title: Efficacy, safety, and use of sildenafil in urologic practice.
abstract: OBJECTIVE
  To evaluate the efficacy, side effects, renewal patterns, and other relevant practice issues of the use of sildenafil in urologic practice after approval of this medication and release for public use.
  
  
  METHODS
  Consecutive male patients with erectile dysfunction were evaluated by one urologist and sildenafil was prescribed when appropriate. Patients were monitored at two follow-up visits: at 3 to 4 months and then at 3 to 8 months (6 to 12 months after the initial prescription). At the follow-up visits, each patient was given a questionnaire assessing his improvement in erectile function, satisfaction with sildenafil, and expectations. Data were obtained on side effects, medical history, tablets taken, subsequent treatment in sildenafil failures, and renewal patterns.
  
  
  RESULTS
  A total of 164 and 82 patients were evaluated at the first and second follow-up visits, respectively. Patients used a mean of 1.2 to 1.4 tablets per week. At the first follow-up visit, an improvement in erection was noted in 68.2% of patients. At the second follow-up visit, an improvement in erection was noted in 80.5% of patients. Sixty-two percent and 78% of patients renewed sildenafil at the first and second follow-up visits, respectively. In those patients who did not renew, a lack of efficacy was the most frequent reason. Intracavernous injection therapy was the most common treatment after sildenafil failure, followed by penile implants.
  
  
  CONCLUSIONS
  Sildenafil is an effective and safe drug in the treatment of erectile dysfunction. At the first and second follow-up visit, most patients requested and received renewal.
authors.affiliation: Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York, USA.
authors.forename: E
authors.initials: E
authors.lastname: Fagelman
authors.forename: A
authors.initials: A
authors.lastname: Fagelman
authors.forename: R
authors.initials: R
authors.lastname: Shabsigh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D007172:Erectile Dysfunction / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010410:Penile Erection; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones; D014572:Urology
chemical_list: D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate