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Abstract
Purpose
This study was designed to evaluate the role of PDE5 inhibitors as combination therapy with conventional treatment of Peyronie's disease (PD).
Materials and Methods
From July 2007 to October 2010, 35 Patients were divided into two groups. Group I (N=14) received PDE5 inhibitors in addition to conventional treatment with tamoxifen and acetyl L-carnitine, while group II (N=21) received only conventional treatment. The follow-up duration was at least 12 weeks after the active therapy of PD. Outcomes were assessed by pain relief, successful attempts for sexual intercourse, resolution of the plaque and any occurring complications.
Results
In the efficacy of overall treatment of 35 patients, 94.3% patients experienced successful sexual intercourse, while 5.7% experienced pain on erection, and 25.7% showed a decrease in plaque size. The analysis of parameters before treatment showed no significant difference between groups in terms of successful attempt at sexual intercourse (p=0.583) and pain on erection (p=0.445). Furthermore, there was no difference between groups after treatment in terms of successful attempts at sexual intercourse (p=0.766), pain on erection (p=0.766) and change in plaque size (p=0.445). However, successful intercourse and pain relief after treatment showed significant change irrespective of groups (p＜0.05). While the addition of a PDE5 inhibitor did not show any significant improvement in clinical outcome measures, the satisfaction of patient was higher in patients who received combination treatment (p=0.042).
Conclusions
Although the effect of PDE5 inhibitor for pain relief, successful intercourse and resolution of plaque size was not significant, patients who received PDE5 inhibitors had a more satisfaction of treatment of PD. Further prospective studies on the effect of PDE5 inhibitor in PD will be needed.
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Table 1.
Efficacy of ovearall treatment after treatment in total 35 patients
Table 2.
Analysis of group I and II
| Variables | Group I∗ | Group II† | Group III‡ |
|---|---|---|---|
| Age | 54.9±10.2 | 59.2±8.2 | 0.194 |
| Number of patients | 14 | 21 | |
| Sexual intercourse (＋) before treatment | 78.6% (11/14) | 90.4% (19/21) | 0.583 |
| Pain (＋) before treatment | 35.7% (5/14) | 23.8% (5/21) | 0.445 |
| Sexual intercourse (＋) after treatment | 92.9% (13/14) | 95.2% (20/21) | 0.766 |
| Pain (＋) after treatment | 7.1% (1/14) | 4.8% (1/21) | 0.766 |
| Resolution of plaque after treatment | 21.4% (3/14) | 33.3% (7/21) | 0.445 |
| Satisfaction of patients | 85.7% (12/14) | 52.4% (11/21) | 0.042 |
∗ Group I patients recieved longterm continuous PDE5 inhibitors (Tadalafil 5 mg once daily) in addition toconventional treatment with tamoxifen 20 mg and acetyl L-carnitine 330 mg twice a day.
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