[Choice of treatment of erectile dysfunction associated with hypogonadism]

A study was made in the urological clinic of I.M. Sechenov Moscow Medical Academy with participation of 96 patients (mean age 48.24 +/- 9.19 years) with erectile dysfunction (ED) associated with hypogonadism. The patients were divided into three groups. Group 1 (n = 30) received 1 intramuscular injection of testosterone undecanoate. Group 2 (n = 34) received on-demand monotherapy with vardenafil for 6 weeks. Group 3 (n = 32) received combined treatment with the above modalities in the same doses and duration. Before and 6 weeks after treatment the patients responded to IIEF-5 questionnaire. All the patients showed a significant improvement of the erectile function. Overall AMS score after the treatment rose more in patients of groups 1 and 3 (p < 0.001). In group 2 the changes were weaker but significant (p = 0.005). The domain of psychological AMS symptoms reduced insignificantly after treatment in group 2 (p = 0.535), but significantly in groups 1 and 3, respectively (p = 0.013 vs p = 0.001). Androgenic deficiency regressed in groups 1 and 3 but enhanced in group 2 (p = 0.001). Domain of sexual symptoms of the AMS scale reduced more significantly in patients of groups 2 and 3 (p < 0.001). Percentage of patients satisfied with the treatment results was 68.85, 70,6 and 90,6% in groups 1, 2 and 3, respectively. Thus, combined treatment of erectile dysfunction in patients with hypogonadism (parenteral testosterone undecanoate and vardenafil) is more effective than monotherapy with androgen-containing drugs or inhibitors of phosphodiesterase of type 5.