Sexual satisfaction among patients with erectile dysfunction treated with counseling, sildenafil, or both.
BACKGROUND
Sexual satisfaction is linked to life satisfaction, and erectile dysfunction (ED) may lead to an impaired quality of life (QOL).


OBJECTIVE
Our goal was to evaluate the QOL among Brazilian patients with ED, before and after three kinds of treatment.


METHODS
Men aged 25-55 years, with a diagnosis of psychogenic or mixed ED, according to the Classification of Mental and Behavioral Disorders of the International Classification of Diseases, 10th edition, and the Standard Practice in Sexual Medicine, were randomly assigned to three treatment groups: counseling, sildenafil, and sildenafil plus counseling. At baseline each group had 40 patients. Sildenafil was provided in 50 mg that could be adjusted to 100 mg. The patients could initially take one to two tablets per week and the entire treatment lasted for 3 months. Counseling was provided in group sessions that took place once a week. They were evaluated at baseline and after 3 months of treatment with the Male Sexual Quotient (MSQ) and the Sexual Health Inventory for Men (SHIM).


METHODS
The correlation between the patients' MSQ score and scores on the SHIM.


RESULTS
One hundred seventeen patients were enrolled. The three groups were similar according to age, marital status, mean time of ED, and ED severity and etiology. At baseline, MSQ and SHIM total scores were not different among the three groups. MSQ scores increased from 41.2 +/- 15.3, 38.7 +/- 18.0, and 46.8 +/- 17.0 to 48.5 +/- 15.3, 63.8 +/- 21.6, and 70.0 +/- 17.3 after counseling, sildenafil, and sildenafil plus counseling, respectively (P < 0.05). SHIM scores also increased significantly (9.6 +/- 4.1, 9.7 +/- 4.1, and 10.2 +/- 3.9 to 12.1 +/- 3.9, 16.7 +/- 5.6, and 17.7 +/- 4.5 after counseling, sildenafil, and sildenafil plus counseling, respectively) (P < 0.05). There were no serious adverse events related to sildenafil, and no patient was withdrawn from the study because of an adverse event.


CONCLUSIONS
The three treatments were significantly efficient, and the best treatment was sildenafil associated with counseling.
Abdo
Carmita H N
CH
Sexuality Project-Department and Institute of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil. carmita.abdo@uol.com.br
Afif-Abdo
João
J
Otani
Fabio
F
Machado
Albangela Ceschin
AC
D000328:Adult; D007172:Erectile Dysfunction / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011446:Prospective Studies; D011581:Psychological Tests; D011594:Psychometrics; D011687:Purines / Q000627:therapeutic use; D011788:Quality of Life; D012731:Sex Counseling; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*; D016896:Treatment Outcome
D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate