International Urology and Nephrology

, Volume 40, Issue 1, pp 133–136 | Cite as

The effect of sildenafil citrate and pentoxifylline combined treatment in the management of erectile dysfunction

  • Ozdem Levent Ozdal
  • Cuneyt Ozden
  • Serkan Gokkaya
  • Guvenc Urgancioglu
  • Binhan Kagan Aktas
  • Ali Memis
Original Article



In the present study, we evaluated the efficacy of sildenafil and pentoxifylline combined therapy in the treatment of vasculogenic erectile dysfunction.


Sixty-eight patients with various degrees and types of vasculogenic erectile dysfunction were included in the study. The patients were recommended to take oral sildenafil (minimum two 50-mg tablets/week) 1 h prior to sexual intercourse for 4 weeks. After 4 weeks of washout period, patients were recommended to take combined therapy (minimum two 50-mg tablets/week sildenafil 1 h prior to sexual intercourse and 1.2 g of pentoxifylline/day divided into three doses) for an additional 4-week period. Both treatment regimes were evaluated with the international index of erectile function (IIEF).


Mean IIEF score was higher after sildenafil treatment when compared to pre-treatment score (14.2 ± 4.3 and 8.6 ± 4.2, respectively, P < 0.05). Likewise after the combination treatment, mean IIEF score was higher when compared to pre-treatment score (18.1 ± 5.2 and 8.6 ± 3.8, respectively, P < 0.05). The increase in the IIEF score was 5.62 ± 2.08 in the sildenafil only group whereas increase in the IIEF score was 9.51 ± 3.77 in the combination therapy group. There was a statistically significant increase in the combination group when compared to the sildenafil only group (P < 0.001).


Our study suggests that use of sildenafil citrate and pentoxifylline combined therapy could be effective in the management of patients with vasculogenic erectile dysfunction.


Drug therapy Erectile dysfunction Penile erection Pentoxifylline Sildenafil 


  1. 1.
    Lizza EF, Rosen RC (1999) Definition and classification of erectile dysfunction: report of the Nomenclature Committee of the International Society of Impotence Research. Int J Impot Res 11:141–143PubMedCrossRefGoogle Scholar
  2. 2.
    Sattar AA, Wery D, Golzarian J et al (1996) Correlation of nocturnal penile tumescence monitoring duplex ultrasonography and infusion cavernosometry for the diagnosis of erectile dysfunction. J Urol 155:1274–1276PubMedCrossRefGoogle Scholar
  3. 3.
    Oates CP, Pickard RS, Powell PH et al (1995) The use of duplex ultrasound in the assessment of arterial supply to the penis in vasculogenic impotence. J Urol 153:354–357PubMedCrossRefGoogle Scholar
  4. 4.
    Padma-Nathan H, Giuliano F (2001) Oral drug therapy for erectile dysfunction. Urol Clin North Am 28:321–334PubMedCrossRefGoogle Scholar
  5. 5.
    Ralph D, McNicholas T (2000) UK management guidelines for erectile dysfunction. BMJ 321:499–503PubMedCrossRefGoogle Scholar
  6. 6.
    Ward A, Clissold SP (1987). Pentoxifylline. A review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic efficacy. Drugs 34:50–97PubMedCrossRefGoogle Scholar
  7. 7.
    Korenman SG, Viosca SP (1993) Treatment of vasculogenic sexual dysfunction with pentoxifylline. J Am Geriatr Soc 41:363–366PubMedGoogle Scholar
  8. 8.
    Peskircioglu L, Karabulut A, Deniz E et al (1996) The role of pentoxifylline in the treatment of erectile dysfunction due to borderline arterial insufficiency. Br J Urol 77:563–565PubMedGoogle Scholar
  9. 9.
    Boolell M, Gepi-Attee S, Gingell JC et al (1996) Sildenafil, a novel effective oral therapy for male erectile dysfunction. Br J Urol 78:257–261PubMedGoogle Scholar
  10. 10.
    Rosen RC, Riley A, Wagner G et al (1997) The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 49:822–830PubMedCrossRefGoogle Scholar
  11. 11.
    Rajfer J (1994) Andrology. J Urol 152:891PubMedGoogle Scholar
  12. 12.
    Feldman HA, Goldstein I, Hatzichristou DG et al (1994) Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study. J Urol 151:54–61PubMedGoogle Scholar
  13. 13.
    Rahman MA (1999) Pathophysiology of erectile dysfunction. In: Vaughan ED Jr, Perlmutter AP (eds) Atlas of clinical urology, Vol 1. Current Medicine, Philadelphia, PA, pp 1–6Google Scholar
  14. 14.
    Baum N, Rhodes D (1995) A practical approach to the evaluation and treatment of erectile dysfunction. A private practitioner’s viewpoint. Urol Clin North Am 22:865–877PubMedGoogle Scholar
  15. 15.
    Jarow JP, Nana-Sinkam P, Sabbagh M et al (1996) Outcome analysis of goal directed therapy for impotence. J Urol 155:1609–1612PubMedCrossRefGoogle Scholar
  16. 16.
    Hanash KA (1997) Comparative results of goal oriented therapy for erectile dysfunction. J Urol 157:2135–2138PubMedCrossRefGoogle Scholar
  17. 17.
    Boolell M, Allen MJ, Ballard SA, et al (1996) Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction. Int J Impot Res 8:47–52PubMedGoogle Scholar
  18. 18.
    Fabbri A, Aversa A, Isidori A (1999) Sildenafil and erectile dysfunction. J Endocrinol Invest 22:486–492PubMedGoogle Scholar
  19. 19.
    Knoll LD, Benson RC Jr, Bilhartz DL, et al (1996) A randomized crossover study using yohimbine and isoxsuprine versus pentoxifylline in the management of vasculogenic impotence. J Urol 155:144–146PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Ozdem Levent Ozdal
    • 1
  • Cuneyt Ozden
    • 1
  • Serkan Gokkaya
    • 1
  • Guvenc Urgancioglu
    • 1
  • Binhan Kagan Aktas
    • 1
  • Ali Memis
    • 1
  1. 1.Department of UrologyNumune Education and Research HospitalAnkaraTurkey

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