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Zhang Y, Wu X, Feng X, Liu G, Jiang H, Zhang X. A novel strategy to induce penile erection during penile doppler ultrasound: oral sildenafil administration plus alprostadil injection. Aging Male 2024; 27:2339352. [PMID: 38590113 DOI: 10.1080/13685538.2024.2339352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/01/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVES To evaluate the efficacy of a novel approach to achieve the optimal penile erection during the penile doppler ultrasound (PDU) examination, which was oral sildenafil combined alprostadil injection. MATERIALS AND METHODS A total of 60 ED patients were enrolled in our prospective study, and they were randomly assigned to two group with different PDU order. The approaches assisted the PDU included two models, mode A meaning injection of 15 μg alprostadil and model B meaning oral sildenafil 100 mg plus injection of 15 μg alprostadil. The PDU parameters were measured continuously before induced erection, and 5, 10, 15, 20, 25 min. RESULTS Each group included 30 ED patients with similar clinical characteristics. After pooling the results together, the PSV, EDV, and RI were all improved significantly, when adding the oral sildenafil administration to assist PDU. Also, the clinical response of oral sildenafil administration plus alprostadil injection was better than that in alprostadil injection alone (p = 0.016). The arterial ED were decreased from 31.67% to 15.00% with the P value 0.031, and the mixed ED was also decreased statistically (23.33% vs 8.33%, p = 0.024). CONCLUSION Oral sildenafil administration plus alprostadil injection could improve the diagnostic accuracy of PDU.
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Affiliation(s)
- Yuyang Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Xu Wu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Xingliang Feng
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- The First People's Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Guodong Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Hui Jiang
- Department of Urology, Peking University First Hospital Institute of Urology, Peking University Andrology Center, Beijing, China
| | - Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
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Gandhi H, Shah B, Patel R, Toshani R, Pujara J, Kothari J, Shastri N. Effect of preoperative oral sildenafil on severe pulmonary artery hypertension in patients undergoing mitral valve replacement. Indian J Pharmacol 2015; 46:281-5. [PMID: 24987174 PMCID: PMC4071704 DOI: 10.4103/0253-7613.132158] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 09/27/2013] [Accepted: 03/20/2014] [Indexed: 11/17/2022] Open
Abstract
Aim: Long standing mitral valve disease is usually associated with severe pulmonary hypertension. Perioperative pulmonary hypertension is a risk factor for right ventricular (RV) failure and a cause for morbidity and mortality in patients undergoing mitral valve replacement. Phosphodiesterase 5 inhibitor-sildenafil citrate is widely used to treat primary pulmonary hypertension. There is a lack of evidence of effects of oral sildenafil on secondary pulmonary hypertension due to mitral valve disease. The study aims to assess the effectiveness of preoperative oral sildenafil on severe pulmonary hypertension and incidence of RV failure in patients undergoing mitral valve replacement surgery. Materials and Methods: A total of 40 patients scheduled for mitral valve replacement with severe pulmonary hypertension (RV systolic pressure (RVSP) ≥60 mmHg) on preoperative transthoracic echo were randomly treated with oral sildenafil 25 mg (N = 20) or placebo (N = 20) eight hourly for 24 h before surgery. Hemodynamic variables were measured 20 min after insertion of pulmonary artery catheter (PAC) under anesthesia (T1), 20 min at weaning from cardiopulmonary bypass (CPB) (T2) and after 1,2, and 6 h (T3, T4, T5, respectively) during the postoperative period. Results: Systolic and mean pulmonary artery pressure (MPAP) and pulmonary vascular resistance index (PVRI) were significantly lower (P < 0.0001) in sildenafil group at all times. Ventilation time and postoperative recovery room stay were significantly lower (P < 0.001) in sildenafil group. Conclusion: Sildenafil produces significant pulmonary vasodilatory effect as compared with placebo in mitral valve replacement patients with severe pulmonary hypertension. It also reduces ventilation time and intensive care unit (ICU) stay time as compared with placebo. It is concluded that sildenafil is effective in reducing pulmonary hypertension when administered preoperatively in patients with severe pulmonary hypertension undergoing mitral valve replacement surgery.
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Affiliation(s)
- Hemang Gandhi
- Department of Cardiac Anesthesia, Uttambhai Nathalal Mehta Institute of Cardiology and Research Center, Sir Byramjee Jeejeebhoy Medical College, Civil Hospital, Asarwa, Ahmadabad, Gujarat, India
| | - Bipin Shah
- Department of Cardiac Anesthesia, Uttambhai Nathalal Mehta Institute of Cardiology and Research Center, Sir Byramjee Jeejeebhoy Medical College, Civil Hospital, Asarwa, Ahmadabad, Gujarat, India
| | - Ramesh Patel
- Department of Cardiac Anesthesia, Uttambhai Nathalal Mehta Institute of Cardiology and Research Center, Sir Byramjee Jeejeebhoy Medical College, Civil Hospital, Asarwa, Ahmadabad, Gujarat, India
| | - Rajesh Toshani
- Department of Cardiac Anesthesia, Uttambhai Nathalal Mehta Institute of Cardiology and Research Center, Sir Byramjee Jeejeebhoy Medical College, Civil Hospital, Asarwa, Ahmadabad, Gujarat, India
| | - Jigisha Pujara
- Department of Cardiac Anesthesia, Uttambhai Nathalal Mehta Institute of Cardiology and Research Center, Sir Byramjee Jeejeebhoy Medical College, Civil Hospital, Asarwa, Ahmadabad, Gujarat, India
| | - Jignesh Kothari
- Department of Cardio Vascular Thoracic Surgery, Uttambhai Nathalal Mehta Institute of Cardiology and Research Center, Sir Byramjee Jeejeebhoy Medical College, Civil Hospital, Asarwa, Ahmadabad, Gujarat, India
| | - Naman Shastri
- Department of Cardio Vascular Thoracic Surgery, Uttambhai Nathalal Mehta Institute of Cardiology and Research Center, Sir Byramjee Jeejeebhoy Medical College, Civil Hospital, Asarwa, Ahmadabad, Gujarat, India
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