[Effects of different treatments on endothelial function in patients with erectile dysfunction and hypogonadism].
OBJECTIVE
To study effects of different treatments on erectile and endothelial functions in patients with erectile dysfunction (ED) and age-related hypogonadism (HG).


METHODS
The study included 66 males with ED who had clinical and laboratory signs of HG. All the patients were examined using questionnaires (international index of erectile function, AMS), blood hormones tests. Endothelial function was assessed with postcompression tests on the cavernous arteries and blood homocystein assay. All the patients were divided into two matched groups. Group 1 (20 males, mean age 54.6 +/- 11.5 years) received androgens only, replacement therapy consisted of testosterone undecanoate (Nebido, Shering) 1000 mg each 10-12 weeks intramuscularly, interval between the first and second injection was 6 weeks. Group 2 (46 males, mean age 53.98 +/- 10.03 years) was given combined treatment (androgens and PDE 5 inhibitors), wardenafil (Levitra, Buer Shering Pharma) was used in a dose 20 mg. The treatment lasted 6 months.


RESULTS
AMS points decreased in group 1 from 38.3 +/- 0.29 to 29.2 +/- 0.32, in group 2--from 39.02 +/- 0.21 to 28.6 +/- 0.95, while testosterone rose from 9.86 +/- 0.4 to 17.77 +/- 0.42 and 9.35 +/- 0.25 to 17.21 +/- 0.63 nmol, respectively. Homocystein lowering was significantly more manifest in group 2. EF index in group 2 rose from 11.4 +/- 0.77 to 25.54 +/- 0.25 points versus 11.2 +/- 1.01 to 23.95 +/- 0.71 points in group 1, improvement of EF in group 2 occurred sooner. Endothelial function by diameter of the cavernous arteries differed after treatment in group 1 and 2 (19.55 +/- 2.88 to 39.2 +/- 0.84% and 19.51 +/- 1.28 to 48.5 +/- 1.76, respectively, p<0.001).


CONCLUSIONS
Combined therapy improves blood homocistein, acts faster and stronger on endothelial and erectile functions and can be recommended as first line for ED and HG patients.
Mazo
E B
EB
Gamidov
S I
SI
Sotnikova
E M
EM
D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D007172:Erectile Dysfunction / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007006:Hypogonadism / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007093:Imidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D010879:Piperazines / Q000008:administration & dosage / Q000627:therapeutic use*; D012307:Risk Factors; D013450:Sulfones / Q000008:administration & dosage / Q000627:therapeutic use; D013739:Testosterone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome; D014227:Triazines / Q000008:administration & dosage / Q000627:therapeutic use; D000069058:Vardenafil Dihydrochloride
D007093:Imidazoles; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D013450:Sulfones; D014227:Triazines; D006710:Homocysteine; D013739:Testosterone; D000069058:Vardenafil Dihydrochloride; C010792:testosterone undecanoate