Aim： To assess the efficacy of sildenafil and continuous positive airway pressure （CPAP） in the treatment of concurrent erectile dysfunction （ED） with obstructive sleep apnea （OSA）, and to gauge the level of tr...Aim： To assess the efficacy of sildenafil and continuous positive airway pressure （CPAP） in the treatment of concurrent erectile dysfunction （ED） with obstructive sleep apnea （OSA）, and to gauge the level of treatment satisfaction in patients and their partners. Methods： Forty men were treated for 12 weeks with sildenafil 100 mg （20 men） or CPAP during nighttime sleep （20 men）. Treatment efficacy was assessed by the rate of successful intercourse attempts, and satisfaction with treatment was assessed by patients＇ and partners＇ answers to question 1 of the Erectile Dysfunction Inventory of Treatment Satisfaction. Results： Under sildenafil, 128 of 249 （51.4%） intercourse attempts were successful; under CPAP, 51 of 193 （26.9%） attempts were successful （^cp 〈 0.001）. Erectile function was improved in both groups. After sildenafil and CPAP treatment, the mean International Index for Erectile Function domain scores were 14.3 and 10.8, respectively （^bp = 0.025）, compared to 7.8 and 7 at baseline, respectively. CPAP and sildenafil were well tolerated. Sporadic episodes of nasal dryness under CPAP and transient headache and flushing under sildenafil were not significant. Fifty percent of patients treated with sildenafil and 25% with CPAP were satisfied with the treatment, and their partners were equally satisfied. The satisfaction scores for both patients and partners under sildenafil were superior to those under CPAP （^cP 〈 0.002）. Conclusion： Both sildenafil 100 mg and CPAP, used separately, had positive therapeutic impact but sildenafil was superior. Patients and their partners were more satisfied with sildenafil for the treatment of ED. However, because of the high proportion of dissatisfied men and partners, new therapeutic agents or a combination of the two methods must be studied further.展开更多
Female storage lower urinary tract symptoms are prevalent and bothersome. They are usually attributed to an overactive bladder and treated with antimusca-rinics. Nevertheless, failure of conventional treatment to alle...Female storage lower urinary tract symptoms are prevalent and bothersome. They are usually attributed to an overactive bladder and treated with antimusca-rinics. Nevertheless, failure of conventional treatment to alleviate nocturia in particular and epidemiological data suggesting that nocturnal polyuria is the only or a contributing factor to nocturia, has attracted interest in decreasing nighttime urine production as a method of managing nocturia. A reduction in urine production could also, at least temporarily, delay daytime stor-age symptoms by delaying bladder filling. Therefore, desmopressin, the synthetic analogue or naturally oc-curring antidiuretic hormone, could have a role in the management of female frequency, urgency and urgency incontinence. This work aims to review data on the use of desmopressin in females with storage symptoms. Available evidence indicates that desmopressin is eff-cacious in reducing nighttime urine production and epi-sodes of nocturia, resulting in fewer sleep interruptions. This translates into improved quality of life. Desmopres-sin is also effective in postponing micturition, urgency and incontinence for several hours after being taken on demand. The tolerability profle of desmopressin is good and signifcantly improved compared to historical figures due to the introduction of new oral formula-tions, tailoring the dose according to gender and age and adhering to instructions for fuid restriction before administration. The incidence of hyponatremia, desmo-pressin’s most important side-effect, is less than 3% in recent trials. The efficacy of desmopressin, combined with its improved safety profle, makes it an interesting method for treating female storage lower urinary tract symptoms.展开更多
文摘Aim： To assess the efficacy of sildenafil and continuous positive airway pressure （CPAP） in the treatment of concurrent erectile dysfunction （ED） with obstructive sleep apnea （OSA）, and to gauge the level of treatment satisfaction in patients and their partners. Methods： Forty men were treated for 12 weeks with sildenafil 100 mg （20 men） or CPAP during nighttime sleep （20 men）. Treatment efficacy was assessed by the rate of successful intercourse attempts, and satisfaction with treatment was assessed by patients＇ and partners＇ answers to question 1 of the Erectile Dysfunction Inventory of Treatment Satisfaction. Results： Under sildenafil, 128 of 249 （51.4%） intercourse attempts were successful; under CPAP, 51 of 193 （26.9%） attempts were successful （^cp 〈 0.001）. Erectile function was improved in both groups. After sildenafil and CPAP treatment, the mean International Index for Erectile Function domain scores were 14.3 and 10.8, respectively （^bp = 0.025）, compared to 7.8 and 7 at baseline, respectively. CPAP and sildenafil were well tolerated. Sporadic episodes of nasal dryness under CPAP and transient headache and flushing under sildenafil were not significant. Fifty percent of patients treated with sildenafil and 25% with CPAP were satisfied with the treatment, and their partners were equally satisfied. The satisfaction scores for both patients and partners under sildenafil were superior to those under CPAP （^cP 〈 0.002）. Conclusion： Both sildenafil 100 mg and CPAP, used separately, had positive therapeutic impact but sildenafil was superior. Patients and their partners were more satisfied with sildenafil for the treatment of ED. However, because of the high proportion of dissatisfied men and partners, new therapeutic agents or a combination of the two methods must be studied further.
文摘Female storage lower urinary tract symptoms are prevalent and bothersome. They are usually attributed to an overactive bladder and treated with antimusca-rinics. Nevertheless, failure of conventional treatment to alleviate nocturia in particular and epidemiological data suggesting that nocturnal polyuria is the only or a contributing factor to nocturia, has attracted interest in decreasing nighttime urine production as a method of managing nocturia. A reduction in urine production could also, at least temporarily, delay daytime stor-age symptoms by delaying bladder filling. Therefore, desmopressin, the synthetic analogue or naturally oc-curring antidiuretic hormone, could have a role in the management of female frequency, urgency and urgency incontinence. This work aims to review data on the use of desmopressin in females with storage symptoms. Available evidence indicates that desmopressin is eff-cacious in reducing nighttime urine production and epi-sodes of nocturia, resulting in fewer sleep interruptions. This translates into improved quality of life. Desmopres-sin is also effective in postponing micturition, urgency and incontinence for several hours after being taken on demand. The tolerability profle of desmopressin is good and signifcantly improved compared to historical figures due to the introduction of new oral formula-tions, tailoring the dose according to gender and age and adhering to instructions for fuid restriction before administration. The incidence of hyponatremia, desmo-pressin’s most important side-effect, is less than 3% in recent trials. The efficacy of desmopressin, combined with its improved safety profle, makes it an interesting method for treating female storage lower urinary tract symptoms.
