Clinical efficacy of sildenafil citrate based on etiology and response to prior treatment

Purpose: We assess the clinical efficacy of sildenafil citrate and predicto rs of satisfactory outcome. Materials and Methods: All patients treated with sildenafil citrate within the first 6 weeks of its release were evaluated with a self-administered qu estionnaire before and at completion of therapy to assess etiology of erect ile dysfunction, level of sexual function, libido, response to previous the rapies, response to therapy with sildenafil citrate and quality of life. Se xual function was measured before and during therapy using an abbreviated v ersion of the International Index of Erectile Function, with a successful o utcome defined as a level of satisfaction of 4 or 5 on a 5-point scale. Results: Followup was obtained in 267 of the 308 patients who entered the s tudy. Mean age plus or minus standard deviation was 61 +/- 9.6 years and du ration of erectile dysfunction was 4.1 +/- 3 years. Overall satisfaction wi th sildenafil citrate for the entire patient population was 65% and respons e to prior therapies did not affect satisfaction. There was a significant p ositive correlation between baseline sexual function and response to silden afil citrate but even patients with severe erectile dysfunction had a 41% s atisfaction rate. Etiology of erectile dysfunction had a significant impact on satisfaction rate, with neurogenic causes of erectile dysfunction (diab etes, prostate surgery and so forth) having significantly lower rates than psychogenic or vasculogenic erectile dysfunction. Conclusions: Sildenafil citrate is a highly effective oral agent for the tr eatment of erectile dysfunction in clinical practice. The best predictors f or response to sildenafil citrate therapy are baseline sexual function and etiology of erectile dysfunction. However, we could not identify any patien t characteristic that would predict absolute failure for sildenafil citrate therapy. Therefore, all patients with erectile dysfunction who do not have specific contraindications should be considered for sildenafil citrate the rapy.