Displaying publications 1 - 20 of 95 in total

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  1. Zaman Huri H, Lian Choo T, Sulaiman CZ, Mark R, Abdul Razack AH
    BMJ Open, 2014 Jul 07;4(7):e005381.
    PMID: 25001396 DOI: 10.1136/bmjopen-2014-005381
    OBJECTIVE: To investigate factors associated with demographic/clinical characteristics and drug selection in patients with erectile dysfunction (ED). The prevalence of ED is increasing worldwide. Studies have shown that ED is associated with age, lifestyle and comorbidities. However, the factors associated with patient characteristics as well as drug selection are incompletely understood.

    SETTING: A tertiary medical centre in Kuala Lumpur, Malaysia.

    PARTICIPANTS: A total of 219 patients (range 23-80 years) who had received phosphodiesterase type-5 (PDE-5) inhibitors as ED treatment were evaluated.

    INCLUSION CRITERIA: Adult patients aged ≥18 years, diagnosed with ED, and prescribed with sildenafil, tadalafil or vardenafil.

    EXCLUSION CRITERIA: Patients diagnosed with ED but who did not receive any PDE-5 inhibitor, or those with missing data.

    PRIMARY AND SECONDARY OUTCOME MEASURES: Factors associated with demographic and clinical characteristics as well as drug selection were assessed.

    RESULTS: Ischaemic heart disease (p=0.025), benign prostatic hyperplasia (p<0.001), obesity (p=0.005), lower urinary tract symptoms (LUTS) (p=0.006) and α-blockers (p<0.001) were significantly associated with elderly patients with ED. Additionally, LUTS (p=0.038) and α-blockers (p=0.008) were significantly associated with the selection of PDE-5 inhibitor.

    CONCLUSIONS: These data showed that elderly patients with ED were significantly associated with comorbidities and α-blockers, whereas LUTS and α blockers were associated with drug selection.

    Matched MeSH terms: Erectile Dysfunction/complications*; Erectile Dysfunction/drug therapy
  2. Zainol M, Sidi H, Kumar J, Das S, Ismail SB, Hatta MH, et al.
    Curr Drug Targets, 2019;20(2):182-191.
    PMID: 28302034 DOI: 10.2174/1389450118666170315110902
    Throughout the world, antidepressants (AD) and phosphodiesterase-5 inhibitors (PDE-5i) are the commonly prescribed psychopharmacological agents for treating patients with co-morbid mental health problem and sexual dysfunction (SD). The serotonergic and noradrenergic ADs, although effective, are not without any SD adverse-effects, especially erectile dysfunction (ED). ED is a failure to obtain a satisfactory erection for rewarding sexual coitus during the phases of male's sexual arousal. It is recognized as an important reason why non-adherence to treatment was observed in patients who were on AD. AD intervention caused remission to some of the pre- treatment psychopathology of ED. However, in many patients, AD potentially magnified the unwanted sexual sideeffects. This made the situation challenging for the mental health professional. These challenges are based on the complexity of ED, its etiology and the associated risk factors, which further add to its AD side-effect. The neuro-psychopharmacological basis for AD treatment selection was deliberated. Bio-psycho-social interventions are recommended at two pivotal stages. Firstly, a step should be taken for proper assessment (e.g. detailed history, psychosocial and laboratory investigations); and identify few modifiable risk factors for ED and associated mental health issues. Secondly, with guidance of an algorithm pathway, a practical intervention should include strategies such as dose reduction, augmentation or changing to an AD with lesser or no sexual adverse-effects. It is recommended that bupropion and mirtazepine to be prescribed when patients develop adverse sexual effects with serotonin selective reuptake inhibitor (SSRI), serotonin norepinephrine reuptake inhibitor (SNRI) and tricyclic antidepressant (TCA). Few suggestions which may be borne in mind are revising sexual scripts and improving sexual techniques, life-style modifications, psychotherapy and other nonpharmacological approaches which may be beneficial to both patients and their partners.
    Matched MeSH terms: Erectile Dysfunction/drug therapy*; Erectile Dysfunction/psychology
  3. Yeong CT, Atputharajah V
    Med J Malaysia, 1999 Mar;54(1):79-86.
    PMID: 10972009
    Ignorance is not bliss when it comes to sexuality. Psychosexual problems lead to shame, fumbling, needless fears, low-self esteem and even subfertility. The demands for help appears to be increasing; as the general population become more aware of its presence and the treatment options available through the mass media and better health education. Sex therapy has traditionally been the realm of the psychiatrist but with the gynaecologist as the first contact for most women, the number of women seeking advice directly from their doctors will only increase with time. A total of 243 new cases of sexual dysfunction were treated at the sexual problem clinic in Kandang Kerbau Hospital between January 1994 and November 1996; majority of which were self-referrals (48.5%). The patient pool consisted of more males than females although the clinical setting is in an obstetrics and gynaecology teaching institute. Vaginismus and erectile problems constituted the main complaints. Erectile problems are more common in the patients above 40 years old (p < 0.001). We report here our experience of such a sexual problem clinic and hope to provide insight into this area of medicine from the perspective of a practising gynaecologist.
    Matched MeSH terms: Erectile Dysfunction/therapy
  4. Yee A, Loh HS, Hisham Hashim HM, Ng CG
    Int J Impot Res, 2014 Sep-Oct;26(5):161-6.
    PMID: 24990199 DOI: 10.1038/ijir.2014.18
    Methadone maintenance treatment is proven to be effective treatment for opioid dependence. Of the many adverse events reported, sexual dysfunction is one of the most common side effects. However, there may be other clinical factors that are associated with sexual dysfunction among methadone users. We conducted a meta-analysis to examine the clinical factors associated with sexual dysfunction among male patients on methadone and buprenorphine treatments, of which eligible studies were selected using prior defined criteria. A total of 2619 participants from 16 eligible studies, published from inception till December 2012, were identified from the PubMed, OVID and EMBASE databases. The included studies provided prevalence estimates for sexual dysfunction among methadone users with a meta-analytical pooled prevalence of 52% (95% confidence interval (CI), 0.39-0.65). Only four studies compared sexual dysfunction between the two groups, with a significantly higher combined odds ratio in the methadone group (odds ratio=4.01, 95% CI, 1.52-10.55, P=0.0049). Our study shows that eight clinical factors are associated with sexual dysfunction among men receiving opioid substitution treatment, namely age, hormone assays, duration of treatment, methadone dose, medical status, psychiatric illness, other current substance use and familial status, and methadone versus buprenorphine treatment. Despite the methodological limitations, the findings of this meta-analysis study may offer better insights to clinicians in dealing with both sexual dysfunction and its related problems.
    Matched MeSH terms: Erectile Dysfunction
  5. Yee A, Loh HS, Loh HH, Riahi S, Ng CG, Sulaiman AHB
    Ann Gen Psychiatry, 2019;18:25.
    PMID: 31649742 DOI: 10.1186/s12991-019-0249-z
    Background: Methadone is an effective therapy for opiate dependence. However, one of the commonest side effects is sexual dysfunction among male patients. Buprenorphine is an alternative to methadone. This study aimed to compare sexual desire among opiate-dependent male patients on buprenorphine (BMT) and methadone maintenance therapy (MMT).

    Methods: This cross-sectional study involved 126 male opiate-dependent patient who were tested for total testosterone (TT) and prolactin levels, and were interviewed and completed the Sexual Desire Inventory-2 (SDI-2), Malay language of International Index of Erectile Function (Mal-IIEF-15) and the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM) questionnaires.

    Results: There were 95 (75.4%) patients on MMT and 31 (24.6%) on BMT. Patients on MMT scored significantly lower in the sexual desire domain (Mal-IIEF-15 scores) (p 

    Matched MeSH terms: Erectile Dysfunction
  6. Yee A, Danaee M, Loh HS, Sulaiman AH, Ng CG
    PLoS One, 2016;11(1):e0147852.
    PMID: 26820154 DOI: 10.1371/journal.pone.0147852
    INTRODUCTION: Methadone has long been regarded as an effective treatment for opioid dependence. However, many patients discontinue maintenance therapy because of its side effects, with one of the most common being sexual dysfunction. Buprenorphine is a proven alternative to methadone. This study aimed to investigate sexual dysfunction in opioid-dependent men on buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT). The secondary aim was to investigate the correlation between sexual dysfunction and the quality of life in these patients.

