Skip to main content


Log in

Influencing Factors for Erectile Dysfunction of Young Adults with No Response to PDE5i

  • Published:
Current Medical Science Aims and scope Submit manuscript


Erectile dysfunction (ED) is a common male disorder. Although orally-administered phosphodiesterase type 5 inhibitors (PDE5 inhibitors) are now recognized as the primary pharmacological treatment method for ED, 20%–30% of the patients treated with PDE5 inhibitors exhibit no significant effects. This study aims to investigate the influencing factors of ED in young adults with no response to PDE5 inhibitors. ED patients who would take PDE5 inhibitors were included and investigated with a questionnaire. Patients with no response to PDE5 inhibitors (tadalafil and sildenafil) served as study group, and those with response to PDE5 inhibitors as control group. Then Chi square test and logistic regression analysis were applied to find the potential influencing factors. In total, 378 ED patients were included. Ninety-three (24.6%) cases were non-responsive to PDE5 inhibitors, and the remaining 285 (75.4%) responded to PDE5 inhibitors. In multiple logistic regression analysis, we found that history of drinking (OR=3.152; 95%CI 1.672–6.975), spousal noncooperation (OR=2.994; 95%CI 1.589–5.638), number of fixed sex partners (OR=0.358; 95%CI 0.132–0.651), duration of ED (OR=3.356; 95%CI 1.352–8.333), and depression (OR=3.689; 95%CI 1.579–8.979) could be the influencing factors for ED patients’ non-response to PDE5 inhibitors. In conclusion, history of drinking, spousal noncooperation, number of fixed sex partner, long duration of ED, and depression could be the influencing factors for ED patients’ non-response to PDE5 inhibitors. Patients and doctors should pay attention to these factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA. 1993,270(1): 83–90

    Article  Google Scholar 

  2. Uckert S, Mayer ME, Stief CG, et al. The future of the oral pharmacotherapy of male erectile dysfunction: things to come. Expert Opin Emerg Drugs, 2007,12(2):219–228

    Article  Google Scholar 

  3. European Association of Urology Guidelines. 2017 edition. 2017

  4. Bacon CG, Mittleman MA, Kawachi I, et al. Sexual function in men older than 50 years of age: results from the health professionals follow-up study. Ann Intern Med, 2003,139(3):161–168

    Article  Google Scholar 

  5. Vicenzini E, Altieri M, Michetti PM, et al. Cerebral vasomotor reactivity is reduced in patients with erectile dysfunction. Eur Neurol, 2008,60(2):85–88

    Article  Google Scholar 

  6. Feldman HA, Johannes CB, Derby CA, et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med, 2000,30(4):328–338

    Article  CAS  Google Scholar 

  7. Miner MM, Kuritzky L. Erectile dysfunction: a sentinel marker for cardiovascular disease in primary care. Cleve Clin J Med, 2007,74(Suppl 3):S30–S37

    Article  Google Scholar 

  8. Fisher WA, Eardley I, Mccabe M, et al. Erectile dysfunction (ED) is a shared sexual concern of couples II: association of female partner characteristics with male partner ED treatment seeking and phosphodiesterase type 5 inhibitor utilization. J Sex Med, 2009,6(11):3111–3124

    Article  Google Scholar 

  9. Hatzimouratidis K. Reply to Pero Bokarica’s letter to the editor re: K. Hatzimouratidis, I. Eardley, F. Giuliano, I. Moncada, A. Salonia. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. European Association of Urology Website. Updated 2015. Eur Urol, 2015,68 (4):e78

  10. Mulhall JP. Penile rehabilitation following radical prostatectomy. Curr Opin Urol, 2008,18(6):613–620

    Article  Google Scholar 

  11. Porst H, Giuliano F, Glina S, et al. Evaluation of the efficacy and safety of once-a-day dosing of tadalafil 5mg and 10mg in the treatment of erectile dysfunction: results of a multicenter, randomized, double-blind, placebo-controlled trial. Eur Urol, 2006,50(2):351–359

    Article  CAS  Google Scholar 

  12. Lee JW, Park HJ, Park NC. Serum High-Sensitivity C-Reactive Protein Levels and Response to 5 mg Tadalafil Once Daily in Patients With Erectile Dysfunction and Diabetes. Korean J Urol, 2013,54(12):858–864

