Annals of Rehabilitation Medicine

Nocturnal Penile Tumescense and Rigidity Testing for Evaluation of Erectile Dysfunction in Men with Spinal Cord Injury.: Kim, Hyung Joon , Lee, Bum Suk , Park, Chul Woo , Choi, Soo Won , Yi, Sook Hee , Kim, Hong Chae , Kim, Seung Su; J Korean Acad Rehabil Med 2008;32(5):544-548.

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Objective: To evaluate erectile dysfunction in patients with spinal cord injury and the relationship between patient's subjective answers and the results of objective tests regarding erectile dysfunction. Method: Twenty-one male patients with erectile dysfunction after spinal cord injury were administered with nocturnal penile tumescense and rigidity testing (NPTR) using Rigiscan^Ⱂ over 2 consecutive nights. NPTR using Rigiscan^Ⱂ at second night was performed after oral administration of sildenafil 50 mg. Answer of the global efficacy question (GEQ) after oral administration of sildenafil 50 mg and the parameters of NPTR were compared. Results: After oral administration of sildenafil 50 mg, number and duration of erectile episodes, and duration of rigidity greater than 60% on NPTR improved significantly (p＜ 0.05). Sixteen out of seventeen patients (94.1%) who showed improved nocturnal erection after oral administration of sildenafil 50 mg answered that they had an improved erectile function after sildenafil. All four patients (100%) who showed no improvement in nocturnal erection after sildenafil answered that their erectile function was not improved after oral administration of sildenafil 50 mg. Conclusion: We expect NPTR using Rigiscan^Ⱂ might be useful for the evaluation of erectile dysfunction in men with spinal cord injury. (J Korean Acad Rehab Med 2008; 32: 544-548)

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Effect of Oral Sildenafil Citrate (Viagra(R)) in Erectile Dysfunction Following Spinal Cord Injury.: Rha, In Soo , Lee, Bum Suk , Kim, Byung Sik , Kim, Kee Kyung; J Korean Acad Rehabil Med 2002;26(3):306-310.

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Objective: To evaluate the effect of oral sildenafil citrate (Viagra^Ⱂ) on erectile dysfunction following spinal cord injury.

Method: Seventy nine male patients with erectile dysfunction after spinal cord injury, who were free from contraindications, received 50 mg of sildenafil. Visual-analogue erection scale (VAES) was used to evaluate the rigidity of penis before and after the medication. In addition, the duration of erection and side effects of sildenafil were evaluated.

Results: Mean VAES score showed a statistically significant increase after the medication from 5.6 to 7.5 (p=0.000). The mean duration of erection also increased from 3.4 minutes to 27.1 minutes after medication (p=0.000). Sixty seven patients (84.8%) reported improved erection with 50 mg of sildenafil and sixty one patients (77.2%) reported rigid erection enough for sexual intercourse. Ten patients (12.7%) reported side effects: facial flushing (3), dizziness (2), headache (2), chest pain (2), and palpitation (1).

Conclusion: This study demonstrated that sildenafil is an effective medication in treating erectile dysfunction after spinal cord injury. (J Korean Acad Rehab Med 2002; 26: 306-310)

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The Erectile Response to Intracavernosal Injection of Prostaglandin E1 in Spinal Cord Injured Men.: Kim, Kee Kyung , Lee, Bum Suk , Kim, Byung Sik , Shin, Byung Soon; J Korean Acad Rehabil Med 1999;23(4):762-769.

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Objective: To study the erectile response to intracavernosal injection of prostaglandin E1 in 33 spinal cord injured men with neurogenic erectile dysfunction.

Method: The erectile response was assessed by the penile palpation. Thirty three subjects (mean age, 35.5 years) were studied. They received a testing dosage starting from 2.5 μg with increasing dosage (maximum 40 μg) to achieve an erection. The positive response accounts for the sufficient erection lasting for more than 30 minutes.

Results: After the injection, 30 subjects (90.9%) achieved the positive response and the mean duration of erection was 59.2 minutes. Of the 30 positive responders, the mean dosage needed to induce positive response was 5.8 μg in the patients with cervical cord injury (12 subjects), 13.1 μg in the patients with thoracic cord injury (12 subjects), and 33.3 μg in the patients with lumbar cord injury (6 subjects). The mean dosage required for the positive response was different according to the pre-injection erectile function of the subjects. For the positive response, it required 7.7 μg in a full erection with short duration group (14 subjects), 9.4 μg in a partial erection group (8 subjects), and 30.6 μg in no erection group (8 subjects). No systemic side effect or complication was noted except for the prolonged erection in 1 subject.

Conclusion: The intracavernosal injection of prostaglandin E1 appears to be a safe and effective treatment for the treatment of erectile dysfunction in spinal cord injured men. The dosage depends on the level of spinal cord injury and pre-injection erectile function.