    METHODS: Two hundred thirty-eight men participated in this cross-sectional study. Four questionnaires were used, the Mini International Neuropsychiatric Interview, Opiate Treatment Index, Malay version of the International Index of Erectile Function 15 (Mal-IIEF-15), and World Health Organization Quality of Life-BREF Scale. Multivariate analysis of covariance was used to examine the relationship between MMT and BMT and the Mal-IIEF 15 scores while controlling for all the possible confounders.

    RESULTS: The study population consisted of 171 patients (71.8%) on MMT and 67 (28.2%) on BMT. Patients in the MMT group who had a sexual partner scored significantly lower in the sexual desire domain (p < 0.012) and overall satisfaction (p = 0.043) domain compared with their counterparts in the BMT group. Similarly, patients in the MMT group without a sexual partner scored significantly lower in the orgasmic function domain (p = 0.008) compared with those in the BMT group without a partner. Intercourse satisfaction (p = 0.026) and overall satisfaction (p = 0.039) were significantly associated with the social relationships domain after adjusting for significantly correlated sociodemographic variables.

    CONCLUSIONS: Sexual functioning is critical for improving the quality of life in patients in an opioid rehabilitation program. Our study showed that buprenorphine causes less sexual dysfunction than methadone. Thus, clinicians may consider the former when treating heroin dependents who have concerns about sexual function.

