Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Outcome analysis of sildenafil citrate for erectile dysfunction of Japanese patients

Abstract

The approved maximal dose of sildenafil is only 50 mg in Japan, but the impact of dose regulation on treatment outcomes has not been established. Moreover, the contributors to the efficacy in patients having an intact peripheral nervous system have not been fully elucidated. We assessed in Japanese patients the treatment outcomes of sildenafil for erectile dysfunction (ED) under regulation of the approved dose and identified factors contributing to its efficacy among those with various etiologies other than pelvic surgery. We retrospectively reviewed 196 ED patients treated with sildenafil. The overall efficacy was 70.9% (139/196), and patients with psychological problems and concomitant cardiovascular disease showed high response rates (82.4 and 87.0%, respectively). Of the 139 responders, 89.9% achieved efficacy with a dose of 25 or 50 mg. Logistic regression analysis revealed concomitant cardiovascular disease and a favorable nocturnal penile tumescence result to be independent contributors to the efficacy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA . Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med 1998; 338: 1397–1404.

    Article  CAS  Google Scholar 

  2. Carson CC, Burnett AL, Levine LA, Nehra A . The efficacy of sildenafil citrate (Viagra) in clinical populations: an update. Urology 2002; 60: 12–27.

    Article  Google Scholar 

  3. Carson III CC . Sildenafil: a 4-year update in the treatment of 20 million erectile dysfunction patients. Curr Urol Rep 2003; 4: 488–496.

    Article  Google Scholar 

  4. Suzuki K, Sato Y, Horita H, Adachi H, Kato R, Hisasue S et al. The correlation between penile tumescence measured by the erectometer and penile rigidity by the RigiScan. Int J Urol 2001; 8: 594–598.

    Article  CAS  Google Scholar 

  5. Martinez-Jabaloyas JM, Gil-Salom M, Villamon-Fort R, Pastor-Hernandez F, Martinez-Garcia R, Garcia-Sisamon F . Prognostic factors for response to sildenafil in patients with erectile dysfunction. Eur Urol 2001; 40: 641–646; discussion 647.

    Article  CAS  Google Scholar 

  6. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA 1993; 270: 83–90.

  7. Morales A, Lunenfeld B . Investigation, treatment and monitoring of late-onset hypogonadism in males. Official recommendations of ISSAM. International Society for the Study of the Aging Male. Aging Male 2002; 5: 74–86.

    Article  CAS  Google Scholar 

  8. Vermeulen A, Verdonck L, Kaufman JM . A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 1999; 84: 3666–3672.

    Article  CAS  Google Scholar 

  9. Matsuda T, Tatsumi M . Diagnosis and treatment of partial androgen deficiency in aging male. Jpn J Urol Surg 2003; 16: 831–837.

    Google Scholar 

  10. Ochiai A, Naya Y, Soh J, Ishida Y, Mizutani Y, Kawauchi A et al. Efficacy of sildenafil as the first-step therapeutic tool for Japanese patients with erectile dysfunction. Int J Impot Res 2005; 17: 339–342.

    Article  CAS  Google Scholar 

  11. Masumori N, Tsukamoto T, Kumamoto Y, Panser LA, Rhodes T, Girman CJ et al. Decline of sexual function with age in Japanese men compared with American men – results of two community-based studies. Urology 1999; 54: 335–344; discussion 344–335.

    Article  CAS  Google Scholar 

  12. Zippe CD, Kedia AW, Kedia K, Nelson DR, Agarwal A . Treatment of erectile dysfunction after radical prostatectomy with sildenafil citrate (Viagra). Urology 1998; 52: 963–966.

    Article  CAS  Google Scholar 

  13. Raina R, Lakin MM, Agarwal A, Sharma R, Goyal KK, Montague DK et al. Long-term effect of sildenafil citrate on erectile dysfunction after radical prostatectomy: 3-year follow-up. Urology 2003; 62: 110–115.

