Pérez-Martínez C, Vargas DIB, Cisneros CM

Language: Spanish
References: 13
Page: 45-49
PDF size: 51.66 Kb.

ABSTRACT

Background. The RigiScan test is the “gold standard” test to diagnose ED. The fast, provocative audiovisual, diurnal fashion of this test has been reported, however its predictive value for oral treatment of ED remains unknown. Aim. To research the predictive value of a fast, provocative audiovisual, diurnal RigiScan test for oral treatment of ED using vardenafil. Patients and method. Twenty eight patients with ED complains were studied. The International Index of Erectile Function of 5 questions (IIEF-5) was applied before and after treatment with vardenafil or placebo by at least 1 month. For RigiScan Test Patients were assigned in two groups. Problem Group (PG). Eighteen patients using vardenafil 20 mg; Control Group (CG). Ten men using placebo. The patients arrived for RigiScan test, without instructions about last meal. All tests were performed by the same nurse using RigiScan Plus device, in a laboratory inside of a clinic of impotence by a fast, provocative audiovisual, diurnal modality. After basal test of 50 minutes, each patient takes 20 mg of vardenafil or placebo, relax by 5 minutes, and the test continue by 50 minutes or more. Patients with cardiovascular disease or with history of oral therapy for ED, were not included. The percent and time of rigidity were assessed and correlated with the difference of IIEF-5 score before and after treatment. Results. The average age in the PG was 46.2 years old (SD 11), in the CG was 52.8 years old (SD 16.3). The percent of rigidity was 37.94% (SD 6.98) in PG and 26.3% (SD 3.1) in CG. Average time of rigidity was 7.1 min (SD 7.8) in PG and 9.2 min (SD 13.45) in CG. The difference in IIEF-5 previous and post treatment was 5.65 (SD 4.7) in PG compared with 1 (SD 1.94) in CG. The Pearson’s Correlation Coeficient (adjusted by age) between IIEF-5 difference and the percent of rigidity 0.78 with p = 0.0000, stronger than the correlation coefficient with time of rigidity (r = 0.15) with p = 0.50. Conclusions. The rigidity assessed by the RigiScan test has a lineal correlation with the increase of IIFE-5 score by using vardenafil in patients with ED. It is possible to predict who will respond to treatment by testing the medication in a fast, provocative audiovisual, diurnal RigiScan Test. Even with a response of rigidity from 30.6% to 44.9% during the test using vardenafil, the average increase of IIFE-5 score was 5.65 pts (SD 4.7) with p = 0.014 (by Mann.Whitney U test), predicting in 78% of patients the response to treatment with vardenafil, with a sensibility of 80%, and a specificity of 50%.

REFERENCES

1. Levine LA, Carroll RA. Nocturnal penile tumescence and rigidity in men without complaints of erectile dysfunction using a new quantitative analysis software. J Urol 1994; 152: 1103-7.

2. Boolell M, Gepi-Attee S, Gingell C, Allen M. Sildenafil (PFIZER UK-92,480), a novel orally active therapy for male erectile dysfunction. Eur Urol 1996; 30: 158.

3. Benet AE, Rehman J, Holcomb RG, Melman A. The correlation between the new RigiScan plus software and the final diagnosis in the evaluation of erectile dysfunction. J Urol 1996; 156: 1947-50.

4. Pérez MC. Imagen de Eco Doppler de pene en el paciente con disfunción sexual. Rev Mex Urol 1994; 54(2): 28-30.

5. Eardley I, Brook J, Yates PK, Wulff MB, Boolell M. Sidenafil (Viagra), a novel oral treatment with rapid onset of action for penile erectile dysfunction. Br J Urol 1997; 79 (Suppl. 4): 66.

6. Pérez MC, Vargas DIB. Prueba de RigiScan. Modalidad rápida provocativa diurna: una alternativa práctica para diagnóstico de disfunción eréctil. Rev Mex Urol 2001; 61(4): 205-8.

7. Dean J. A practical diagnostic approach to patients with erectile dysfunction in the oral drug therapy Era. EAU Update Series 2004; 2: 49-55.

8. Potempa AJ, Ulbrich E, Bernard I, Beneke M. Efficacy of vardenafil in men with erectile dysfunction: a flexible-dose Community Practice Study. Eur Urol 2004; 46: 73-9.

9. Boolell M, Pearson J, Gingell C, Gepi-Attee S, Wareham K, Price D. Sildenafil (Viagra) is an efficacius oral theraphy in diabetic patients with erectile dysfunction (ED). Int J Impot Res 1996; 8: 186.

10. 10.Denismore W, Maytom M, Multicentre Group. Sildenafil (Viagra)- a two-stage, double-blind, placebo-controlled study in men with erectile dysfunction (ED) caused by traumatic spinal cord injury (SCI). Int J Impot Res 1998; 10 (Suppl. 1): Abs. 56.

11. 11.Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The International Index of Erectile Function (IIEF); a multidimensional scale for assessment of erectile dysfunction. Urology 1997; 49: 822-30.

12. 12.WMA. World Medical Association Declaration of Helsinky. In: Chatelain C, Denis L, Foo KT, Khoury S, Mc Connell J (eds.). Benign Prostatic Hyperplasia, 5th International Consultation on Benign Prostatic Hyperplasia (BPH) June 25-28. 2000 Paris. Apendix I. p. 369-70.

13. 13.Pérez MC, Vargas DIB. Therapy with sildenafil for ED. Why to wait one hour? 15th World Association of Sexology Meeting. Abstracts Book, Jun 24-28. 2001, Paris, France. Abstract: 182.