    Matched MeSH terms: Erectile Dysfunction/chemically induced*
  7. Yee A, Loh HS, Ong TA, Ng CG, Sulaiman AH
    Am J Mens Health, 2018 Sep;12(5):1705-1718.
    PMID: 29973132 DOI: 10.1177/1557988318784152
    Methadone is largely recognized as an effective treatment for opiate-dependent patients; however, it causes reduced brain dopaminergic action resulting in significant sexual dysfunction. Bupropion is a dopamine reuptake inhibitor which can potentially improve erectile function among male patients on methadone (MMT). This is a phase II, randomized, double-blind, parallel-group, placebo-controlled trial, involving 80 MMT male patients (73.4%) with mean age of 42.83 years ±9.68. These MMT male patients were randomly assigned into two groups to receive bupropion and placebo, respectively. The primary efficacy outcome measure was the difference between the two groups in end-point mean improvement scores using the measurement of Clinical Global Impression Scale adapted for Sexual Function (CGI-SF) at baseline (week 0) and at weeks 2, 4, and 6. Malay version of the sexual desire inventory-2 (SDI-2-BM) and Malay version of International Index of Erectile Function 15 (Mal-IIEF-15) domain scores were evaluated as secondary parameters. Improvement of the end-point mean from baseline were seen across the scores of SDI-2-BM (mean difference = 11.77 ± 2.90, 95% confidence interval (CI) [3.89, 19.54], p < .001) and Mal-IIEF-15 (mean difference = 8.37 ± 2.71, 95% CI [15.75, 0.99], p = .02), and the total plasma testosterone level (mean difference = 4.03, 95% CI [0.90, 7.15], p = .01). A categorical improvement of "much/very much improved" (CGI-SF score = 2) was reported by 58.3% ( n = 21/36) of bupropion SR-assigned versus 27.7% ( n = 10/36) placebo-assigned patient. Bupropion was well tolerated with no serious adverse events reported other than insomnia (17.7%). Six weeks of bupropion SR treatment reported significant improvement in key aspects of sexual function among male opiate-dependent patients on methadone maintenance treatment with emergent sexual dysfunction.
    Matched MeSH terms: Erectile Dysfunction/chemically induced; Erectile Dysfunction/drug therapy*
  8. Udani JK, George AA, Musthapa M, Pakdaman MN, Abas A
    PMID: 24550993 DOI: 10.1155/2014/179529
    Background. Physta is a proprietary product containing a freeze-dried water extract of Eurycoma longifolia (tongkat ali), which is traditionally used as an energy enhancer and aphrodisiac. We aim to evaluate a 300 mg combination of Physta and Polygonum minus, an antioxidant, with regard to sexual performance and well-being in men. Methods. Men that aged 40-65 years were screened for this 12-week randomized, double-blind, placebo-controlled, parallel-group study. Outcome measures included validated questionnaires that aimed to evaluate erectile function, satisfaction with intervention, sexual intercourse performance, erectile hardness, mood, and overall quality of life. Results. 12 subjects in the active group and 14 in the placebo group completed the study. Significant improvements were noted in scores for the Sexual Intercourse Attempt diary, Erection Hardness Scale, Sexual Health Inventory of Men, and Aging Male Symptom scale (P < 0.05 for all). Three adverse events were reported in the active group and four in the placebo group, none of which were attributed to study product. Laboratory evaluations, including liver and kidney function testing, showed no clinically significant abnormality. Conclusion. Supplementation for twelve weeks with Polygonum minus and the proprietary Eurycoma longifolia extract, Physta, was well tolerated and more effective than placebo in enhancing sexual performance in healthy volunteers.
    Matched MeSH terms: Erectile Dysfunction
  9. Teoh JI, Lee M
    Singapore Med J, 1974 Jun;15(2):132-8.
    PMID: 4415368
    This paper deals with the aetiological factors of psychogenic impotence, more emphasis however, being placed on the psychological theories. The characteristics of forty cases of impotence were analysed and discussed. Two cases, one of erectile impotence (failure of erection) and another of premature ejaculation were treated by the authors with systematic desensitization successfully. The "squeeze" technique was utilized for the case of premature ejaculation
    Matched MeSH terms: Erectile Dysfunction*
  10. Teoh JB, Yee A, Danaee M, Ng CG, Sulaiman AH
    J Addict Med, 2017 Jan-Feb 6;11(1):40-46.
    PMID: 27753719 DOI: 10.1097/ADM.0000000000000267
    OBJECTIVES: Erectile dysfunction (ED) is a problem commonly encountered by patients on methadone maintenance therapy (MMT). This study aimed to assess the prevalence of ED among this group of patients along with its risk factors and association with quality of life (QOL).
    METHODS: Male patients on MMT in a tertiary hospital in Malaysia were included in the study. A total of 134 patients with sexual partners were assessed for ED using the International Index of Erectile Function. Patients were assessed for substance use using Opiate Treatment Index (OTI) and depression using the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM). QOL was evaluated using World Health Organisation Quality of Life (WHOQOL)-BREF.
    RESULTS: The prevalence of ED among patients on MMT was 67%, with 26.1% having mild ED, 30.4% having mild-to-moderate ED, 7.0% having moderate ED, and 17.2% having severe ED. Patients with depression were 4 times more likely to have ED compared with patients without depression, whereas increasing age significantly correlated with the severity of ED. Having ED predicted a poorer QOL in the social relationships domain.
