Clinical follow up of patients with multiple sclerosis 10 years after PDE5Is treatment for Erectile Dysfunction: a real life cohort study.

Thomas C1, Kratiras Z2, Samarinas M3, Diamantis G4, Konstantinidis C4

Research Type

Clinical

Abstract Category

Male Sexual Dysfunction

Abstract 348
Open Discussion ePosters
Scientific Open Discussion Session 101
Wednesday 23rd October 2024
10:15 - 10:20 (ePoster Station 2)
Exhibition Hall
Male Multiple Sclerosis Sexual Dysfunction
1. General Hospital of Corinth, Urology dpt, Greece, 2. National & Kapodistrian University, Urology dpt Attiko Hospital, Athens, Greece, 3. General Hospital of Larissa, Urology dpt /General Hospital, Larissa, Greece, 4. National Rehabilitation Center, Urology and Neuro urology Unit/National Rehabilitation Center, Athens, Greece
Presenter
C

Charalampos Konstantinidis
National Rehabilitation Center, Urology and Neuro urology Unit/National Rehabilitation Center, Athens, Greece
Links

Poster

Abstract

Hypothesis / aims of study 
Erectile Dysfunction (ED)  is very common in patients suffering from Multiple Sclerosis (MS); the prevalence varies from 30% to almost 90%. Our aim was to study the adherence of MS patients to PDE 5 Is, in 10 years period.
Study design, materials and methods 
119 MS patients suffering from ED that were treated with PDE 5 Is were evaluated in 2015 Concomitant
cardiovascular diseases, hormonal and psychiatric disorders were excluded Efficacy was evaluated
with IIEF 5 and SEP 2 and SEP3 questions.
We are re-evaluating our data now in order to assess the adherence to PDE 5 Is, almost 10 years after the initial treatment.
Results 
10 years after the initial treatment we collected data from 94 patients out of the original 101 responders
•From the sildenafil group, 20 out of 36 patients are still on treatment, 5 have changed to  daily tadalafil, 1 on intra cavernosal injections (ICIs), 1 died, 3 were lost from follow up, 1 underwent a 3 piece inflatable penile prosthesis insertion, 2 have stopped due to lack of sexual partner and 3 have stopped due to MS progression
•From the vardenafil group, 5 out of 15 patients are still on treatment, 2 have changed to sildenafil, 2 on daily tadalafil, 1 on ICIs, 3 don't have a sexual  partner and 2 have stopped due to progression
•From the avanafil group, 4 out of 8 responders are still on treatment, 1 have changed to sildenafil, 1 on daily tadalafil, 1 is on ICIs and 1 have stopped
due to MS progression
•From the on demand tadalafil group, 7 out of 18 patients  are still on treatment, 5 have changed to daily tadalafil, 1 on sildenafil, 2 were lost from follow
up, 1 is on ICIs, 1 without partner and 1 stopped due to progression
•From daily tadalafil group, 10 out of 24 patients are still on treatment, 1 is dead, 1 on ICIs, 6 have changed to sildenafil, 1 underwent penile
prosthesis, 2 don;t have a sexual partner, and 3 have stopped due to progression
Interpretation of results 
After almost 10 years of follow up, the majority of our MS patients remained on PDE 5 inhibitors, either the one prescribed initially or a different one The medication dropout rate, in our cohort, is approximately 24% while disease progression and lack of sexual partner were the major reasons for withdrawal
Concluding message 
PDE5Is consist the first line of conservative treatment for ED. They are very well tolerated by men with neurogenic ED, especially by men with MS, which is depicted by the high level of adherence they demonstrate during the years.
Figure 1 Table
Disclosures
Funding None Clinical Trial Yes Public Registry No RCT No Subjects Human Ethics not Req'd PDE5Is are the treatment of choice for ED Helsinki not Req'd PDE5Is are the treatment of choice for ED Informed Consent Yes
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