| 201 Room 518 | Société Francophone de Médecine Sexuelle Sunday, July 10, 2005 Time: 1:30 PM-5:00 PM |
Que faire en cas d'échec ou de refus des inhibiteurs de la PDE5 ?
Wespes, Eric*,1, 1 , Belgique
ABSTRACT- Before considering a patient non responder two PDE5 education of the drug use has to be controlled. Information on the use of these drugs is very important. The stomach has to be empty, the time before the initial of sexual activity must be at least 1 hour and the maximum allowed dosage has to be taken. A sexual stimulation is mandatory to achieve an erection. Using these simple recommendations 50% of the non responders respond to PDE5 inhibitors. The dosage of testosterone is important because it is now well demonstrated that hypogonadism decreases; the PDE5 inhibitors response. Supplementation of testosterone restores erectile rigidity with PDE5 inhibitors in 50% of the cases. For those who do not yet respond, intracavernous injection can be used. These patients in whom PDE5 inhibitors fail can be treated successfully in 80% with intracavernosal alprostadil therapy. The most common adverse effect seen is penile pain. Vacuum device can also be used, however this therapeutical approach is reserved for the patients with stable relationship. Penile prosthesis is the most successful therapeutic option but due to its invasive approach its remains the third line therapy.
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