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Combination of Vacuum Erection Device and PDE5 Inhibitors as Salvage Therapy in PDE5 Inhibitor Nonresponders with Erectile Dysfunction

Oral phosphodiesterase type 5 inhibitors (PDE5i) have improved treatment options for erectile dysfunction (ED). In case of unresponsiveness to PDE5i, alternative therapies are considered. To evaluate whether combination of vacuum erection device (VED) and PDE5i is effective as salvage therapy in sub...

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Published in:Journal of sexual medicine 2009-09, Vol.6 (9), p.2561-2567
Main Authors: Canguven, Onder, Bailen, James, Fredriksson, William, Bock, David, Burnett, Arthur L.
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description Oral phosphodiesterase type 5 inhibitors (PDE5i) have improved treatment options for erectile dysfunction (ED). In case of unresponsiveness to PDE5i, alternative therapies are considered. To evaluate whether combination of vacuum erection device (VED) and PDE5i is effective as salvage therapy in subjects with ED in whom PDE5i alone failed. From September 2007 to May 2008, we evaluated 69 men (aged 36–82 years) in whom PDE5i treatment at the highest recommended dose, with at least 4–6 attempts at intercourse during a 3 months period, had failed. The clinical efficacy of combination therapy was evaluated using the International Index of Erectile Function-5 (IIEF-5) questionnaire, Sexual Encounter Profile (SEP)-2, SEP-3, and Global Patient Assessment Scale (GPAS). Scores on IIEF-5, SEP-2, SEP-3, and GPAS before and after combination therapy were measured. After 4 weeks of combination therapy, the mean IIEF-5 score increased significantly over baseline from 9.0 to 17.6 (P < 0.001). Of the 34 subjects with a SEP-2 response of “no” at baseline, 27 (79%) responded “yes” after combination therapy (P < 0.001). Of the 50 subjects with a SEP-3 response of “no” at baseline, 35 (70%) responded “yes” after combination therapy (P < 0.001). Furthermore, of the 42 subjects with a GPAS response of “not at all” or “slightly” improved at baseline, 31 (74%) responded “moderately” or “greatly” improved after combination therapy (P < 0.001). One subject (1.5%) experienced device-related intermittent penile pain, which resolved after 4 days without any action. Statistically significant improvements over baseline were seen in IIEF-5, SEP-2, SEP-3, and GPAS measures following 4 weeks of combination therapy of PDE5i and VED. This study supports the use of PDE5i with VED in men in whom PDE5i alone failed. This combination therapy may be offered to patients not satisfied with PDE5i alone before being switched to more invasive alternatives. Canguven O, Bailen J, Fredriksson W, Bock D, and Burnett AL. Combination of vacuum erection device and PDE5 inhibitors as salvage therapy in PDE5 inhibitor nonresponders with erectile dysfunction. J Sex Med 2009;6:2561–2567.
doi_str_mv 10.1111/j.1743-6109.2009.01364.x
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In case of unresponsiveness to PDE5i, alternative therapies are considered. To evaluate whether combination of vacuum erection device (VED) and PDE5i is effective as salvage therapy in subjects with ED in whom PDE5i alone failed. From September 2007 to May 2008, we evaluated 69 men (aged 36–82 years) in whom PDE5i treatment at the highest recommended dose, with at least 4–6 attempts at intercourse during a 3 months period, had failed. The clinical efficacy of combination therapy was evaluated using the International Index of Erectile Function-5 (IIEF-5) questionnaire, Sexual Encounter Profile (SEP)-2, SEP-3, and Global Patient Assessment Scale (GPAS). Scores on IIEF-5, SEP-2, SEP-3, and GPAS before and after combination therapy were measured. After 4 weeks of combination therapy, the mean IIEF-5 score increased significantly over baseline from 9.0 to 17.6 (P &lt; 0.001). 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Canguven O, Bailen J, Fredriksson W, Bock D, and Burnett AL. Combination of vacuum erection device and PDE5 inhibitors as salvage therapy in PDE5 inhibitor nonresponders with erectile dysfunction. J Sex Med 2009;6:2561–2567.</abstract><cop>Malden, USA</cop><pub>Elsevier Inc</pub><pmid>19627462</pmid><doi>10.1111/j.1743-6109.2009.01364.x</doi><tpages>7</tpages></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Combination Therapy
Health Status Indicators
Humans
Impotence, Vasculogenic - drug therapy
Impotence, Vasculogenic - therapy
Male
Middle Aged
Patient Satisfaction
Penile Erection
Penile Erection - drug effects
Personal Satisfaction
Phosphodiesterase
Phosphodiesterase Inhibitors - therapeutic use
Psychometrics
Salvage Therapy
Surveys and Questionnaires
Treatment Failure
Treatment Outcome
Vacuum
Vasodilator Agents - therapeutic use
VED
title Combination of Vacuum Erection Device and PDE5 Inhibitors as Salvage Therapy in PDE5 Inhibitor Nonresponders with Erectile Dysfunction
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