Is Viagra always a success?



Scientists have found that genetic variation at the hexokinase-1 gene is linked to variation in the blood concentration of glycated hemoglobin, an index of long-term blood glucose concentration widely used in the follow-up of diabetes patients. The study, conducted by researchers from the Brigham and Women’s Hospital in Boston, USA, is published December 19 in

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Erectile dysfunction (ED) can be caused by a number of different conditions. Some will not respond to any medication. This means either that there will be no effective treatment at all or that additional therapy is required for the underlying cause of the ED (which may extend to surgery, chemo- and radiotherapy, etc.). Thus, when you evaluate Viagra across all possible causes, the success rate varies between 48% and 81% which, under the circumstances, is impressive.

Etiology

Success rate

Source(s) and studies

General population 70% N Engl J Med 1998;338:1397-1404 Urology 1999;S3:800-805
Hypertension 70% N Engl J Med 1998;338:1397-1404
Spinal cord injury 57-93% Eur Urol 2000;38:134-193 Neurology 1998;51:1629-1633
Spina bifida (myelomeningocele) 80% J Urol 2000;164(3, part 2):958-961
Multiple sclerosis 90% Urol Clin N Am 2001;32:289-308
Psychogenic: depression and antidepressent treatment related 73-89% Int J Impot Res 1998;10:53, 254a
Bilateral nerve-sparing radical prostatectomy 32-80% Int J Impot Res 2001;13(Suppl 5):568
Radiation for prostate cancer 70-80% Urology 2001;57:769-773 J Clin Oncol 1999;17:3444-3449
Diabetes mellitus 50-65% JAMA 1999;281:421-426

Spinal Injuries
If there is little or no damage to the spinal cord — the part of the central nervous system that carries messages from the brain to the important parts of the body — Viagra is likely to be effective at dosages between 25mg and 50mg. This will include situations in which congenital conditions such as spina bifida are the underlying cause of the nervous system inadequacy. If the scale of the damage is greater and there are lesions in the spinal cord which significantly disrupt message traffic up and down the cord, higher dosages may be tried, but there is no guarantee of success.

Diabetes Mellitus
Whether Viagra will be successful will depend on how advanced the diabetes is. In general terms, the sole factor determining outcome is whether the central nervous system has been damaged. This can occurs in the later stages of diabetes when treatment has been delayed or proves inadequate. None of the following factors is relevant:
• the age of the patient;
• the length of time the patient has been affected by ED;
• the length of time the patient has had diabetes;
• the patient’s levels of glycosylated haemoglobin (haemoglobin A1C, the trace chemical used to monitor the blood sugar level); and
• whether there is damage to the peripheral nervous system.

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