TREATMENT OF VASCULOGENIC SEXUAL DYSFUNCTION WITH PENTOXIFYLLINE

Objective: To evaluate the use of pentoxifylline to treat impotence in men with mild to moderate penile vascular insufficiency. Design: Double-blind randomized clinical trial. Setting: Sexual Dysfunction Clinic at VA Medical Center, Sepulveda, CA. Participants: Convenience sample of couples. Intervention: Twelve weeks of treatment with placebo or 400 mg tid of pentoxifylline. Measurements: (1) Report of patient verified by partner as to number of coital episodes per month; (2) penile-brachial pressure index determinations. Results: Pentoxifylline therapy regularly increased the PBPI in impotent men in comparison with the placebo, frequently into the normal range. Pentoxifylline therapy was particularly useful in restoring the PBPI in men with the pelvic steal syndrome; six of seven such subjects improved into the normal range. During the pentoxifylline treatment period, in contrast with the control period, nine men were able to reestablish coital function and three had no improvement. Six couples did not attempt intercourse despite a professed interest in sexual activity; however five out of the six men experienced erections during episodes of fantasy or attempts at masturbation during treatment. There were no complications of therapy. Conclusions: These promising preliminary results suggest a well tolerated alternative therapy for erectile dysfunction in patients with mild to moderate penile vascular disease.