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Articles
Erectile Dysfunction |
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Abstract 25.7.03
THE ADDITION OF TESTOSTERONE REPLACEMENT THERAPY TO
TREAT ERECTILE DYSFUNCTION AFTER FAILURE OF SILDENAFIL ALONE IN MEN WITH ACQUIRED ANDROGEN
DEFICIENCY SYNDROME
Brian Rosenthal, Phillip C. Ginsberg, Michael Metro, Richard C. Harkaway,
Philadelphia PA
(The Journal of Urology, Vol. 169, No 4, Supplement, Tuesday, April 29, 2003)
INTRODUCTION AND OBJECTIVE: While Viagra (sildenafil citrate) is an
affective treatment for erectile dysfunction, it does not always result in adequate
potency. We evaluated whether combination therapy with Viagra and testosterone replacement
theapy is effective in achieving adequate potency in patients who have failed with Viagra
alone and were subsequently found to have low serum testosterone levels.
METHODS: Between July 2000 and June 2001, we evaluated 80 men who failed
3 months of Viagra therapy at maximum dosage with at least three attempts at intercourse
during the three month period. 24 of the 80 men were found to have testosterone between 90
and 400mg/ml. Each of the 24 men was then started on testosterone replacement (Androgel
5mg daily) for 4 weeks, Viagra was subsequently restarted in combination therapy with the
Androgel after 4 weeks of androgen replacement therapy. Potency was defined as the ability
to have at least one episode of satisfactory intercourse during the treatment period.
RESULTS: At 4 weeks follow up, after the start of Hormone Replacement
Therapy (HRT) alone, none of the men had regained potency. At 3 months follow up after
combination therapy was started, 22 of the 24 men (92%) reported improved potency.
CONCLUSIONS: We recognize that this study lacks an adequate control group
of men with prolonged use of HRT alone to determine the success of potency. However, our
data shows promising results for the use of combination therapy with testosterone
replacement therapy and Viagra in patients who have failed Viagra and were found to have
low normal serum levels of testosterone. In addition, it underscores the number of men
with low or low-normal testosterone levels who would benefit from testosterone screening
when being evaluated for erectile dysfunction.
Source of funding: None |
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