From the Sexual Medicine Society of North America
NEW YORK—Previous research has shown that >70% of men with ­sym­p­toms of benign prostatic hyperplasia (BPH) also have erectile dysfunction (ED). It is estimated that >50% of American men who are >40 years old have difficulties achieving or main­taining an erection and that >50% of American men older than 50 years have some sign of BPH.
Results of a new study presented at a meeting of the Sexual Medicine Society of North America indicate that sildenafil citrate (Viagra), which has been shown to improve ED, also effectively treats the prostate and lowers urinary tract symptoms associated with prostate enlargement that often coexists with ED.
This 12-week, double-blind, placebo-controlled study included 366 men aged >=45 years who scored ?25 on the erectile function domain of the International Index of Erectile Function (IIEF), had an International Prostate Symptom Score (IPSS) >=12, and a prostate-specific antigen level ?10 ng/mL. Excluded from the study were men with confirmed or suspected prostate cancer.
Participants were told to take sildenafil (50 or 100 mg) or placebo each night at bedtime or 30 minutes to 1 hour before anticipated sexual activity. The primary end point was the change in erectile function from baseline at the end of the study. Secondary end points included changes in self-esteem based on the Self-Esteem and Relationship Questionnaire (SEAR), total IPSS, IPSS subscores for irritative and obstructive symptoms, quality of life, BPH impact index, and maximum ­urinary flow rate (Qmax).
After 12 weeks of treatment, men ­taking sildenafil showed significant improvements in IIEF erectile function domain scores compared with men taking ­placebo (P <.001). They also improved their SEAR scores (+20.95 vs +1.11; P <.001) and reduced their total IPSS, irritative, and obstructive subscores ­versus the placebo group (P <.001). There were no significant increases in Qmax in either group. Adverse events included headache, dyspepsia, flushing, and rhinitis.
“These results suggest that sildenafil taken daily improves erectile function and ameliorates [lower urinary tract symptoms],” noted lead investigator Kevin V. McVary, MD, FACS, of the Feinberg School of Medicine, North­western University, Chicago, and his colleagues.—R.M.