Park et al identified risk factors for a poor response to therapy with sildenafil citrate in an elderly male with erectile dysfunction. The authors are from Seoul National University Hospital.
Patient selection: age > 60 years of age with erectile dysfunction
Parameters:
(1) severity of erectile dysfunction as determined on the ED domain of the International Index of Erectile Function (IIEF)
(2) current cigarette smoking
(3) hypogonadism, as indicated by a low serum total testosterone (< 3 µg/L)
Parameter |
Finding |
Points |
ED domain |
>= 17 (mild to moderate or better) |
0 |
|
< 17 (moderate to severe) |
1 |
current cigarette smoking |
absent |
0 |
|
present |
1 |
hypogonadism |
absent |
0 |
|
present |
1 |
where:
• The free testosterone might be a better measure of hypogonadism.
• Uncontrolled diabetes mellitus was a risk factor in the univariate model. While listed in Table 2 (page 368) the text says that it did not make it to the multivariate model.
• Erectile dysfunction was severe if the ED domain score was 6 to 10 and moderate if the score was 11 to 16.
number of risk factors =
= SUM(points for all 3 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• The response to sildenafil citrate is best when none of these risk factors are present.
• Both cigarette smoking and hypogonadism are potentially treatable. Reversal of one or both may improve the response to therapy.
Specialty: Urology
ICD-10: ,