Objective: To analyze the cavernous arteries vasodilation and psychological correlates of men with mild hypogonadism (testosterone levels between 2 and 3 ng/mL) and erectile dysfunction (ED) after interventional therapy with testosterone plus sildenafil. Methods: 20 subjects with testosterone levels between 2 and 3.0 ng/mL on two consecutive determinations were enrolled in this multicentric study. Patients received a fixed dose of both Testogel 50 mg/day (T) or matching placebo (P) for 3 mo and Viagra 50 mg (SIL) on-demand and were then crossed over to receive the alternative treatment for the next 3 mo. The penile duplex ultrasound, IIEF, CES-D, AMS and EDITS were administered at baseline and at the end of each treatment period. Results: Serum testosterone levels raised after T + SIL but not after P + SIL (from 2.6 +/- 2.3 to 3.8 +/- 2.2 ng/dL, p < 0.05). PSVs but not EDVs improved after T + SIL (from 26.0 +/- 7.3 to 34.0 +/- 8.9 cm/sec, p < 0.0001) compared with P + SIL. As expected, erectile function and sexual desire scores were significantly improved by T + SIL (from 17.2 +/- 6.9 SD to 25.1 +/- 3.1, p < 0.001 vs. baseline and from 4.6 +/- 2.4 to 6.3 +/- 1.4, p < 0.01, respectively) but not by P + SIL. Depression scale as well as psychological and somatic scores of AMS questionnaire greatly improved after T + SIL (14.0 +/- 10.5 vs 10.7 +/- 7.7, p < 0.05; 12.4 +/- 6.9 vs. 8.9 +/- 3.8 and 14.1 +/- 5.8 vs. 11.7 +/- 4.9, p < 0.01) while no changes were observed in patients randomized to P + SIL. No modification in intercourse and overall satisfaction scores as well as in the EDITS were found after both treatments. Conclusion: Our results show that T supplementation in men with mild hypogonadism and ED improves cavernous vasodilation, erectile capacity and sexual desire after three months of therapy. Improvements in erection, depressive and psychological scores are not sufficient to improve the quality of life of patients probably due to inadequate rise in T levels until young adults reference range is attained.
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|Titolo:||A double-blind, randomized, placebo-controlled cross-over study on the effects of testosterone (testogel) plus sildenafil on cavernous arteries and psychological correlates in men with mild hypogonadism and erectile dysfunction|
|Data di pubblicazione:||2006|
|Appartiene alla tipologia:||04d Abstract in atti di convegno|