Adherence to PDE 5 inhibitors in patients with Erectile Dysfunction (ED) following Spinal Cord Injury (SCI). Real life data after 10 years of treatment.

Thomas C1, Kratiras Z2, Samarinas M3, Diamantis G4, Konstantinidis C4

Research Type

Clinical

Abstract Category

Male Sexual Dysfunction

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Abstract 201
Nocturia and Sexual Dysfunction
Scientific Podium Short Oral Session 19
Thursday 24th October 2024
18:15 - 18:22
Hall N105
Sexual Dysfunction Spinal Cord Injury Conservative Treatment
1. General Hospital of Corinth, Greece, 2. National & Kapodistrian University, Urology dpt Attiko Hospital, Athens, Greece, 3. General Hospital of Larissa, Urology dpt /General Hospital, Larissa, Greece, 4. National Rehabilitation Center, Urology and Neuro urology Unit/National Rehabilitation Center, Athens, Greece
Presenter
C

Charalampos Konstantinidis
National Rehabilitation Center, Urology and Neuro urology Unit/National Rehabilitation Center, Athens, Greece
Links

Abstract

Hypothesis / aims of study 
PDE5Is are the first line of conservative treatment for ED in general, and an effective treatment for neurogenic ED also, such as SCI individuals. Based on that, a real life cohort study was performed to evaluate the adherence to PDE5Is as well as the dropout rate, almost 10 years after the initiation of treatment.
Study design, materials and methods 
97 SCI patients suffering from ED that were treated with PDE5Is were evaluated in 2015. Concomitant
cardiovascular diseases, hormonal and psychiatric disorders were excluded. Efficacy was evaluated with IIEF5 and SEP2 & SEP3 questions.
We re evaluate our data now in order to assess the adherence to PDE5Is, almost 10 years after the initial treatment.
Results 
10 years after the initial treatment, we collected data from 81 patients out of the original 87 responders.

From the sildenafil group, 18 out of 31 responders are still on, 6 on daily us tadalafil, 1 on intra cavernosal
injections (ICI), 1 died, 2 were lost in follow up, 2 are off treatment due to lack of sexual partner and 1 stopped the medication due to other comorbidities.

From the vardenafil group, 5 out of 13 patients  are still on therapy, 2 have changed to sildenafil, 2 on  daily tadalafil, 1 on ICI, 1 without partner and 2 patients have stopped due to comorbidities..

From the avanafil group, 3 out of 7 patients are still on treatment, 1 have changed to sildenafil and 2 on daily tadalafil.

From the on demand tadalafil group, 7 out 22 patients are still on treatment, 5 have changed to daily tadalafil, 2 on sildenafil, 2 were lost in follow up, 1 died, 1 on ICI, 2 don't have a sexual partner and 2 stopped due to other comorbidities.

From the daily tadalafil group, 9 patients are still on, 1 died, 1 on ICI, 2 have changed to sildenafil, 1 underwent penile prosthesis implantation and 1 stopped the medication due to other comorbidities.
Interpretation of results 
After almost 10 years of follow up, the majority of our SCI patients remained on PDE5 inhibitors, either the one prescribed initially or a different one. The medication dropout rate, in our cohort, is approximately 20%, while other comorbidities and lack of sexual partner were the major reasons for withdrawal.
Concluding message 
PDE5Is consist the first line of conservative treatment for ED. They are very well tolerated by men with neurogenic ED, especially by men with SCI, which is depicted by the high level of adherence they demonstrate during the years.
Figure 1 Table
Disclosures
Funding None Clinical Trial Yes Public Registry No RCT No Subjects Human Ethics not Req'd PDE5Is is the treatment of choice for ED Helsinki not Req'd PDE5Is is the treatment of choice for ED Informed Consent Yes
Citation

Continence 12S (2024) 101543
DOI: 10.1016/j.cont.2024.101543

22/11/2024 18:59:06