250 male urology patients undertaken from October 2007 to August 2008 at the same site reveal that treatment users' preferences were linked to fears about the safety and situational inappropriateness of medical ED treatment. These findings suggest that by focusing on patients' use of pharmaceuticals, biomedically oriented research has overlooked the most common responses to changing erectile function. Broadening the focus of ED treatment research to include analysis of men's rejection of pharmaceutical treatment - either in favor of alternative treatment, or because they do not see their erectile function changes as requiring medical intervention - would correct this imbalance in the literature. Further, the knowledge that even men who seek treatment may prefer alternatives to pharmaceutical interventions will help physicians to offer treatments, such as lifestyle change, that their patients might find more acceptable. Such measures would simultaneously help to mitigate the chronic illnesses, like diabetes and hypertension, which frequently co-occur with diminished erectile function.
Collapse
Affiliation(s)
- Emily Wentzell
- Department of Anthropology, University of Michigan, 101 West Hall, 1085 S. University Ave., Ann Arbor, MI 48109-1107, USA.
| | | |
Collapse
|
6
|
Park BH, Kim SW, Kim SW, Kim JJ, Kim HS, Min KS, Park K, Park NC, Lee SW, Chung WS, Hong JH, Park JK. Evaluation of Complementary and Alternative Medicine for Treating Patients with Erectile Dysfunction. Korean J Urol 2006. [DOI: 10.4111/kju.2006.47.9.987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Bong Hee Park
- Department of Urology, Chonbuk National University Medical School, and The Institute for Medical Sciences, and The Research Institute of Clinical Medicine of Chonbuk National University Hospital, The Regional Research Centers Program of the Korean Ministry of Education & Human Resources Development through the Center for Healthcare Technology Development, Jeonju, Korea
| | - Soo Woong Kim
- Department of Urology, Seoul National University, Seoul, Korea
| | - Sae Woong Kim
- Department of Urology, The Catholic University of Korea, Seoul, Korea
| | - Je Jong Kim
- Department of Urology, Korea University, Seoul, Korea
| | - Hong Sik Kim
- Department of Urology, Chungnam National University, Daejeon, Korea
| | - Kweon Sik Min
- Department of Urology, Inje University, Busan, Korea
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Nam Cheol Park
- Department of Urology, Pusan National University, Busan, Korea
| | - Sung Won Lee
- Department of Urology, Sungkyunkwan University, Seoul, Korea
| | - Woo Sik Chung
- Department of Urology, Ewha Womens University, Seoul, Korea
| | - Jun Hyuk Hong
- Department of Urology, Ulsan University, Seoul, Korea
| | - Jong Kwan Park
- Department of Urology, Chonbuk National University Medical School, and The Institute for Medical Sciences, and The Research Institute of Clinical Medicine of Chonbuk National University Hospital, The Regional Research Centers Program of the Korean Ministry of Education & Human Resources Development through the Center for Healthcare Technology Development, Jeonju, Korea
| |
Collapse
|
7
|
Gore JL, Swerdloff RS, Rajfer J. Androgen Deficiency in the Etiology and Treatment of Erectile Dysfunction. Urol Clin North Am 2005; 32:457-68, vi-vii. [PMID: 16291037 DOI: 10.1016/j.ucl.2005.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The evaluation and management of erectile dysfunction (ED) has evolved dramatically following the introduction of oral phosphodiesterase-5 inhibitors. Despite the limited role of directed diagnostic testing in the evaluation of the impotent patient, routine de-termination of a serum testosterone likely is indicated based on evidence that testosterone modulates erectile function, that hypogonadism is prevalent among elderly men and men with ED, and that symptomatology alone rarely detects hypogonadism. Forms of testosterone commonly used include oral, parenteral, transdermal, and implantable preparations, each with significant advantages and disadvantages. The risks and benefits of testosterone supplementation have been characterized incompletely and will require further validation before widespread use of testosterone as hormone replacement therapy in aging men.
Collapse
Affiliation(s)
- John L Gore
- Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, CHS Rm 66-124, Los Angeles, CA 90095-1738, USA.
| | | | | |
Collapse
|
8
|
Salama N. Satisfaction with the malleable penile prosthesis among couples from the Middle East--is it different from that reported elsewhere? Int J Impot Res 2004; 16:175-80. [PMID: 14961064 DOI: 10.1038/sj.ijir.3901150] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
No studies from the Middle East have investigated the psychosexual aspects of penile prosthesis. Therefore, several questions were used herein to address satisfaction with the use of malleable penile prosthesis among couples from this geographic area, as an option to treat erectile dysfunction (ED). A total of 50 patients who underwent the insertion of AMS 650 and Acu-form penile prostheses and their partners were evaluated with a retrospective clinical record review, as well as patient and partner questionnaires. In all, 70% of the patients and 57% of the partners were satisfied with the prosthesis. There was an increase in frequency of intercourse, sexual desire, and ability to achieve orgasm. Dislike for the device was the most common cause for nonsatisfaction of patients with the device, while sense of unnaturalness was that for partners. Results from this evaluation highlight the obvious need for proper preoperative counseling for both the patient and his partner to minimize unrealistic expectations. They also emphasize the importance of careful screening of both psychosocial and psychosexual aspects of the couple based on cultural ethnic background, since these are important predictors of the therapeutic outcome of prosthesis insertion. Efforts to extend information about ED to the public may be useful to reduce patients' exaggerated embarrassment about this problem and make their partners actively involved in the treatment.
Collapse
Affiliation(s)
- N Salama
- Department of Urology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
| |
Collapse
|
9
|
Lewis JH. Challenges in the assessment of erectile dysfunction and treatment with oral therapies: review with case examples. JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS 2004; 16:428-40. [PMID: 15543920 DOI: 10.1111/j.1745-7599.2004.tb00421.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
PURPOSE To review the clinical dimensions, etiology, assessment, and treatment of erectile dysfunction (ED) and to increase awareness of oral therapies for this condition. DATA SOURCES Scientific literature, consensus guidelines, and manufacturers' product information and guidelines. CONCLUSIONS A prevalent condition, particularly in middle-aged and elderly men, ED is vastly underreported and undertreated. Oral therapies, including phosphodiesterase type 5 inhibitors, are effective and well tolerated in many patients and represent potential first-line treatments for ED. IMPLICATIONS FOR PRACTICE ED has been associated with both life-threatening illnesses and reduced quality of life. Improving recognition and treatment of this condition and counseling patients about ED represent important clinical opportunities. A broad and expanding array of ED treatments enable therapy to be individualized to the needs of patients and their partners.
Collapse
Affiliation(s)
- Jean H Lewis
- Erectile Dysfunction Clinic, Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.
| |
Collapse
|