Relative efficacy of sildenafil compared to other treatment options for erectile dysfunction

We examined and compared the efficacy of sildenafil in patients previously using other agents or devices for erectile dysfunction (ED) treatment.

We identified 47 patients with organic ED who had tried other therapies (intracavernosal injection therapy [ICIT], intraurethral prostaglandin suppositories [IPS], vacuum erection devices [VEDs], or yohimbine) before using sildenafil. Comparisons of the efficacy of sildenafil to the previously used agent or device were assessed by telephone questionnaire. Responses were compared using nonparametric Wilcoxon rank sum and analysis of variance testing.

Sildenafil therapy was no more effective than ICIT or VEDs but was more effective than IPS. No significant difference occurred in response to sildenafil with age. Of 22 patients achieving erections adequate for intercourse with their previous therapy, 14 (63%) achieved equal or improved erections with sildenafil. Of the remaining 18 patients who had erections inadequate for intercourse with previous therapy, 5 (27%) had adequate erections with sildenafil.

Oral sildenafil therapy provides results comparable to those of other available ED treatment modalities. A trial of this drug in this patient population is warranted.