title: Thalassaemic men affected by erectile dysfunction treated with transurethral alprostadil: case report.
abstract: The aim of this controlled clinical study, performed in a specialized institutional unit for thalassaemic men, was to consider the possibility of restoring erection in beta-thalassaemic patients with erectile dysfunction by administering E(1) prostaglandins (alprostadil) transurethrally. Four patients affected by beta-thalassaemia, aged between 32 and 52 years, and having an erectile dysfunction were included in the study. Each patient was given 500 microg alprostadil in the distal urethra. Response was evaluated by the erection assessment scale. The main outcome measures were: (i) the clinical study; (ii) FSH, LH, total and free testosterone plasma concentrations; and (iii) basal and dynamic Doppler sonography of cavernous arteries. The treatment produced a response of 3-4 on the erection assessment scale. Average minimum response time was 20 min, while average maximum response time was about 60 min. There was no evidence of significant side effects. Our hypothesis is that the delayed reaction was due to organ damage induced by iron load, causing a reduction or absence of elasticity in the interstitial tissue of the corpora cavernosa. Thus, we believe that treatment with alprostadil can be considered an effective, non-invasive therapy for thalassaemic patients with erectile dysfunction.
authors.affiliation: Division of Thalassaemia and Department of Microbiological Science and Gynaecological Science, Ospedale S.Bambino, Catania.
authors.forename: T
authors.initials: T
authors.lastname: Lombardo
authors.forename: B
authors.initials: B
authors.lastname: Giammusso
authors.forename: V
authors.initials: V
authors.lastname: Frontini
authors.forename: S
authors.initials: S
authors.lastname: D'Arpa
authors.forename: C
authors.initials: C
authors.lastname: Pafumi
authors.forename: S
authors.initials: S
authors.lastname: Caruso
mesh_terms: D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage* / Q000627:therapeutic use; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000187:drug effects; D013789:Thalassemia / Q000150:complications*; D013997:Time Factors; D014521:Urethra; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D000527:Alprostadil