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Öğe Causes of sildenafil citrate treatment discontinuation in patients with erectile dysfunction(2005) Tu?lu, Devrim; Başar, M. Murad; Akbulut, Ziya; Güngör, Sefa; Tekdo?an, Ümit Y.; Atan, AliIntroduction: Although there are many methods in the treatment of erectile dysfunction, no one is successful and sufficient in all the patients. Sildenafil treatment has been found the most successful method among ED treatments. In spite of high efficacy of sildenafil, some patients still stop sildenafil treatment due to various reasons. The aim of the present study is to evaluate the causes of sildenafil citrate treatment discontinuation in the patients with erectile dysfunction. Materials and methods: A total of 217 patients who admitted to our outpatient clinic due to erectile dysfunction were included in the study. They were evaluated with a detailed medical and sexual history and physical examination. Erectile function was assessed with IIEF scores before and after the treatment. The patients' ages ranged from 22 to 74 years (52.3±11.7). They suffered from erectile dysfunction for 34.3±31.3 months (2-240 months). Sildenafil citrate 50 mg was given for a month. At the end of this period, patients were re-evaluated and questioned about the efficacy of sildenafil citrate, its' side effects and whether they wanted to continue the treatment or not. Later, sildenafil 100 mg was recommended to patients desiring to use higher dose of it, and they were questioned 4 week later. Finally, the efficacy and side effects of sildenafil was evaluated, and the causes of dropout were obtained from the patients who discontinued sildenafil treatment. Results: At the 4th week control, sufficient erection was observed in 163 patients (75.1%), no erection was encountered in 54 patients (24.9%). Out of 163 patients, 131 (80.4%) who had sufficient erection with sildenafil left the treatment. The causes of discontinuation in these patients were the high price of the drug in 86 patients (%65.6), improvement of erection problem in 26 (%19.8), fear of asparagus news appearing in the media in 12 patients (%9.2), and side effects of sildenafil in 7 patients (%5.3). Of sildenafil failed patients (n: 54), 12 (22.2%) accepted to try sildenafil 100 mg, 42 (77.8%) did not accept to try sildenafil 100 mg. The reasons not, to try sildenafil 100 mg for these patients were high prize in 20 patients (47.6%), consideration of penile prosthesis in 2 patients (3.2%), side effects of sildenafil 50 mg in 13 patients (30.9%), nothing for 7 patients (16.7%). At the end of the treatment period, only 35 (16.1%) patients continued to use sildenafil 50 or 100 mg, 182 patients (83.9%) left the treatment due to different causes. These causes were high prize in 108 patients (59.3%), improvement of erection quality in 26 patients (14.3%), side effects in 20 patients (10.9%), asparagus news in 12 patients (6.6%), inefficacy in 7 patients (3.8%), choosing other treatment alternatives in 2 patients (1.1%). The other 7 (3.8%) did not describe any cause. Side effects were headache in 15 patients (6.9%), sweating in 12 patients (5.5%), visual problems in 6 patients (2.8%) and chest pain in 4 patients (1.8%). Conclusion: Although Sildenafil treatment is found very effective with acceptable side effects in the treatment of ED regardless to the etiology, discontinuation of the drug is very high. In this study, 80.4% of the patients in whom sildenafil treatment was successful left the treatment. The most important factor of this low ratio is the difficulty of buying the drug due to economic problems.Öğe CAUSES OF SILDENAFIL CITRATE TREATMENT DISCONTINUATION IN PATIENTS WITH ERECTILE DYSFUNCTION(Aves, 2005) Tuglu, Devrim; Basar, M. Murad; Akbulut, Ziya; Gungor, Sefa; Tekdogan, Umit Y.; Atan, AliIntroduction: Although there are many methods in the treatment of erectile dysfunction, no one is successful and sufficient in all the patients. Sildenafil treatment has been found the most successful method among ED treatments. In spite of high efficacy of sildenafil, some patients still stop sildenafil treatment due to various reasons. The aim of the present study is to evaluate the causes of sildenafil citrate treatment discontinuation in the patients with erectile