Efficacy and safety of sildenafil in Asian males with erectile dysfunction and cardiovascular risk.

OBJECTIVE: Assess the effectiveness of sildenafil in Asian males with erectile dysfunction (ED) and one or more of the co-morbidities, mild-to-moderate hypertension, dyslipidemia, and diabetes. MATERIAL AND METHOD: A six-week, double-blind, randomized, placebo-controlled, multicenter study was carried out in Thailand, Malaysia and Singapore. One hundred and fifty five male subjects were randomized (2:1) to sildenafil (n = 104) or placebo (n = 51). Sildenafil was started at 50 mg and increased (100 mg) or decreased (25 mg) at week 2 if necessary. RESULTS: On the primary efficacy endpoint, sildenafil-treated subjects had significantly better scores on the International Index of Erectile Function (IIEF) questions 3 and 4 than placebo (p < 0.001, both questions). When accumulated into IIEF domains, all five domains were significant in favor of sildenafil. In addition, sildenafil-treated subjects were more satisfied with treatment and had a higher intercourse success rate. The majority of adverse events were mild in severity; the most commonly reported treatment-related events were dizziness (7.7%) and tinnitus (2.9%). CONCLUSION: Sildenafil (25, 50, and 100 mg) was found to be an effective, safe, and well-tolerated treatment for ED in the present study population of Thai, Malaysian, and Singaporean males who also had increased cardiovascular risk

The association between erectile function and severity of lower urinary tract symptoms.

It is unclear whether the erectile dysfunction (ED) that frequently occurs with lower urinary tract symptoms (LUTS) may have a common causative factor: sympathetic overactivity. The aim of this study was to evaluate the association between ED and LUTS. From June 1998 to March 2000, 75 male patients, presenting with LUTS, enrolled into the present study. A total of 63 patients were included into the study, age ranging from 51 - 74 years (mean 61.5). Allpatients completed an American Urological Association (AUA) symptom severity index and IIEF-5 questionnaires. The results from the present study demonstrated that the AUA symptom and IIEF-5 scores do not correlate with increasing age. When the statistical analyses were performed for each age group, there were no significant differences in mean IIEF-5 values between any degree of AUA symptom score in the same age group (p > 0.05). The present results indicate that there is no association between the degree of LUTS and the erectile function. Moreover, the statistical analyses of the association between any degree of erectile function and the mean A UA symptom score either for obstructive or irritative symptoms revealed no significant differences (p > 0.05). The present study demonstrates that there is no association between BPH and erectile function in any age group, inconsistent with the sympathetic overactivity theory.

The Aging Males' Symptoms rating scale: cultural and linguistic validation into Thai.

The interest in clinically investigating the health-related quality of life and symptoms of aging males has increased in recent years. Recently, a couple of validated questionnaires have been proposed for either screening, diagnosing and assessing response to therapy. Among these, the Aging Males' Symptom (AMS) questionnaire has been one of the most accepted questionnaires used in aging male clinics worldwide. The AMS questionnaire was originally developed and standardized in Germany in accordance with psychometric tests, and translated into English. The objective of this study was to develop the Thai AMS questionnaire, which is culturally and linguistically validated, and to present the translation process from English to Thai. The translation for the Thai speaking culture was planned specifically for use in Thailand. The forward translation into Thai was performed independently by two Thai-English translators with clinical experience in the aging male field. Another two Thai-English translators performed the back translation into English. Reconciliation of problematic items or explanations with the investigators was performed point by point to get the final version. The test and retest of Thai AMS questionnaire were performed within the time interval of 14 days by 20 Thai men aged 41-62 who came from different social classes and had various levels of education. The correlation between the first and the second questionnaires was statistically analyzed using Pearson correlation coefficient (r). The results of the linguistic and cultural adaptation of the English AMS scale led to a Thai AMS questionnaire. The results of the test and retest reliability demonstrated good correlation and were promising (r = 0.87). Therefore, this scale can be used as a valuable tool for assessing symptoms in the aging males in Thailand.