Treatment of erectile dysfunction with sildenafil

Objectives. To determine the efficacy of sildenafil for the treatment of er ectile dysfunction (ED) in a clinical practice setting; to evaluate the cor relation between patient and partner perceptions of treatment outcomes; and to assess the relation between the severity of ED and response to treatmen t. Methods, Among the first 100 men to receive sildenafil in a urology practic e setting, 74 (mean +/- SD age 64 +/- 11 years) completed a validated sexua l function questionnaire (International Index of Erectile Function [IIEF]) before and after a 4 to 6-week treatment period. A modified version of the same questionnaire was independently completed by partners. ED was categori zed into a severity class of I to IV. Results. Sildenafil treatment improve d erections by 71% to 95%, according to responses in key IIEF questions 3 a nd 4. Overall, 57 (77%) of 74 patients desired to continue treatment after the test period. Patient score on the IIEF was correlated with partner scor e on the modified questionnaire before and after treatment (r = 0.67 to 0.8 1, P < 0.01). IIEF scores were reflected in a simple severity classificatio n system. Men with the best presentation of erections (severity class I) ex hibited the best responses to sildenafil, whereas men with no erections (se verity class IV) were much less likely to respond to the drug and desire co ntinuation of treatment (P <0.01). Patients with a radical prostatectomy we re relatively refractory to sildenafil. except for 2 of 5 who had undergone a nerve-sparing operation. Conclusions. In clinical practice, sildenafil is an effective treatment of ED, according to partner-validated questionnaire responses; and the results of treatment are predictable with an ED severity classification system. UR OLOGY 53: 19-24, 1999. (C) 1999, Elsevier Science inc. All rights reserved.