THE ROLE OF (SILDENAFIL)DRUG IN THE MANAGEMENT OF WEDDING NIGHT IMPOTENCE
Keywords:
wedding night Impotence, Erectile Dysfunction, SildenafilAbstract
Background and Aims: Wedding night impotence or first night erectile dysfunction (ED) is one kind of psychogenic ED which is not uncommon. Prevalence of this kind of ED is higher in conservative communities especially the Muslim population. The study aims to assess the role of Sildenafil, a phosphodiesterase inhibitor (PDE-5) in the management of wedding night (psychogenic) impotence. Methods:The study was conducted at private clinic. All patients having erectile dysfunction (ED) after marriage with normal nocturnal erections were enrolled in this prospective study for two years(2008-2009). They were visiting private clinic either directly or referred from dermatologist colleague in Nassirya city. Reassurance & Sildenafil 100 mg at bed time was given to every patient and dose reduced to 50 mg after 3 successful intercourses. Patients who did not respond to PDE-5 inhibitor (3 doses), were given sex therapy(Master and Johnson technique)and shifted to. Sildenafil after successful intercourse. Results: Total number of patients was 45 with age range of 20-39 years. Mean duration elapsed before seeking medical advice was 10±14 days. Eighty percent patients had successful intercourse on first dose of Sildenafil with 95% confidence interval (CI) and 13% patients responded to 2nd dose of Sildenafil. Twelve percent patients suffered mild, well tolerable complications. Conclusions: Wedding night impotence is not an uncommon condition in some special population. Sildenafil proved to be effective, with high success rate and few tolerable complications.References
Sharlip ID. Evaluation and nonsurgical management of erectile dysfunction. Urol Clin North Am. 1998;25:647-59.
NIH Consensus Conference Impotence. NIH Consensus Development Panel on Impotence.JAMA. 1993;270:83-90.
Lue TF. Impotence: a patient’s goal-directed approach to treatment. World J Urol. 1990;8:67-74.
LoPiccolo J. Postmodern sex therapy for erectile failure. In: Rosen RC, Leibtum SR, editors. Erectile disorders: Assessment and treatment. New York: Gullford Press 1992:171-97.
Frank E, Anderson C, Rubinstein D. Frequency of sexual dysfunction in “normal” couples. N Engl J Med. 1978;299:111-5.
Brock GB, McMahon CG, Chen KK, et al. Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses. J Urol. 2002;168:1332-6.
Althof SE. Quality of life and erectile dysfunction. Urology. 2002;59:803-10.
Manning M, Junemann K. Pharmacotherapy of Erectile Dysfunction. In Male infertility and Honeymoon Impotence International Journal of Nephrology & Urology, 2009; 1(2):103-107 Muhammad Akram Malik et al 107 Sexual dysfunction. Hellstorm WJG, editor. New York: Springer-Verlag 1997:440-51.
Masters WH, Johnson VE. Human sexual inadequacy. Boston: Little Brown 1970.
Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med. 1998;338:1397-404.
Ghanem H, Sherif T, Adbel-Gawad T, Asaad T. Short term use of intracavernous vasoactive drugs in the treatment of persistent psychogenic erectile dysfunction. Int J Impot Res. 1998;10:211-4.
Hirsch M, Donatucci C, Glina S, Montague D, Montorsi F, Wyllie M. Standards for clinical trials in male sexual dysfunction: erectile dysfunction and rapid ejaculation. J Sex Med. 2004;1:87-91.
Gingell C, Sultana SR, Wulff MB, Gepi-Attee S. Duration of action of sildenafil citrate in men with erectile dysfunction. J Sex Med. 2004;1:179-84.
El-Meliegy A. A retrospective study of 418 patients with honeymoon impotence in an
andrology clinic in Jeddah, Saudi Arabia. Eur J Sexol. 2004;13:1-4.
Shamloul R. Management of honeymoon impotence. J Sex Med. 2006;3:361-6.