title: Efficacy, safety and predictive factors of therapeutic success with sildenafil for erectile dysfunction in patients with different spinal cord injuries.
abstract: METHODS
  Multicenter, open, prospective, before-after study.
  
  
  OBJECTIVE
  To assess the efficacy and safety of sildenafil therapy for erectile dysfunction in patients with spinal cord injury, and the association between the response to sildenafil and factors such as causes and levels of spinal cord injury, grade of ASIA deficit, time since injury, orgasmic perception, and degree of baseline erection.
  
  
  METHODS
  Homes of outpatients of 16 spinal cord injury units in Spain.
  
  
  METHODS
  One hundred and seventy patients with erectile dysfunction secondary to spinal cord injury, from whom baseline data were collected on their sexual function, and who started treatment with sildenafil 50 mg. An efficacy assessment was made by the patient and his partner, and the score of the International Index of Erectile Function (IIEF) was recorded.
  
  
  RESULTS
  It was reported by 88.2% of the patients and 85.3% of their partners that treatment with sildenafil had improved their erections, regardless of the baseline characteristics of the spinal cord injury and erectile function. In responders, this improvement was confirmed by an increase from 12.5 to 24.8 points (P<0.001) of the Erectile Function Domain of IIEF. A significant improvement was also seen in patients' satisfaction with sexual activity and general satisfaction derived from sexual life. Preservation of orgasmic perception and a baseline degree of erection of 3 or 4 (P=0.006) were predictors of therapeutic success. No serious adverse events occurred.
  
  
  CONCLUSIONS
  Sildenafil is an effective, well-tolerated treatment for erectile dysfunction caused by spinal cord injury, regardless of the cause, neurological level, ASIA grade, and time since injury.
  
  
  BACKGROUND
  Spanish Society of Paraplegia.
authors.affiliation: Hospital Nacional de Parapléjicos, Toledo, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Sánchez Ramos
authors.forename: J
authors.initials: J
authors.lastname: Vidal
authors.forename: M L
authors.initials: ML
authors.lastname: Jáuregui
authors.forename: M
authors.initials: M
authors.lastname: Barrera
authors.forename: C
authors.initials: C
authors.lastname: Recio
authors.forename: M
authors.initials: M
authors.lastname: Giner
authors.forename: L
authors.initials: L
authors.lastname: Toribio
authors.forename: S
authors.initials: S
authors.lastname: Salvador
authors.forename: A
authors.initials: A
authors.lastname: Sanmartín
authors.forename: M
authors.initials: M
authors.lastname: de la Fuente
authors.forename: J F
authors.initials: JF
authors.lastname: Santos
authors.forename: F J
authors.initials: FJ
authors.lastname: de Juan
authors.forename: S
authors.initials: S
authors.lastname: Moraleda
authors.forename: J L
authors.initials: JL
authors.lastname: Méndez
authors.forename: L
authors.initials: L
authors.lastname: Ramírez
authors.forename: R M
authors.initials: RM
authors.lastname: Casado
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D007172:Erectile Dysfunction / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010264:Paraplegia; D010879:Piperazines / Q000008:administration & dosage* / Q000009:adverse effects; D011237:Predictive Value of Tests; D011336:Probability; D011446:Prospective Studies; D011687:Purines; D011782:Quadriplegia; D000068677:Sildenafil Citrate; D013119:Spinal Cord Injuries / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D018709:Statistics, Nonparametric; D013450:Sulfones; D016896:Treatment Outcome
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate