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Currently available data from recent studies suggest that a combination of an alphablocker and a 5-alpha-reductase inhibitor may be useful in patients with symptomatic BPH and a prostate of more than 40 grams with PSA > 1.6 ng/ml. Long-term

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effect of Sildenafil Citrate ( Viagra ) on erectile dysfunction after radical prostatectomy. The study consisted of 91 patients with erectile dysfunction
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from our institution who received oral Sildenafil Citrate ( Viagra ) after RP. Bilateral NS, unilateral NS, and non-NS. Sildenafil Citrate ( Viagra
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) was prescribed
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at a dose of 50 mg and increased to 100 mg if needed. Prostatic obstruction may be treated either by alphablockers with their peripheral muscle-relaxant action on the smooth muscle fibers of
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the prostate and bladder neck, or by 5-alpha-reductase inhibitors for their reducing effect on gland volume. To evaluate the long-term effect and safety of Sildenafil Citrate ( Viagra ) for the treatment of erectile dysfunction
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after radical prostatectomy (RP).

This chronic disorder, which is in fact more complex than it appears, may benefit in theory from a combination of molecules with different complementary action mechanisms. No differences were found in the 1-year and 3-year five-item International Index of Erectile Function (Sexual

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erectile dysfunction
Health Inventory of Men) and Erectile Dysfunction Inventory of Treatment Satisfaction scores between the NS groups. Data were collected from a self-administered questionnaire using the abridged five-item version of the International Index of Erectile Function questionnaire, referred to as the Sexual Health Inventory of Men, and the Erectile Dysfunction Inventory of Treatment Satisfaction. At 3 years, 31 (71%)
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of the 43 patients who had returned the second surveys were still responding to sildenafil.

Those who had responded

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positively to the drug were surveyed again 3 years later (n 48). Combinations including an antimuscarinic are effective
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in patients with BPH with marked irritative symptoms. The dropout rate was 27%; 6 of 12 had discontinued because of the return of natural erections, 5 because of a loss of efficacy, and 1 because his spouse had died. No patient discontinued the drug at 3 years because of side effects.
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The patients were stratified according to the type of nerve-sparing (NS) RP procedure they underwent. Of these 31 respondents, 10 (31%) had augmented their dose from 50 to 100
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mg. Finally, the combination of an alphablocker and a phosphodiesterase type 5 inhibitor may be useful in patients with lower urinary tract symptoms (LUTS)
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associated with erectile dysfunction.

Irritative bladder symptoms involving the detrusor may be treated by antimuscarinics and to a lesser extent by alphablockers. Combination therapy in benign prostatic hyperplasia (BPH)Because of the constant progress in our understanding

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of the physiopathology of benign prostatic hyperplasia, it is now possible to propose a more rational use of combination therapy, which is often used empirically, though not recommended, in routine practice. The results of this study indicate that the vast majority of patients with erectile dysfunction after RP who initially respond to Sildenafil
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Citrate ( Viagra ) continue to do so at 3 years and are satisfied and compliant with the treatment regimen.. The most com side effects at 3 years were headache (12%), flushing (10%), and blue or blurred vision (2%). We surveyed these patients using a self-administered questionnaire during the first year of Sildenafil Citrate ( Viagra ) use to determine treatment satisfaction, patient compliance, and safety.

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