dysfunction. Materials and Methods: A total of 217 patients who admitted to our outpatient clinic due to erectile dysfunction were included in the study. They were evaluated with a detailed medical and sexual history and physical examination. Erectile function was assessed with IIEF scores before and after the treatment. The patients' ages ranged from 22 to 74 years (52.3 +/- 11.7). They suffered from erectile dysfunction for 34.3 +/- 31.3 months (2-240 months). Sildenafil citrate 50 mg was given for a month. At the end of this period, patients were re-evaluated and questioned about the efficacy of sildenafil citrate, its' side effects and whether they wanted to continue the treatment or not. Later, sildenafil 100 mg was recommended to patients desiring to use higher dose of it, and they were questioned 4 week later. Finally, the efficacy and side effects of sildenafil was evaluated, and the causes of dropout were obtained from the patients who discontinued sildenafil treatment. Results: At the 4th week control, sufficient erection was observed in 163 patients (75.1%), no erection was encountered in 54 patients (24.9%). Out of 163 patients, 131 (80.4%) who had sufficient erection with sildenafil left the treatment. The causes of discontinuation in these patients were the high price of the drug in 86 patients (% 65.6), improvement of erection problem in 26 (% 19.8), fear of asparagus news appearing in the media in 12 patients (% 9.2), and side effects of sildenafil in 7 patients (% 5.3). Of sildenafil failed patients (n: 54), 12 (22.2%) accepted to try sildenafil 100 mg, 42 (77.8%) did not accept to try sildenafil 100 mg. The reasons not to try sildenafil 100 mg for these patients were high prize in 20 patients (47.6%), consideration of penile prosthesis in 2 patients (3.2%), side effects of sildenafil 50 mg in 13 patients (30.9%), nothing for 7 patients (16.7%). At the end of the treatment period, only 35 (16.1%) patients continued to use sildenafil 50 or 100 mg, 182 patients (83.9%) left the treatment due to different causes. These causes were high prize in 108 patients (59.3%), improvement of erection quality in 26 patients (14.3%), side effects in 20 patients (10.9%), asparagus news in 12 patients (6.6%), inefficacy in 7 patients (3.8%), choosing other treatment alternatives in 2 patients (1.1%). The other 7 (3.8%) did not describe any cause. Side effects were headache in 15 patients (6.9%), sweating in 12 patients (5.5%), visual problems in 6 patients (2.8%) and chest pain in 4 patients (1.8%). Conclusion: Although Sildenafil treatment is found very effective with acceptable side effects in the treatment of ED regardless to the etiology, discontinuation of the drug is very high. In this study, 80.4% of the patients in whom sildenafil treatment was successful left the treatment. The most important factor of this low ratio is the difficulty of buying the drug due to economic problems.Öğe Common symptoms in men with prostatic inflammation(Springer, 2006) Tuncel, Altuğ; Akbulut, Ziya; Atan, Ali; Basar, M. MuradPurpose We evaluated 96 patients with prostatic inflammation in terms of their symptoms and aimed to find common types and frequencies of symptoms in these patients. Patients and methods The mean age of the patients was 38.0 +/- 8.7 (range 21-58) years. Physical examination, digital rectal examination, microscopic prostatic secretion assessment and urine cultures after taking a detailed medical history were performed. Urine samples before and after prostatic massage were collected for urine culture. Frequency and types of patients' symptoms were evaluated. All patients were asked about lower urinary tract symptoms, sexual dysfunction and other complaints. Results Lower urinary tract symptoms and lumbal pain were more prevalent in elder patients. Ejaculation disorder was the most common sexual problem (n = 65, 67.7%). Erectile dysfunction and decreased libido were observed in 29 (30.2%) and 22 (22.9%) of the patients. Other complaints were lumbal pain (n = 34, 35.4%), perineal fullness (n = 50, 52.1%), haemospermia (n = 20, 20.8%) and scrotal pain (n = 43, 44.8%). Conclusion Prostatic inflammation was usually seen in men of the third and fourth decade. Sexual dysfunction was the most common symptom in this particular group of patients.