    CONCLUSION: Depression is highly associated with ED, which negatively influences the social aspect of QOL among patients on methadone maintenance therapy.
    Study site: outpatient addiction psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Erectile Dysfunction*
  11. Tan WS, Ng CJ, Khoo EM, Low WY, Tan HM
    Aging Male, 2011 Dec;14(4):231-6.
    PMID: 22115177 DOI: 10.3109/13685538.2011.597463
    The etiology of erectile dysfunction (ED) is multi-factorial. This paper examines the association between ED, testosterone deficiency syndrome (TDS) and metabolic syndrome (MS) in Malaysian men in an urban setting. One thousand and forty-six men aged ≥ 40 years from Subang Jaya, Malaysia were randomly selected from an electoral-roll list. The men completed questionnaires that included: socio-demographic data, self-reported medical problems and the International Index of erectile function (IIEF-5). Physical examination and the following biochemical tests were performed: lipid profile, fasting blood glucose (FBG) and total testosterone. The response rate was 62.8% and the mean age of men was 55.8 ± 8.4 (41-93) years. Ethnic distribution was Chinese, 48.9%; Malay, 34.5%; Indian, 14.8%. The prevalence of moderate-severe ED was 20.0%, while 16.1% of men had TDS (< 10.4 nmol/L) and 31.3% of men had MS. Indian and Malay men were significantly more likely to have ED (p  = 0.001), TDS (p  < 0.001) and MS (p < 0.001) than the Chinese. Multivariate regression analysis showed that elevated blood pressure, elevated FBG, low high-density lipoprotein and heart disease were predictors of ED while all MS components were independently associated with TDS. Malay and Indian men have a higher disease burden compared to Chinese men and were more likely to suffer with ED, TDS and MS. MS components were closely related to TDS and ED.
    Matched MeSH terms: Erectile Dysfunction/blood; Erectile Dysfunction/etiology; Erectile Dysfunction/epidemiology*
  12. Tan WP, Fong ZV, Tong SF, Low WY, Tan HM
    Journal of Men's Health, 2011;8:S81-S83.
    DOI: 10.1016/S1875-6867(11)60029-8
    Background: Men's major concern (MMC) is a common quality of life issue affecting the aging male population. This paper examines the association between MMC and cardiometabolic diseases in Malaysian men in an urban setting.
    Methods: A cross-sectional community based study was conducted in an urban area involving 1046 men, aged over 40 years and above, who were randomly selected using the electoral roll in Selangor Malaysia. Participants were assessed by trained doctors using structured questionnaire which included medical history, IIEF-5 to assess men's erectile dysfunction and IPSS score to assess prostatic symptoms. Clinical assessments including blood pressure, weight, height and waist circumference were performed. In addition, biochemical assessments for fasting blood glucose and lipid profile were done.
    Results: The response rate was 62.8%. The mean age of the participants was 55.8±8.4 (range: 41-93) years. Around two fifth of the participants (39.8%) had no MMC, 28.4% were diagnosed with 1 MMC, 9.9% with 2MMCs and 1.2% with 3MMCs. Increasing number of MMCs were significantly associated with increasing rate of cardiometabolic diseases (No MMC = 26.2%, 1 MMC = 43.4%, 2 MMCs = 63.5% and 3 MMCs = 69.2%) (P < 0.01) and metabolic syndrome based on Asian criteria (No MMC = 21.5%, 1 MMC = 39.0%, 2 MMCs = 49.1%, 3 MMCs = 62.5%) (P < 0.01). Participants with one or more MMC significantly showed a higher proportion of undiagnosed diabetes as well as reported diabetes (No MMC = 1.7%, 1 or more MMCs = 3.6%) when compared to participants without MMC (P ≤ 0.01).
    Conclusions: Men's Major Concerns (e.g., ED, LUTS and TD) were associated with cardiometabolic diseases and collectively, they could be used as an important portal to men's health. © 2011 WPMH GmbH.
    Matched MeSH terms: Erectile Dysfunction
  13. Tan HM, Tong SF, Ho CC
    J Sex Med, 2012 Mar;9(3):663-71.
    PMID: 22188573 DOI: 10.1111/j.1743-6109.2011.02582.x
    INTRODUCTION: Sexual dysfunction in men, such as erectile dysfunction, hypogonadism, and premature ejaculation, generates considerable attention. Its association with physical and psychological health is an issue which should be addressed seriously.
    AIM: A review of the literature pertaining to the correlation between sexual dysfunction and physical and psychological health.
    METHODS: PubMed search for relevant publications on the association between sexual dysfunction in men and physical and psychological health.
    MAIN OUTCOME MEASURE: Clinical and epidemiological evidence that demonstrates the association between sexual dysfunction in men and physical and psychological health.
    RESULTS: Sexual dysfunction, i.e., erectile dysfunction, hypogonadism, and premature ejaculation, has been shown to be associated with physical and psychological health. There is a strong correlation between sexual dysfunction and cardiovascular disease, metabolic syndrome, quality of life, and depression.
    CONCLUSION: The association between men's sexual dysfunction and physical and psychological health is real and proven. Therefore, it should not be taken lightly but instead treated as a life-threatening medical problem.
    Matched MeSH terms: Erectile Dysfunction
  14. Tan HM, Marumo K, Yang DY, Hwang TI, Ong ML
    Int J Urol, 2009 May;16(5):507-14; discussion 514-5.
    PMID: 19467120 DOI: 10.1111/j.1442-2042.2009.02283.x
    OBJECTIVES:
    To explore by a pooled subanalysis of the Global Better Sex Survey sexual aspirations and unmet needs of men and women from Hong Kong, Indonesia, Japan, Malaysia, Singapore, South Korea, Taiwan, and Thailand.

