Vardenafil improves ejaculation success rates and self-confidence in men with erectile dysfunction due to spinal cord injury.
METHODS
Multicenter, double-blind, placebo-controlled, parallel-group study.


OBJECTIVE
To assess the effect of the oral phosphodiesterase type-5 inhibitor, vardenafil, on ejaculation rates and self-confidence in men with spinal cord injury (SCI).


BACKGROUND
Spinal command of male sexual functions is often seriously impaired by traumatic spinal cord injury (SCI). A high proportion of men with SCI cannot ejaculate during sexual intercourse. SCI-related ejaculatory disorders are often responsible for male infertility. Sexual dysfunction associated with SCI can also affect men's self-confidence.


METHODS
In this 12-week study, 418 men aged >or=18 years with erectile dysfunction >6 months resulting from a traumatic SCI were randomized to vardenafil (n = 207) or placebo (n = 211) 10 mg for 4 weeks, then maintained or titrated to 5 or 20 mg at weeks 4 and 8. Assessments included questions of the International Index of Erectile Function (IIEF) about ejaculation success and orgasmic perception; the Global Confidence Question; and quality-of-life scales to measure psychological well-being, self-esteem, depression, and mental health status.


RESULTS
Overall per patient ejaculation success rates were significantly greater with vardenafil than placebo over 12 weeks of treatment (19% vs. 10%; P < 0.001). At last observation carried forward, the IIEF "orgasmic function" score increased from 2.9 at baseline to 4.0 for vardenafil and from 3.0 at baseline to 3.4 for placebo. Sixteen percent of men receiving vardenafil and 8% receiving placebo felt orgasm "almost always" or "always" at weeks 8-12, compared with 4% and 6%, respectively, at baseline. Significant improvements in confidence scores were observed with vardenafil compared with placebo (P < 0.0001). There were no clinically significant differences between vardenafil and placebo in the quality-of-life measures at the study endpoint, but these had been in the normal range at baseline.


CONCLUSIONS
Vardenafil significantly improved ejaculation and self-confidence in men with erectile dysfunction due to SCI.
Giuliano
Francois
F
AP-HP, Neuro-Uro-Andrology, Department of Physical Medicine and Rehabilitation, Raymond Poincaré Hospital, Garches, France. giuliano@cyber-sante.org
Rubio-Aurioles
Eusebio
E
Kennelly
Michael
M
Montorsi
Francesco
F
Kim
Edward D
ED
Finkbeiner
Alex E
AE
Pommerville
Peter J
PJ
Colopy
Michael W
MW
Wachs
Barton H
BH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003075:Coitus; D004311:Double-Blind Method; D004542:Ejaculation / Q000187:drug effects; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology*; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000187:drug effects; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000150:complications*; D013450:Sulfones / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use; D000069058:Vardenafil Dihydrochloride
D007093:Imidazoles; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D013450:Sulfones; D014227:Triazines; D000069058:Vardenafil Dihydrochloride