    Article  Google Scholar 

  14. Burchardt M, Burchardt T, Baer L, Kiss AJ, Pawar RV, Shabsigh A et al. Hypertension is associated with severe erectile dysfunction. J Urol 2000; 164: 1188–1191.

    Article  CAS  Google Scholar 

  15. Marumo K, Nakashima J, Murai M . Age-related prevalence of erectile dysfunction in Japan: assessment by the International Index of Erectile Function. Int J Urol 2001; 8: 53–59.

    Article  CAS  Google Scholar 

  16. Naya Y, Mizutani Y, Ochiai A, Soh J, Kawauchi A, Fujito A et al. Preliminary report of association of chronic diseases and erectile dysfunction in middle-aged men in Japan. Urology 2003; 62: 532–536.

    Article  Google Scholar 

  17. Jarow JP, Burnett AL, Geringer AM . Clinical efficacy of sildenafil citrate based on etiology and response to prior treatment. J Urol 1999; 162: 722–725.

    Article  CAS  Google Scholar 

  18. Shirai M, Thukamoto T, Sato Y, Horita H, Kato S, Yachiku S et al. Randomized, placebo-controlled, double-blind study of oral sildenafil in Japanese men with erectile dysfunction. Nishinihon J Urol 2000; 62: 373–383.

    Article  Google Scholar 

  19. Choi HK, Ahn TY, Kim JJ, Kim SC, Paick JS, Suh JK et al. A double-blind, randomised-placebo, controlled, parallel group, multicentre, flexible-dose escalation study to assess the efficacy and safety of sildenafil administered as required to male outpatients with erectile dysfunction in Korea. Int J Impot Res 2003; 15: 80–86.

    Article  CAS  Google Scholar 

  20. Lim PH, Li MK, Ng FC, Chia SJ, Consigliere D, Gooren L et al. Clinical efficacy and safety of sildenafil citrate (Viagra) in a multi-racial population in Singapore: A retrospective study of 1520 patients. Int J Urol 2002; 9: 308–315.

    Article  CAS  Google Scholar 

  21. Padma-nathan H, Eardley I, Kloner RA, Laties AM, Montorsi F . A 4-year update on the safety of sildenafil citrate (Viagra). Urology 2002; 60: 67–90.

    Article  Google Scholar 

  22. Atiemo HO, Szostak MJ, Sklar GN . Salvage of sildenafil failures referred from primary care physicians. J Urol 2003; 170: 2356–2358.

    Article  Google Scholar 

  23. El-Galley R, Rutland H, Talic R, Keane T, Clark H . Long-term efficacy of sildenafil and tachyphylaxis effect. J Urol 2001; 166: 927–931.

    Article  CAS  Google Scholar 

  24. McCullough AR, Barada JH, Fawzy A, Guay AT, Hatzichristou D . Achieving treatment optimization with sildenafil citrate (Viagra) in patients with erectile dysfunction. Urology 2002; 60: 28–38.

    Article  Google Scholar 

  25. Cayan S, Bozlu M, Canpolat B, Akbay E . The assessment of sexual functions in women with male partners complaining of erectile dysfunction: does treatment of male sexual dysfunction improve female partner's sexual functions? J Sex Marital Ther 2004; 30: 333–341.

    Article  Google Scholar 

  26. Hisasue S, Kumamoto Y, Sato Y, Masumori N, Horita H, Kato R et al. Prevalence of female sexual dysfunction symptoms and its relationship to quality of life: a Japanese female cohort study. Urology 2005; 65: 143–148.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to K Kobayashi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kobayashi, K., Hisasue, S., Kato, R. et al. Outcome analysis of sildenafil citrate for erectile dysfunction of Japanese patients. Int J Impot Res 18, 302–305 (2006). https://doi.org/10.1038/sj.ijir.3901400

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3901400

Keywords

Search

Quick links