The results of the included studies are inconclusive , though they show a trend towards a larger effect of combined treatment compared with PI or PDE5-I treatment alone .
The meta- analysis found that , overall , combined treatment was more efficacious for ED symptoms than PDE5-I treatment or PI alone .
Combined treatment was more efficacious than PDE5-I use alone on sexual satisfaction .
No differences were found between PDE5-Is and PI as st and -alone treatments .
The combination of PI and PDE5-Is is a promising strategy for a favorable outcome in ED and can be considered as a first-choice option for ED patients .
INTRODUCTION Erectile dysfunction ( ED ) is an increasing health problem that dem and s effective treatment .
There is evidence that phosphodiesterase-5 inhibitors ( PDE5-Is ) and psychological intervention ( PI ) are effective treatment options ; however , little is known about their comparative efficacy and the efficacy of combined treatments .
AIM The aim of this systematic review and meta- analysis is to evaluate the comparative efficacy of PI , PDE5-Is , and their combination in the treatment of ED .
MAIN OUTCOME MEASURES Primary outcome was ED symptoms , and secondary outcome was sexual satisfaction of the patient .
Integrated sildenafil and cognitive-behavior sex therapy for psychogenic erectile dysfunction: a pilot study.
INTRODUCTION Men with psychogenic erectile dysfunction ( ED ) present a challenge to physicians . Treatment with pharmacological agents alone does not address the complexities of the causative or result ing psychological issues . AIM To evaluate the effectiveness of an integrative treatment protocol ( ITP ) with sildenafil and cognitive-behavior sex therapy ( CBST ) compared with sildenafil alone for men with psychogenic ED . MAIN OUTCOME MEASURES Change from baseline on the International Index of Erectile Function ( IIEF ) in the domains of erectile function and sexual satisfaction to demonstrate improved sexual functioning and confidence . METHODS Men with psychogenic ED and female partners were r and omized to receive either sildenafil alone or an ITP with sildenafil and CBST for the first 4 weeks . In the last 4 weeks , couples in the sildenafil group added CBST sessions to their regimen ; patients in the ITP group continued the combined therapy . The IIEF question naire was used to compare erectile function and overall satisfaction serially at pretreatment , 4 , and 8 weeks . Couples who met the success criteria in both domains after the first 4 weeks received no further treatment . RESULTS Fifty-three couples constituted the study population . After the first 4 weeks of sildenafil and ITP , 48 % of men met criteria for success on erectile function and 65.5 % for satisfaction compared to men on sildenafil alone with 29 % and 37.5 % success rates , respectively . After the last 4 weeks , integration of CBST with sildenafil result ed in a 58 % success rate for erectile function which was comparable to the 66 % rate for the initial drug/ITP group ; satisfaction rates for men were 45 % and 75 % , respectively . CONCLUSIONS CBST was shown to have a positive influence when used throughout the entire 8 weeks of the ITP or added to the sildenafil in the last 4 weeks . Although patients in both treatment regimens had significant improvements in the IIEF domain scores confirming efficacy of sildenafil , those in the CBST and drug regimen achieved higher rates of clinical success within the first 4 weeks of therapy
The results of the included studies are inconclusive , though they show a trend towards a larger effect of combined treatment compared with PI or PDE5-I treatment alone .
The meta- analysis found that , overall , combined treatment was more efficacious for ED symptoms than PDE5-I treatment or PI alone .
Combined treatment was more efficacious than PDE5-I use alone on sexual satisfaction .
No differences were found between PDE5-Is and PI as st and -alone treatments .
The combination of PI and PDE5-Is is a promising strategy for a favorable outcome in ED and can be considered as a first-choice option for ED patients .
INTRODUCTION Erectile dysfunction ( ED ) is an increasing health problem that dem and s effective treatment .
There is evidence that phosphodiesterase-5 inhibitors ( PDE5-Is ) and psychological intervention ( PI ) are effective treatment options ; however , little is known about their comparative efficacy and the efficacy of combined treatments .
AIM The aim of this systematic review and meta- analysis is to evaluate the comparative efficacy of PI , PDE5-Is , and their combination in the treatment of ED .
MAIN OUTCOME MEASURES Primary outcome was ED symptoms , and secondary outcome was sexual satisfaction of the patient .