AB233. PDE5-Is for erectile dysfunction in patients with multiple sclerosis

OBJECTIVE: Male patients with multiple sclerosis commonly suffered sexual dysfunction. Phosphodiesterase five inhibitors are efficacious and widely used for erectile dysfunction in general population and even post-TURPT patients. However, whether PDE5-Is is effective for MS-associated ED is still unclear. METHODS: PubMed, ISI Web of Science and Google Scholar were searched and relevant studies were evaluated for the efficacy and safety of PDE5-Is on MS-associated ED. RESULTS: Sildenafil and tadalafil were used for the treatment of MS-associated ED in reported trials. In Safarinejad trial, sildenafil was slightly better than placebo regarding improved erections, successful penetration and successful sexual attempts. For side-effects, patients in sildenafil group showed significantly high proportion and the main AE was headache. In Fowler and Lombardi trials, sildenafil and tadalafil were used for treatment of MS-associated ED respectively. Both trials showed that PDE5-Is could improve erection or quality of life for patients and his partners. Although adverse events reported in two trials, no patient discontinued because of AEs. CONCLUSIONS: PDE5-Is seems to be an effective for those MS-associated ED patients. However, the detail mechanism and long-term efficacy is still unknown.