title: [A new approach to raising the efficiency of drug therapy for erectile dysfunction].
abstract: OBJECTIVE
  To try combined treatment of erectile dysfunction with viagra and alprostadil in case of failure of their monotherapy; to compare effectiveness of viagra in dynamics of treatment, in various doses and dose adjustment.
  
  
  METHODS
  82 patients with ED of different genesis received a course of intracavernous injections of alprostadil followed by a course of viagra; 25 patients received combined treatment with alprostadil and viagra. Each course lasted for 3 months. Viagra efficiency was also assessed in long-term use (12 months) and different initial doses (50 or 100 mg).
  
  
  RESULTS
  Monotherapy with alprostadil or viagra was effective in 73.2 and 75.6% patients, respectively. Their combination was more beneficial--88.0%. When used for a long time, viagra lost efficiency in psychogenic ED by 17.7%, in organic ED--by 16.9%. In an initial viagra dose 50 mg efficiency reached 70.3%, 100 mg--80.0%.
  
  
  CONCLUSIONS
  Combined treatment of ED is a method of choice in monotherapy failure and in severe ED. Lowering of viagra efficiency in long-term administration may be explained by disappearance of placebo effect.
authors.forename: D G
authors.initials: DG
authors.lastname: Dmitriev
authors.forename: S I
authors.initials: SI
authors.lastname: Gamidov
authors.forename: E B
authors.initials: EB
authors.lastname: Mazo
authors.forename: R I
authors.initials: RI
authors.lastname: Ovchinnikov
mesh_terms: D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000627:therapeutic use*; D007172:Erectile Dysfunction / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate; D000527:Alprostadil