title: Phosphodiesterase type 5 inhibitors: Irrational use in Saudi Arabia.
abstract: OBJECTIVE
  To identify the criteria of phosphodiesterase type 5 inhibitor (PDE5i) users and to analyse the knowledge, attitude, and practices of PDE5i use amongst Saudi men.
  
  
  METHODS
  A web-based, cross-sectional survey was conducted in Saudi Arabia between January and April 2015. Sexually active adult men were interviewed using a website questionnaire designed by the authors. Descriptive statistics were used to analyse the data.
  
  
  RESULTS
  In all, 1008 men participated in the survey with 378 (37.5%) reporting use of PDE5i. Of those using PDE5i, 144 (38.1%) reported erectile dysfunction and 234 (61.9%) reported normal erection (recreational users). We found several demographic features, including high education level, health field occupation, high income, smoking, and increased frequency of sexual intercourse amongst the PDE5i users. Most of the PDE5i users (92.3%) had knowledge about PDE5i and 84.1% of them bought it without medical prescription. The most commonly used PDE5i was tadalafil (46.1%) and most of the users (79.9%) reported improvement in their sexual activity after PDE5i usage. Amongst the recreational users, the main reasons for PDE5i usage were curiosity (38.5%) and improving self-confidence (25.6%). Of them, 69.2% reported benefits from PDE5i usage, mainly in the form of enhancement of erection (36.7%) and increasing erection duration (31.2%).
  
  
  CONCLUSIONS
  PDE5i use appears to be frequent in Saudi Arabia. Most of the users had knowledge about PDE5i and claimed to get benefits from it, even if used as a recreational drug.
authors.affiliation: Department of Urology, College of Medicine, Prince Sattam Bin Abdulaziz University, Saudi Arabia.
authors.forename: Saad
authors.initials: S
authors.lastname: Alshahrani
authors.affiliation: Department of Urology, College of Medicine, Prince Sattam Bin Abdulaziz University, Saudi Arabia; Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
authors.forename: Abul-Fotouh
authors.initials: AF
authors.lastname: Ahmed
authors.affiliation: Department of Urology, College of Medicine, Prince Sattam Bin Abdulaziz University, Saudi Arabia; Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt.
authors.forename: Ahmed H
authors.initials: AH
authors.lastname: Gabr
authors.affiliation: Bahrain Defence Force Hospital, Department of Surgery, Arabian Gulf University, Bahrain.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al Ansari
authors.affiliation: Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Feky
authors.affiliation: Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt.
authors.forename: Mohamed S
authors.initials: MS
authors.lastname: Elbadry
keywords: AE, adverse event; ED, erectile dysfunction; Erectile dysfunction; IIEF-5, five-item version of the International Index of Erectile Function questionnaire; Irrational; Men; PDE5i, phosphodiesterase type 5 inhibitors; Phosphodiesterase type 5 inhibitors