Abstract
Aims: Erectile and endothelial dysfunctions are the most common complications of diabetes. We studied the endothelial function and response to treatment of a topical alprostadil in diabetics with erectile dysfunction. Sample and Methods: 30 patients were enrolled in the non-intervention, postregistration, prospective study with 300 (MU)g alprostadil cream. We examined vascular endothelial function using an ENDO-PAT 2000 device. We used International Index of Erectile Function (IIEF-5), Erectile Hardness Score (EHS), Global Assessment Questionnaire (GAQ) and Sexual Encounter Profile Q 2 and 3 (SEP 2, SEP 3) to assess erectile function. The primary outcome measures were the proportion of patients with an optimal treatment response at baseline and at 6 and 12 weeks after treatment and the evaluation of patients and their partner’s subjective satisfaction. Results: We diagnosed endothelial dysfunction in 15 diabetics. After 12 weeks of treatment with alprostadil 53.3% of the sample, reached normal erectile function. We found a significant increase in IIEF-5 scores with a median of 6 points (range 0–19, p<0.001) after 6 weeks compared to baseline, and of 7 points (range 0–20, p<0.001) after 12 weeks of treatment compared to baseline; a significant increase occurred both after 6 and 12 weeks of treatment (p=0.002). After both 6 and 12 weeks we found a significant increase in erection rigidity, EHS, compared to baseline (p< 0.001, p = 0.014). After 12 weeks of treatment, GAQ, improving erectile function was reached in 76.7% patients. Conclusion: We have demonstrated that topical alprostadil is efficient in diabetic men with erectile-endothelial dysfunction.
Highlights
Erectile dysfunction (ED) is the most common sexual complication of diabetes, affecting 35–75% of patients
We found a significant increase in International Index of Erectile Function (IIEF-5) after 6 and 12 weeks compared to baseline; a significant increase was found between 6 and 12 weeks of treatment
After 6 weeks, we found a significant Erectile Hardness Score (EHS) change compared to baseline, rigidity increased in week 12 (Table 1). 76.7% of the sample described improved erections (GAQ) after 12 weeks of treatment
Summary
Erectile dysfunction (ED) is the most common sexual complication of diabetes, affecting 35–75% of patients. Vascular disease as a hypertension, peripheral neuropathy, low level of testosterone and obesity are all more common in diabetics and predispose to developing ED. ED in diabetic patients is associated with endothelial dysfunction, atherosclerosis and coronary artery disease [1]. Cardiovascular disease leads to erectile dysfunction and increases the risk of mortality in diabetics. In our study we examined vascular endothelial function to diagnose endothelial-erectile dysfunction in diabetics. Ankle brachial index (ABI) is the principal screening method for peripheral arterial disease (PAD) in diabetics [3]. We measured vascular endothelial function with prediction: endothelial dysfunction is the first clinical stage of atherosclerosis. Alprostadil cream (Vitaros®, Herbacos Recordati) is a single-use topical cream approved for treatment of erectile dysfunction
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