    Article  Google Scholar 

  13. Moncada I, Martinez-Salamanca JI, Allona A, et al. Current role of penile implants for erectile dysfunction. Curr Opin Urol, 2004,14(6):375–380

    Article  Google Scholar 

  14. Lee CH, Kim HS, Goo MJ, et al. Chronic administration of udenafil, a selective phosphodiesterase type 5 inhibitor, promotes erectile function recovery in an animal model of bilateral cavernous nerve crush injury. J Sex Med 2011,8(5):1330–1340

    Article  CAS  Google Scholar 

  15. Washington SR, Shindel AW. A once-daily dose of tadalafil for erectile dysfunction: compliance and efficacy. Drug Des Devel Ther, 2010,4:159–171

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Liu DF, Jiang H, Hong K, et al. Epidemiological changes of ED patients: investigations in 11 Chinese cities during the past 5 years. Zhonghua Nan Ke Xue (Chinese), 2009,15(8):724–726

    Google Scholar 

  17. Kim SC, Lee YS, Seo KK, et al. Reasons and predictive factors for discontinuation of PDE-5 inhibitors despite successful intercourse in erectile dysfunction patients. Int J Impot Re, 2014,26(3):87–93

    Article  CAS  Google Scholar 

  18. Bechara A, Casabe A, De Bonis W, et al. Twelve-Month Efficacy and Safety of Low-Intensity Shockwave Therapy for Erectile Dysfunction in Patients Who Do Not Respond to Phosphodiesterase Type 5 Inhibitors. Sex Med, 2016,4(4):e225–e232

    Article  Google Scholar 

  19. Hakim L, Van der Aa F, Bivalacqua TJ, et al. Emerging tools for erectile dysfunction: a role for regenerative medicine. Nat Rev Urol, 2012,9(9):520–536

    Article  CAS  Google Scholar 

  20. Liu Y, Song H, Wang T, et al. Determinants of tobacco smoking among rural-to-urban migrant workers: a cross-sectional survey in Shanghai. BMC Public Health, 2015,15:131

    Article  Google Scholar 

  21. Sereda Y, Dembitskyi S. Validity assessment of the symptom checklist SCL-90-R and shortened versions for the general population in Ukraine. BMC Psychiatry, 2016,16(1):300

    Article  Google Scholar 

  22. Roberts N, Parker KC, Dagnone M. Comparison of Clinical Diagnoses, NIMH-DISC-IV Diagnoses and SCL-90-R Ratings in an Adolescent Psychiatric Inpatient Unit: A Brief Report. Can Child Adolesc Psychiatr Rev, 2005,14(4):103–105

    PubMed  PubMed Central  Google Scholar 

  23. Barbonetti A, Cavallo F, Felzani G, et al. Erectile Dysfunction is the Main Determinant of Psychological Distress in Men with Spinal Cord Injury. J Sex Med, 2012,9(3):830–836

    Article  Google Scholar 

  24. Aghighi A, Grigoryan VH, Delavar A. Psychological determinants of erectile dysfunction among middle-aged men. Int J Impot Res, 2015,27(2):63–68

    Article  CAS  Google Scholar 

  25. Juan YS, Long CY, Chou YH, et al. Sexual Dysfunction in Men with Chronic Pelvic Pain Syndrome. Incontinence Uff06 Pelvic Floor Dysfunction, 2011,5(2):31–34

    Google Scholar 

  26. Zeng HQ, Zhang CH, Lu GC. Psychological factors and erectile function in men with refractory chronic prostatitis, Zhonghua Nan Ke Xue (Chinese), 2008, 14(8):728–730

    Google Scholar 

  27. Cairoli C, Reyes LA, Henneges C, et al. PDE5 inhibitor treatment persistence and adherence in Brazilian men: post-hoc analyses from a 6-month, prospective, observational study. Int Braz J Urol, 2014,40(3):390–399

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Han-qing Zeng.

Ethics declarations

The authors declare that there is no conflict of interest with any financial organization or corporation or individual that can inappropriately influence this work.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, J., Wang, Yl., He, Y. et al. Influencing Factors for Erectile Dysfunction of Young Adults with No Response to PDE5i. CURR MED SCI 41, 529–534 (2021).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

Key words