    METHODS:
    To qualify, respondents must have had sexual intercourse at least once in the past 12 months. Women must have had heterosexual intercourse. Data were weighted by population size between countries.

    RESULTS:
    Of 3538 Asian respondents (1776 men and 1762 women), 52% were aged <40 years, 40% were aged 40-59 years, and 8% were aged >or=60 years. The majority were married or in a relationship. Men and women reported having sexual intercourse 5.1 and 4.0 times monthly, respectively. Attraction to partner, foreplay, intercourse, and achieving orgasm were important to most men and women. Two thirds were less than very satisfied with their sex life, and 36% of men were interested in improving sex. For a good sexual experience, the man's ability to get and maintain an erection and erection hardness were important to the majority of Asian men and women. Few respondents reported using a prescription erectile dysfunction medication, but many showed interest in using these medications to improve their sex lives. A comparison between individual countries suggests that attitudes about sex differ from country to country, and between men and women in each country.

    CONCLUSIONS:
    Sex is very important to Asian men and women, but many of them are not fully satisfied with their sex lives and want to improve them.
    Matched MeSH terms: Erectile Dysfunction/drug therapy; Erectile Dysfunction/ethnology*; Erectile Dysfunction/psychology
  15. Tan HM, Low WY, Ng CJ, Chen KK, Sugita M, Ishii N, et al.
    J Sex Med, 2007 Nov;4(6):1582-92.
    PMID: 17908233 DOI: 10.1111/j.1743-6109.2007.00602.x
    INTRODUCTION: There have been limited multiregional studies in Asia examining the parameters of men's general and sexual health and quality of life in the general population vs. those in clinical cohorts of patients with erectile dysfunction (ED).
    AIMS: The aims of the Asian Men's Attitudes to Life Events and Sexuality (Asian MALES) study were to investigate the prevalence of ED, associated health conditions, and ED treatment-seeking patterns in the general male population in five regions of Asia (China, Japan, Korea, Malaysia, and Taiwan).
    MAIN OUTCOME MEASURE: Standardized questionnaire previously used in a similar multiregional study and modified to ensure culturally appropriate content for Asia.
    METHODS: Phase I of the study involved 10,934 adult men, aged 20-75 years, who were interviewed using the standardized questionnaire. Phase II of the study involved men with self-reported ED recruited from Phase I and via physician referral, invitations in general practitioner offices, and street interception (total Phase II sample, N = 1,209).
    RESULTS: The overall prevalence of self-reported ED in the Phase I study population was 6.4%. ED prevalence varied by region and significantly increased with age (P < 0.01). Men with ED reported significantly greater rates of comorbid illness (P < 0.0001) and a reduced quality of life (P = 0.0001), compared with men without ED. Phase II of the study revealed that fewer than half of men with self-reported ED had sought treatment for their problem. Men were more likely to seek help for erection difficulties from Western doctors than from traditional medicine practitioners (P = 0.0001). A man's partner/spouse was the most common influencer of treatment seeking in all regions except Malaysia.
    CONCLUSION: The findings confirm those of existing research on ED in both Asian and non-Asian males: ED is a prevalent condition; the prevalence of ED increases with age and is strongly associated with comorbid conditions; and the majority of men have never sought treatment for their condition. This study highlights a substantial need for the evaluation and treatment of ED in Asian men.
    Matched MeSH terms: Erectile Dysfunction/epidemiology*; Erectile Dysfunction/therapy
  16. Tan HM, Moh CL, Mendoza JB, Gana T, Albano GJ, de la Cruz R, et al.
    Urology, 2000 Oct 1;56(4):635-40.
    PMID: 11018621 DOI: 10.1016/s0090-4295(00)00688-9
    OBJECTIVES:
    To evaluate the efficacy, safety, and tolerability of oral sildenafil in Asian men with erectile dysfunction of various causes (organic, psychogenic, or mixed) and of more than 6 months' duration.

