RESULTS For the comparison of statins ( + /- sildenafil ) with placebo ( + /- sildenafil ) , the mean International Index of Erectile Function ( IIEF-5 ) ( the st and ardized mean difference [ SMD ] = 3.23 , 95 % confidence interval [ CI ] = -1.65 to 4.80 , P < 0.0001 ) indicated that statins ( + /- sildenafil ) showed statistically significantly greater improvements in the mean IIEF-5 compared with placebo ( + /- sildenafil ) .
For the comparison of statins plus sildenafil with placebo plus sildenafil , the mean IIEF-5 ( SMD = 3.60 , 95 % CI = 2.64 to 4.56 , P < 0.00001 ) , the IIEF domain ( SMD = 4.88 , 95%CI = 3.01 to 6.74 , P < 0.00001 ) , and the global efficacy question ( odds ratio = 6.44 , 95 % CI = 2.92 to 14.23 , P < 0.00001 ) showed that compared with placebo plus sildenafil , statins plus sildenafil clearly improved erectile function .
CONCLUSIONS This meta- analysis indicates that statins ( + /- sildenafil ) may improve ED compared with placebo ( + /- sildenafil )
INTRODUCTION It is not known if statins will improve symptoms in patients with established erectile dysfunction ( ED ) .
AIM We carried out a systematic review and meta- analysis to assess the effect of statins on ED .
Atorvastatin improves the response to sildenafil in hypercholesterolemic men with erectile dysfunction not initially responsive to sildenafil
Despite the initial enthusiasm , the significant number of patients in whom sildenafil is contraindicated or ineffective is a major challenge to all urologists . Our aim was to determine the safety and efficacy of adjunctive atorvastatin in restoring normal erectile function in hypercholesterolemic ( low-density lipoprotein ( LDL ) cholesterol > 120 mg per 100 ml ) sildenafil nonresponders . The study comprised 131 men with ED not responding to sildenafil citrate .  They were r and omized either to 40 mg atorvastatin daily ( n=66 , group 1 ) or matching placebo ( n=65 , group 2 ) for 12 weeks while they were taking on-dem and 100 mg sildenafil . Erectile function was subjectively assessed using the 5-item version of the International Index of Erectile Function ( IIEF-5 ) question naire and response to the global efficacy question ( GEQ ) . Serum biochemical and lipid profile ( total cholesterol , triglycerides , LDL cholesterol and high-density lipoprotein cholesterol ) analyses were performed at baseline and repeated at post-treatment weeks 6 and 12 . Compared with the placebo group ( 59 patients , mean age±s.d . 61.9±6.1 , mean years ED 3.9±1.8 ) , the atorvastatin group ( 59 patients , mean age±s.d . 63.9±6.9 , mean years ED 3.7±1.6 ) had significantly greater improvements in all IIEF-5 questions ( P=0.01 ) and GEQ ( P=0.001 ) . Subgroup analyses did reveal trends in the atorvastatin group to indicate that a change in the IIEF-5 score is affected by age , severity of ED and baseline serum levels of LDL . Patients with moderate ( r=0.28 , P=0.01 ) and severe ( r=0.20 , P=0.01 ) ED had better positive response rates  to adjunctive atorvastatin than patients with mild to moderate ED . None of the patients taking atorvastatin achieved a response of 5 to the IIEF-5 questions and none of the patients regained normal erectile function as defined by the IIEF-5 score > 21 . Subjects experienced a statistically significant but modest improvement in erectile function . Further investigation is needed to test the usefulness of long-term atorvastatin administration to restore erectile function in sildenafil nonresponders
RESULTS For the comparison of statins ( + /- sildenafil ) with placebo ( + /- sildenafil ) , the mean International Index of Erectile Function ( IIEF-5 ) ( the st and ardized mean difference [ SMD ] = 3.23 , 95 % confidence interval [ CI ] = -1.65 to 4.80 , P < 0.0001 ) indicated that statins ( + /- sildenafil ) showed statistically significantly greater improvements in the mean IIEF-5 compared with placebo ( + /- sildenafil ) .
For the comparison of statins plus sildenafil with placebo plus sildenafil , the mean IIEF-5 ( SMD = 3.60 , 95 % CI = 2.64 to 4.56 , P < 0.00001 ) , the IIEF domain ( SMD = 4.88 , 95%CI = 3.01 to 6.74 , P < 0.00001 ) , and the global efficacy question ( odds ratio = 6.44 , 95 % CI = 2.92 to 14.23 , P < 0.00001 ) showed that compared with placebo plus sildenafil , statins plus sildenafil clearly improved erectile function .
CONCLUSIONS This meta- analysis indicates that statins ( + /- sildenafil ) may improve ED compared with placebo ( + /- sildenafil )
INTRODUCTION It is not known if statins will improve symptoms in patients with established erectile dysfunction ( ED ) .
AIM We carried out a systematic review and meta- analysis to assess the effect of statins on ED .