Integrated sildenafil and cognitive-behavior sex therapy for psychogenic erectile dysfunction: A pilot study
Integrated sildenafil and cognitive-behavior sex therapy for psychogenic erectile dysfunction: A pilot study
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DOI：
10.1111/j.1743-6109.2007.00535.x
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发表时间：
2007-07-01
影响因子：
3.5
通讯作者：
Anderson, Rodney U.
中科院分区：
文献类型：
--
作者：
Banner, Linda L.;Anderson, Rodney U.
介绍。男性心因性勃起功能障碍（ED）提出了一个挑战，医生。单靠药物治疗并不能解决复杂的致病或由此产生的心理问题。目的：评价西地那非与认知行为性治疗（CBST）相结合的综合治疗方案（ITP）与单独使用西地那非治疗男性心因性ed的效果。国际勃起功能指数（IIEF）在勃起功能和性满意度方面的基线变化，以证明性功能和信心的改善。患有心因性ED的男性和女性伴侣在前4周随机接受西地那非单独治疗或西地那非加CBST的ITP治疗。在过去的4周内，西地那非组的夫妇在他们的治疗方案中增加了CBST疗程；ITP组患者继续联合治疗。使用IIEF问卷在预处理、4周和8周分别比较勃起功能和总体满意度。在最初的4周后，在两个领域都达到成功标准的夫妇不再接受进一步的治疗。53对夫妇构成了研究对象。在西地那非和ITP治疗的前4周后，48%的男性达到了勃起功能成功的标准，65.5%的男性达到了满意度，而单独使用西地那非的男性的成功率分别为29%和37.5%。在最后4周后，CBST与西地那非的结合导致58%的勃起功能成功率，与初始药物/ITP组的66%的成功率相当；男性满意度分别为45%和75%。在ITP的整个8周内使用CBST或在最后4周加入西地那非时显示出积极的影响。虽然两种治疗方案的患者在IIEF域评分上都有显著改善，证实了西地那非的疗效，但CBST和药物治疗方案的患者在治疗的前4周内取得了更高的临床成功率。
Introduction. Men with psychogenic erectile dysfunction (ED) present a challenge to physicians. Treatment with pharmacological agents alone does not address the complexities of the causative or resulting psychological issues.Aim. To evaluate the effectiveness of an integrative treatment protocol (ITP) with sildenafil and cognitive-behavior sex therapy (CBST) compared with sildenafil alone for men with psychogenic ED.Main Outcome Measures. Change from baseline on the International Index of Erectile Function (IIEF) in the domains of erectile function and sexual satisfaction to demonstrate improved sexual functioning and confidence.Methods. Men with psychogenic ED and female partners were randomized to receive either sildenafil alone or an ITP with sildenafil and CBST for the first 4 weeks. In the last 4 weeks, couples in the sildenafil group added CBST sessions to their regimen; patients in the ITP group continued the combined therapy. The IIEF questionnaire was used to compare erectile function and overall satisfaction serially at pretreatment, 4, and 8 weeks. Couples who met the success criteria in both domains after the first 4 weeks received no further treatment.Results. Fifty-three couples constituted the study population. After the first 4 weeks of sildenafil and ITP, 48% of men met criteria for success on erectile function and 65.5% for satisfaction compared to men on sildenafil alone with 29% and 37.5% success rates, respectively. After the last 4 weeks, integration of CBST with sildenafil resulted in a 58% success rate for erectile function which was comparable to the 66% rate for the initial drug/ITP group; satisfaction rates for men were 45% and 75%, respectively.Conclusions. CBST was shown to have a positive influence when used throughout the entire 8 weeks of the ITP or added to the sildenafil in the last 4 weeks. Although patients in both treatment regimens had significant improvements in the IIEF domain scores confirming efficacy of sildenafil, those in the CBST and drug regimen achieved higher rates of clinical success within the first 4 weeks of therapy.