Drug duo resolves impotence after prostate surgery

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The common problem of impotence for men who have undergone radical prostate surgery is often treatable with so-called PDE-5 inhibitors like Viagra. When this doesn’t work, adding an injected drug can improve the situation, researchers report.

Dr. Jack H. Mydlo and colleagues at Temple University, Philadelphia studied 34 men who had undergone radical prostatectomy --complete surgical removal of their prostates—and subsequently experienced erectile dysfunction.

None had responded adequately to as many as eight oral doses of PDE-5 inhibitors alone, so they had been taught how to self-inject another erectile dysfunction drug, alprostadil, into the penis.

The team reports in the medical journal BJU International that, of the 32 patients who continued with the combined therapy, 22 (68 percent) had an improvement in erectile function.

At follow-up, 36 percent of these patients said that they used the injections only intermittently, as this was sufficient to give good results.

Overall, the researchers conclude that the use of such injections as an addition to oral medication offers a treatment alternative for these men.

Combining PDE-5 inhibitors with “injections, vacuum pumps or intra-urethral suppositories will become more practical and commonplace in future applications when monotherapy is suboptimal,” said Mydlo.

“This is especially true,” he concluded, “in improving the quality of life in post-prostatectomy patients.”

SOURCE: BJU International, April 2005.

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