Treatment with sildenafil citrate in renal transplant patients with erectile dysfunction.

OBJECTIVE: To assess the safety and efficacy of sildenafil citrate in renal transplant patients with erectile dysfunction, as up to half of men with renal failure may be affected and only 60-75% recover potency after transplantation. PATIENTS AND METHODS: Fifty patients with erectile dysfunction and a functioning renal transplant were treated using sildenafil (mean age 54 years, mean time on dialysis 35 months, mean time from transplantation 20 months). The hypogastric artery was not used during transplantation in any patient. Sildenafil citrate was prescribed at doses of 25 or 50 mg depending on baseline creatinine values and on the response, and plasma levels of cyclosporin/FK506 were monitored. RESULTS: Thirty patients (60%) had a satisfactory response, with a mean time on dialysis of 23 months. Six patients (12%) did not take the sildenafil and in 14 (28%) the drug was ineffective. The mean time on dialysis in this group was 43 months. Six patients (12%) had side-effects that in no case led to withdrawal of treatment. Plasma levels of cyclosporin/FK506 remained within the safety and efficacy limits in all patients. CONCLUSIONS: Treatment with sildenafil citrate in renal transplant patients with erectile dysfunction is an effective and safe option, with few side-effects. Plasma levels of immunosuppressants are unchanged. The response was more effective in patients with a shorter time on dialysis, as penile vascular disease is less advanced.

[Complete androgenic blockade: myth or reality. Study and follow-up of 35 patients with advanced carcinoma of the prostate]. / Bloqueo androgénico completo: mito o realidad. Estudio y seguimiento de 35 pacientes con carcinoma de próstata avanzado.

Retrospective evaluation of the efficacy of complete androgenic blockade started by Labrie et al. using therapy with leuprolide acetate in monthly dosage of 7.5 mg i.m. associated to flutamide at the usual dosage in 35 patients with prostate adenocarcinoma in C-D1-D2 stages, who had not been given prior anti-neoplastic therapy. Clinical and analytical control studies were carried out during therapy follow-up for a maximum time of 36 months. The objective response of adverse events that can be superimposed to previous studies carried out with analogs on daily administration was assessed. Castration levels achieved were maintained for the length of the study below 50 ng/dl. Correlation between tissue type, rated according to the Mostofi classification, evolution or degree of response obtained and preserved increase of tumour markers (PSA, PAP, LDH, Prolactin) was evaluated; the evolution observed in patients who maintained high values of markers was worse with the referred treatment.