Relative efficacy of sildenafil compared to other treatment options for erectile dysfunction

Objective, We examined and compared the efficacy of sildenafil in patients previously using other agents or devices for erectile dysfunction (ED) trea tment. Methods. We identified 47 patients with organic ED who had tried other ther apies (intracavernosal injection therapy [ICIT], intraurethral prostaglandi n suppositories [IPS], vacuum erection devices [VEDs], or yohimbine) before using sildenafil. Comparisons of the efficacy of sildenafil to the previou sly used agent or device were assessed by telephone questionnaire. Response s were compared using nonparametric Wilcoxon rank sum and analysis of varia nce testing. Results. Sildenafil therapy was no more effective than ICIT or VEDs but was more effective than TPS. No significant difference occurred in response to sildenafil with age. Of 22 patients achieving erections adequate for inter course with their previous therapy, 14 (63%) achieved equal or improved ere ctions with sildenafil. Of the remaining 18 patients who had erections inad equate for intercourse with previous therapy, 5 (27%) bad adequate erection s with sildenafil. Conclusions. Oral sildenafil therapy provides results comparable to those o f other available ED treatment modalities. A trial of this drug in this pat ient population is warranted.