    METHODS:
    In this double-blind, parallel-group trial conducted at eight centers in Malaysia, the Philippines, and Singapore, 254 men, 26 to 78 years old, were randomized to 12 weeks of sildenafil or placebo taken as needed 1 hour before anticipated sexual activity. Initially, the sildenafil (n = 127) or matching placebo (n = 127) dose was 50 mg but could be increased to 100 mg or decreased to 25 mg because of a lack of efficacy or intolerance, respectively. Efficacy was assessed by the 15-question International Index of Erectile Function, patients' event logs of sexual activity, and a global efficacy question about erections.

    RESULTS:
    The two primary efficacy variables relating to achievement and maintenance of an erection sufficient for sexual intercourse, as assessed by the mean scores for International Index of Erectile Function question 3 (4.22 versus 2.59) and question 4 (4.15 versus 2.41), were both significantly higher with sildenafil than with placebo (P <0.0001). In addition, the five separate International Index of Erectile Function domains of sexual function, the percentage of successful intercourse attempts, and the global efficacy assessment of erections revealed significantly greater treatment effects in favor of sildenafil (P <0.0001 versus placebo for all variables). Treatment-related adverse events occurred in 22.8% of patients who received sildenafil and in 10.2% of those who received placebo.

    CONCLUSIONS:
    Sildenafil is an effective and well-tolerated treatment for Asian men with erectile dysfunction of broad-spectrum etiology.
    Matched MeSH terms: Erectile Dysfunction/drug therapy*; Erectile Dysfunction/etiology
  17. Tan HM
    Int. J. Androl., 2000;23 Suppl 2:87-8.
    PMID: 10849506
    The quest for improving and maintaining sexual function has been going on since time immemorial. The advent of an effective oral drug, sildenafil, has brought about unprecedented open discussion on male erectile dysfunction, and gas accelerated the pace of development of new therapies for erectile dysfunction. New knowledge in the physiology of sexual function has enabled researchers to target drug treatment at the whole network of the central nervous system and the numerous cascadic enzymatic reactions leading to relaxation of the corporal smooth muscle. One of the brightest potential applications of future molecular technology in the study of erectile dysfuction is in the utilization of gene therapy.
    Matched MeSH terms: Erectile Dysfunction/drug therapy*; Erectile Dysfunction/physiopathology
  18. Tan HM, Chin CM, Chua CB, Gatchalian E, Kongkanand A, Moh CL, et al.
    Asian J Androl, 2008 May;10(3):495-502.
    PMID: 18385912 DOI: 10.1111/j.1745-7262.2008.00388.x
    To evaluate the efficacy and tolerability of vardenafil, a phosphodiesterase type-5 (PDE-5) inhibitor, in men of Asian ethnicity with erectile dysfunction (ED).
    Matched MeSH terms: Erectile Dysfunction/drug therapy*
  19. Suppiah B, Vicknasingam B, Singh D, Narayanan S
    J Psychoactive Drugs, 2016 Apr-Jun;48(2):86-92.
    PMID: 27014841 DOI: 10.1080/02791072.2016.1156790
    Despite the rise in recreational use of ketamine in Malaysia, there have been no studies of users or of the health-related consequences they face. This study was initiated to examine ketamine use and its health consequences. A structured questionnaire was used to elicit information. A final sample of 127 males was divided into persons who used only ketamine and those who were poly-drug users. Each group was further divided into long-period and short-period users. Urine toxicology screening for ketamine and other illicit drugs commonly used in Malaysia was also done. Our findings corroborate those of earlier studies that link ketamine use to urological problems such as frequent urination, dysuria, incontinence, painful bladder, nocturia, and urinary urgency. A new finding in this study is the significant association between ketamine use and erectile dysfunction, such that higher odds of reporting erectile dysfunction were linked to long-period users. Our findings strengthen the case for early intervention, as ketamine users are drawn from young and unmarried male participants. The association of ketamine use with erectile dysfunction, if substantiated, will help physicians in their diagnosis of erectile dysfunction, particularly among youths.
    Matched MeSH terms: Erectile Dysfunction/chemically induced*; Erectile Dysfunction/epidemiology
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