Erectile dysfunction in patients with spina bifida is a treatable condition

Purpose: Now that individuals with spina bifida live well into adulthood er ectile dysfunction has become a recognized associated medical disorder. To our knowledge no study has dealt specifically with treatment of erectile dy sfunction in men with spina bifida. Therefore, we conducted a prospective, blinded, randomized, placebo controlled, dose escalation, crossover study t o determine the ability to treat erectile dysfunction in men with spina bif ida with sildenafil citrate. Materials and Methods: Erectile dysfunction was diagnosed in 15 men 19 to 3 5 years old with spina bifida who were assigned to take 4 sets of tablets, 5 tablets per set, in a random order. All patients took 25 and 50 rug. sild enafil and 2 identical looking sets of corresponding placebos I hour before planned sexual activity. Efficacy was assessed by the effect of treatment compared to baseline, that is before treatment, on rating of erections (sco red from 0 to 10), duration of erections, frequency of erections based on r esponse to question 1 (scored from 0 to 5) of the International Index of Er ectile Function and confidence to obtain an erection based on response to q uestion 15 (scored from 1 to 5) of the International Index of Erectile Func tion. Results: Improved erectile function was reported while on sildenafil by 12 (80%) men compared to baseline and placebos. There was a significant dose d ependent improvement of erectile function with both 25 and 50 mg. sildenafi l compared to baseline (p < 0.05), as mean erectile score increased by 50% and 88%, mean duration of erections increased by 192% and 266%, mean freque ncy of erections increased by 61% and 96%, and mean level of confidence inc reased by 33% and 63%, respectively. Furthermore, 50 mg. sildenafil provide d greater improvement in all 4 parameters compared to 25 mg. The placebo re sults were not significantly different compared to baseline for any of the parameters. Conclusions: Erectile dysfunction in patients with spina bifida is a medica lly treatable condition. Sildenafil is effective in this patient population and improves level of sexual confidence.