title: The clinical studies of sildenafil for the ageing male.
abstract: Erectile dysfunction (ED) represents an important quality-of-life issue for many ageing men. Low serum testosterone level and other factors may be involved. Sildenafil is effective and well tolerated in patients with ED of various aetiologies, showing an efficacy of about 75%. However, few efficacy and adverse effect studies have focused specially on ageing men. In 150 patients below 65 years and 44 patients over 65 years, sildenafil was used to treat ED. Efficacy in the younger group (89.1%) was greater than in the older group (65.7%; p < 0.01). Mean serum luteinizing hormone (LH) and follicle-stimulating hormone concentrations (11.0 and 18.9 mIU/mL, respectively) in the older group were higher than in younger group (5.2 and 8.7 mIU/mL, respectively; p < 0.01). Serum testosterone and prolactin (PRL) were similar between groups. Older patients showed higher prevalence of diabetes mellitus, hypertension, and benign prostatic hyperplasia. Only diabetes appeared to decrease efficacy of sildenafil in older patients (p=0.019). A high prevalence of diabetes might be one of the many causes of lower efficacy rate of sildenafil in older men, although efficacy in patients even without diabetes in older men was relatively low. Sildenafil can be used safely and it is still effective for ageing male, because nearly two-thirds of our older subjects had a good response to the drug and no adverse effect was specific to older patients.
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tsujimura
authors.forename: Masaki
authors.initials: M
authors.lastname: Yamanaka
authors.forename: Toru
authors.initials: T
authors.lastname: Takahashi
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Miura
authors.forename: Kenji
authors.initials: K
authors.lastname: Nishimura
authors.forename: Minoru
authors.initials: M
authors.lastname: Koga
authors.forename: Atsushi
authors.initials: A
authors.lastname: Iwasa
authors.forename: Masami
authors.initials: M
authors.lastname: Takeyama
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Matsumiya
authors.forename: Shiro
authors.initials: S
authors.lastname: Takahara
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okuyama
mesh_terms: D015106:3',5'-Cyclic-GMP Phosphodiesterases / Q000037:antagonists & inhibitors; D000328:Adult; D017677:Age Distribution; D000368:Aged; D007172:Erectile Dysfunction / Q000188:drug therapy*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000000981:diagnostic imaging; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011388:Prolactin / Q000097:blood; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones; D013739:Testosterone / Q000097:blood; D014463:Ultrasonography
chemical_list: D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D013739:Testosterone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D000068677:Sildenafil Citrate; D015106:3',5'-Cyclic-GMP Phosphodiesterases