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Sildenafil citrate vs intracavernous alprostadil for patients with arteriogenic erectile dysfunction: a randomised placebo controlled study

International Journal of Impotence Research volume 16, pages 8–12 (2004)Cite this article

Abstract

We compared the effectiveness of sildenafil citrate and alprostadil in improving arterial penile inflow (peak systolic velocity (PSV)) and penile rigidity in 55 patients with erectile dysfunction caused by atherosclerosis. A total of 35 patients with pure vasculogenic impotency were randomly assigned to alprostadil (Av group; n=11), sildenafil (Sv group; n=12), or placebo (P group; n=12), and 20 patients with nonvasculogenic impotency were randomly assigned to alprostadil (A group; n=10) or Sildenafil (S group; n=10): Av and A used alprostadil injection (capable of giving a full erection) once a week for 1 month, Sv and S took daily oral sildenafil (25 mg) for 1 month, and P took daily oral placebo for one month. The PSV was measured with Duplex sonography and penile rigidity was assessed using the IIEF-15 questionnaire, both of which were administered before and after treatment. Although both treatments improved penile rigidity, they increased PSV only in the Av and Sv groups. Our results suggest that alprostadil and oral therapy should be the starting therapy in men with vasculogenic impotency, whereas alprostadil should be avoided as the first-line approach in men with nonvasculogenic impotency.

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Authors and Affiliations

  1. Andrology Unit, San Paolo Hospital, Milan, Italy

    M Mancini, F Nerva & G M Colpi

  2. Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA

    R Raina & A Agarwal

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  1. M Mancini
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  2. R Raina
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  3. A Agarwal
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  4. F Nerva
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  5. G M Colpi
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Correspondence to M Mancini.

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Mancini, M., Raina, R., Agarwal, A. et al. Sildenafil citrate vs intracavernous alprostadil for patients with arteriogenic erectile dysfunction: a randomised placebo controlled study. Int J Impot Res 16, 8–12 (2004). https://doi.org/10.1038/sj.ijir.3901123

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