EFFECT OF SILDENAFIL CITRATE (VIAGRA) ON PENILE VASCULATURE AND CARDIODYNAMICS IN DIABETIC MALES WITH AND WITHOUT NEUROPATHY

Abstract

Background: Erectile and cardiovascular dysfunctions in diabetes are important signs resulting probably due to pelvic autonomic neuropathy with damage to the parasympathetic nervierignetes. Direct evidence for a neuropathic etiology comes from studies that show structural changes in autonomic nerve fibers supplying the corpora cavernosa. The present study deals with the diabetic neuopathies prevailing in men and the possible role of sildenafil citrate (Viagra) treatment for these neurogenic cardio-sexual disturbances. Methods: Penile mid shaft circumference and length, penile pulse amplitude, both systolic and diastolic blood pressures, and heart rate were measuredin response to erotic stimulation by film and fantasy and the effect of the treatment of sildenafil citrate (50 mg oral dose) was noted in 50 insulin dependent diabetes mellitus (IDDM) and in 50
non insulin dependent diabetes mellitus (NIDDM) patients with and without an objective evidence of neuropathy, having an age span in between 20 and 65 years and a duration of diabetes distributed over 1-25 years with their age matched non diabetic controls. Results: Sildenafil treatment showed a significant increase (P<0.0005) in penile mid shaft circumference and length, and penile pulse amplitude, where as both systolic and diastolic blood pressures and heart rate exhibited a significant decrease (P<0.025 and P<0.005 respectively) in both IDDM and NIDDM diabetic neuropathic patients. However this difference was found to be non-significant in both types of diabetic patients without neuropathy and when compared with their respective control
subjects .