Tadalafil resolves Erectile Dysfunction (Impotence) in men with Spinal Cord Injury (SCI)
Spinal Cord Injury (SCI) is of common occurrence in young persons, leading to several physical, psychological and social consequences. A common sexual complication of SCI in males is Erectile Dysfunction (formerly called impotence). This occurs in almost 75% of the spinal cord injured, and the degree of sexual impairment varies depending on the site of injury and its extent. As the nerve centers in the spinal cord are damaged by the injury they no longer communicate the sexual signals and that leads to the dysfunction.
Till recently the patients of SCI in addition to their vows resulting from the condition, used to be deprived of sexual pleasure too. With the advent of drugs called PDE-5 inhibitors (Viagra was the first-comer in this class) the plight of the SCI patients improved.
Clinical experience suggests that Tadalafil improves erectile function in men with SCI too, in addition to ED arising from a number of other causes. Research by several teams of scientists has provided evidence for this.
Very recently a team of researchers led by Dr. Francois Giuliano, MD, PhD, Department of Physical Medicine and Rehabilitation, Raymond Poincare´ Hospital, Garches, France conducted a randomized, double-blind study with placebo control in several centers in France, Germany, Italy, and Spain to determine the efficacy and safety of Tadalafil when taken on demand. Of the 186 patients who participated for the study, 142 were randomly given 1 dose (max.) of Tadalafil per day and the rest were given placebo (a vitamin pill or something that does not have therapeutic benefit).
The participants’ erectile function was assessed through a validated diagnostic questionnaire called IIEF (International Index of Erectile Function) administered before and after therapy. Out a total of 15 questions in IIEF, 6 are specifically intended to assess erectile function (EF) and can have score ranging from 1-30.
The scores reflect the severity of ED, for ex., a score of 5-10 indicates severe ED, 17-21 reflects mild ED while a score above 26 is normal erectile function. Finally if the score improves by 4-5 points after treatment, it is considered significant change.
Using such criteria, coupled with a few others, the researchers found out that Tadalafil indeed improved erectile function in patients of SCI suffering from ED. They could not only achieve satisfactory erections (75% of the time), but could actually penetrate , and sustain erections till completion of intercourse (47% of the time). In contract those on placebo could have intercourse only 16% of the time.
Tadalafil has certain advantages over other drugs of its class (PDE-5 inhibitors). Tadalafil is not influenced by dietary intake, which means that it can be taken regardless of meals, unlike other PDE5 inhibitors.
Secondly it has clinical efficiency of up to 36 hours, so there is no compulsion to plan intercourse within hours of taking Tadalafil. It can take place anytime within the next one-and-a-half days. Good enough indeed.
As to side effects Tadalafil shares the same side effects as any other PDE-5 I’s, namely, head aches, urinary tract infection, upper abdominal pain etc. but they were within tolerable limits.
Thus the advent of PDE-5 inhibitor therapy is indeed a boon for patients of ED resulting from pre-existing conditions (e.g., prostate removal surgery, diabetes mellitus and now spinal cord injury.
