The use of phosphodiesterase type 5 (pde-5) inhibitors in treatment of erectile dysfunction in patients with diabetes mellitus of different age groups
Aim. To study the effect of phosphodiesterase type 5 inhibitors used to treat the erectile dysfunction in patients of different age groups with concomitant diabetes mellitus. Methods. The study included 293 patients with diabetes mellitus type I and II aged 17–60 years, with duration of diabetes varying from 6 months to 29 years, duration of erectile dysfunction — from 6 months to 12 years. To diagnose the erectile dysfunction, an international index of erectile function, together with routine and special methods were used. Patients were administered phosphodiesterase type 5 inhibitors: sildenafil, taladafil and vardenafil. The control group included men with the erectile dysfunction without diabetes. To identify the male hypogonadism, patients were examined depending on the age group: 18–29 years, 30–39 years, 40–49 years, 50–59 years. Patiens were tested for sex hormones level, male ageing questionnaires were administered. Results. The increased rate of hypogonadism (from 12.5 to 54%) was associated with older age in patients with diabetes mellitus. The androgen status index in patients with diabetes mellitus, according to the Aging Males’ Symptoms rating scale, was 37.1±1.4 points. Phosphodiesterase type 5 inhibitors were more effective in younger age groups (57.1–91.7%) compared to older (36.8–67.3%). When comparing the study drugs, vardenafil showed better effect and relatively few side effects. Conclusion. Androgen deficiency, developing with increasing age is accompanied by a decrease in phosphodiesterase type 5 inhibitors efficiency. The use of small doses of these drugs corresponding the circadian rhythm of testosterone in males with normal testosterone blood level has the same effect as large doses.