Objective: We aimed to evaluate whether changes in urinary and sexual function can influence health-related quality of life. Patients and Methods: Out of 54 recruited patients, 36 were enrolled, and data for 30 participants with erectile dysfunction were available. At baseline and after 1 and 2 months, each participant completed the International Index of Erectile Function (IIEF-15), the International Prostate Symptom Score (IPSS) and the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36). Uroflowmetry, post-voiding residual volume and the nocturnal penile tumescence (NPT) test were performed at baseline and at the study's conclusion. Results: Compared with baseline, the IPSS, IIEF-15, peak urinary flow rate, NPT parameters and mental component of the SF-36 exhibited significant improvement at the study's conclusion. Among the symptomatic parameters, the changes in the storage and erectile function parameters contributed significantly to the change in the mental component score on the SF-36 (p = 0.007, R2 = 0.502). Conclusions: The daily administration of low-dose mirodenafil (50 mg) produced improvements in urinary and erectile function with or without sexual stimulation. Furthermore, this therapy enhanced the mental component of health-related quality of life by improving storage and erectile symptoms.

Keywords:
Erectile dysfunction, Health-related quality of life, Phosphodiesterase type 5 inhibitors
1.
McMahon C: Comparison of efficacy, safety and tolerability of on-demand tadalafil and daily dosed tadalafil for the treatment of erectile dysfunction. J Sex Med 2005;2:415-425.
2.
Porst H, Brock GB, Kula K, Moncada I, Montorsi F, Basson BR, Kinchen K, Aversa A: Effects of once-daily tadalafil on treatment satisfaction, psychosocial outcomes, spontaneous erections, and measures of endothelial function in men with erectile dysfunction but naive to phosphodiesterase type 5 inhibitors. J Androl 2012;33:1305-1322.
3.
Bertolotto M, Trincia E, Zappetti R, Bernich R, Savoca G, Cova MA: Effect of Tadalafil on prostate haemodynamics: preliminary evaluation with contrast-enhanced US. Radiol Med 2009;114:1106-1114.
4.
Oelke M, Giuliano F, Mirone V, Xu L, Cox D, Viktrup L: Monotherapy with tadalafil or tamsulosin similarly improved lower urinary tract symptoms suggestive of benign prostatic hyperplasia in an international, randomised, parallel, placebo-controlled clinical trial. Eur Urol 2012;61:917-925.
5.
Roehrborn CG, Kaminetsky JC, Auerbach SM, Montelongo RM, Elion-Mboussa A, Viktrup L: Changes in peak urinary flow and voiding efficiency in men with signs and symptoms of benign prostatic hyperplasia during once daily tadalafil treatment. BJU Int 2010;105:502-507.
6.
Litwin MS, Nied RJ, Dhanani N: Health-related quality of life in men with erectile dysfunction. J Gen Intern Med 1998;13:159-166.
7.
Paige NM, Hays RD, Litwin MS, Rajfer J, Shapiro MF: Improvement in emotional well-being and relationships of users of sildenafil. J Urol 2001;166:1774-1778.
8.
Chung JH, Kang DH, Oh CY, Chung JM, Lee KS, Kim TH, Moon KH, Lee W, Cho JM, Lee SW: Safety and efficacy of once daily administration of 50 mg mirodenafil in patients with erectile dysfunction: a multicenter, double-blind, placebo controlled trial. J Urol 2013;189:1006-1013.
9.
Bang WJ, Oh CY, Yoo C, Cho JS, Yang DY, Lee DH, Lee SH, Chung BH: Efficacy and safety of the simultaneous administration of mirodenafil and an α-blocker in men with BPH-LUTS: a multicenter open-label prospective study. Int J Impot Res 2013;25:149-154.
10.
Park HJ, Choi HK, Ahn TY, Park JK, Chung WS, Lee SW, Kim SW, Hyun JS, Park NC: Efficacy and safety of oral mirodenafil in the treatment of erectile dysfunction in diabetic men in Korea: a multicenter, randomized, double-blind, placebo-controlled clinical trial. J Sex Med 2010;7:2842-2850.
11.
Hirshkowitz M, Schmidt MH: Sleep-related erections: clinical perspectives and neural mechanisms. Sleep Med Rev 2005;9:311-329.
12.
Griffith ML, Boord JB, Eden SK, Matheny ME: Clinical inertia of discharge planning among patients with poorly controlled diabetes mellitus. J Clin Endocrinol Metab 2012; 97:2019-2026.
13.
Darby E, Anawalt BD: Male hypogonadism: an update on diagnosis and treatment. Treat Endocrinol 2005;4:293-309.
14.
Molnar J, Zhang F, Weiss J, Ehlert FA, Rosenthal JE: Diurnal pattern of QTc interval: how long is prolonged? Possible relation to circadian triggers of cardiovascular events. J Am Coll Cardiol 1996;27:76-83.
15.
Barry MJ, Fowler FJ Jr, O'Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, Cockett AT: The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol 1992;148:1549-1557.
16.
Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A: The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997;49:822-830.
17.
Tokatli Z, Akand M, Yaman O, Gulpinar O, Anafarta K: Comparison of international index of erectile function with nocturnal penile tumescence and rigidity testing in evaluation of erectile dysfunction. Int J Impot Res 2006;18:186-189.
18.
McHorney CA, Ware JE Jr, Lu JF, Sherbourne CD: The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994;32:40-66.
19.
Elhanbly S, Elkholy A, Elbayomy Y, Elsaid M, Abdel-gaber S: Nocturnal penile erections: the diagnostic value of tumescence and rigidity activity units. Int J Impot Res 2009;21:376-381.
20.
McVary KT: Erectile dysfunction and lower urinary tract symptoms secondary to BPH. Eur Urol 2005;47:838-845.
21.
Turk S, Solak Y, Kan S, Atalay H, Kilinc M, Agca E, Bodur S: Effects of sildenafil and vardenafil on erectile dysfunction and health-related quality of life in haemodialysis patients: a prospective randomized crossover study. Nephrol Dial Transplant 2010;25:3729-3733.
22.
Engström G, Henningsohn L, Walker-Engström ML, Leppert J: Impact on quality of life of different lower urinary tract symptoms in men measured by means of the SF 36 questionnaire. Scand J Urol Nephrol 2006;40:485-494.
23.
Laydner HK, Oliveira P, Oliveira CR, Makarawo TP, Andrade WS, Tannus M, Araújo JL: Phosphodiesterase 5 inhibitors for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a systematic review. BJU Int 2011;107:1104-1109.
24.
Barry MJ, Cockett AT, Holtgrewe HL, McConnell JD, Sihelnik SA, Winfield HN: Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia. J Urol 1993;150:351-358.
25.
Ezz el Din K, Kiemeney LA, de Wildt MJ, Debruyne FM, de la Rosette JJ: Correlation between uroflowmetry, prostate volume, postvoid residue, and lower urinary tract symptoms as measured by the International Prostate Symptom Score. Urology 1996;48:393-397.
26.
Yang CC, Porter MP, Penson DF: Comparison of the International Index of Erectile Function erectile domain scores and nocturnal penile tumescence and rigidity measurements: does one predict the other? BJU Int 2006;98:105-109.
27.
Rajfer J, Aronson WJ, Bush PA, Dorey FJ, Ignarro LJ: Nitric oxide as a mediator of relaxation of the corpus cavernosum in response to nonadrenergic, noncholinergic neurotransmission. N Engl J Med 1992;326:90-94.
28.
Everaert K, de Waard WI, Van Hoof T, Kiekens C, Mulliez T, D'herde C: Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves. Spinal Cord 2010;48:182-191.
29.
Melnik T, Abdo CH, de Moraes JF, Riera R: Satisfaction with the treatment, confidence and ‘naturalness' in engaging in sexual activity in men with psychogenic erectile dysfunction: preliminary results of a randomized controlled trial of three therapeutic approaches. BJU Int 2012;109:1213-1219.
30.
Abdel-Naser MB, Imam A, Wollina U: Sildenafil citrate significantly improves nocturnal penile erections in sildenafil non-responding patients with psychogenic erectile dysfunction. Int J Impot Res 2004;16:552-556.
© 2014 S. Karger AG, Basel
2014
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.