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首页> 外文期刊>The journal of sexual medicine >Ten years of phosphodiesterase type 5 inhibitors in spinal cord injured patients.
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Ten years of phosphodiesterase type 5 inhibitors in spinal cord injured patients.

机译：脊髓损伤患者中使用了10年的5型磷酸二酯酶抑制剂。

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INTRODUCTION: The majority of men with spinal cord injury (SCI) require chronic treatment for erectile dysfunction (ED), but most of them, prior to taking phosphodiesterase type 5 (PDE5) inhibitors, stopped therapy due to side-effects or low compliance rate. AIM: Analysis of literature on oral PDE5 inhibitors in individuals with SCI and ED in order to evaluate how much their release changed the management of ED in SCI subjects and what remains to be seen of their potential or limits. MAIN OUTCOME MEASURES: Questionnaires on sexual function. METHODS: 18 internationally published clinical studies that enrolled SCI males treated with at least one of the PDE5 inhibitors were analyzed. RESULTS: The small numbers of papers with large and diverse outcome measures did not consent a meta-analysis of treatment results. 705 used sildenafil, 305 vardenafil and 224 tadalafil. Median age was less than 40 years. Only 1 study excluded tetraplegic individuals. For measures of ED evaluated, 11 out of 13 studies reported a significant statistical improvement with PDE5 inhibitors versus placebo or erectile baseline (P < 0.01, or p < 0.005). The most frequent predicable factor for the therapeutic success of PDE5 inhibitors was upper motoneuron lesion. Statistical impact on ejaculation success rates was shown in at least one paper for all PDE5 inhibitors (p < 0.05). Overall, 15 patients, (7 using sildenafil), discontinued the therapies due to drawbacks. Only 1 sildenafil study reported a follow-up maximum of 24 months. CONCLUSIONS: Literature suggests that all oral PDE5 inhibitors represent a safe and effective treatment option for ED caused by SCI. Further research is needed on head-to-head comparative trials and SCI patient preference for these drugs; their impact on ejaculation and orgasm function, their early use after SCI for increasing the recovery rate of a spontaneous erection, and their effectiveness and tolerability in the long-term are still to be investigated.
机译：简介：大多数患有脊髓损伤（SCI）的男性都需要对勃起功能障碍（ED）进行慢性治疗，但是其中大多数人在服用5型磷酸二酯酶（PDE5）抑制剂之前，由于副作用或依从率低而停止治疗。目的：对SCI和ED患者口服PDE5抑制剂的文献进行分析，以评估其释放多少改变了SCI受试者的ED管理，以及其潜力或局限性尚待观察。主要观察指标：性功能问卷。方法：对18项国际公开的临床研究进行了分析，这些研究招募了使用至少一种PDE5抑制剂治疗的SCI男性。结果：少数具有大量不同结果指标的论文不同意对治疗结果的荟萃分析。 705个使用了西地那非，305个伐地那非和224个他达拉非。中位年龄小于40岁。只有1项研究排除了四肢瘫痪患者。对于评估的ED量度，在13项研究中，有11项报告了PDE5抑制剂相对于安慰剂或勃起基线有显着统计学改善（P <0.01或p <0.005）。 PDE5抑制剂治疗成功的最常见可预测因素是上运动神经元病变。对于所有PDE5抑制剂，至少有一篇论文显示了对射精成功率的统计学影响（p <0.05）。总体而言，有15例患者（其中7例使用西地那非）因有缺陷而中断了治疗。只有1份西地那非研究报告最长随访24个月。结论：文献表明，所有口服PDE5抑制剂代表了由SCI引起的ED的安全有效的治疗选择。还需要进一步的研究进行头对头比较试验和SCI患者对这些药物的偏爱。它们对射精和性高潮功能的影响，在SCI后早期使用以提高自发性勃起的恢复率以及长期的有效性和耐受性尚待研究。

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