URO1 The success of a goal-oriented, comprehensive disease management approach for patients with erectile dysfunction in the era of sildenafil. (Urology).

URO1 THE SUCCESS OF A GOAL-ORIENTED, COMPREHENSIVE DISEASE MANAGEMENT APPROACH FOR PATIENTS WITH ERECTILE DYSFUNCTION IN THE ERA OF SILDENAFIL. Ahmed Fawzy, MD, Joseph Macaluso, MD, Caren Crotty, MD, Glenn Landry, MD, Frank Cerniglia, MD, Frank Deus, MD, David Debessonet, MD, Nadine Gauthier, RN, and Jules Deutsch, MD. Urologic Institute of New Orleans (UINO), New Orleans, La.

The objectives of this study were to (1) evaluate the success of a goal-oriented comprehensive erectile dysfunction (ED) disease management protocol in a large urology group practice, (2) assess the clinical success of the oral medication sildenafil in a community-based, large urology group practice, and (3) measure patient compliance and drop-out rate. All ED patients followed a goal-oriented comprehensive disease management protocol. Evaluation included complete H/P examination and administration of the International Index of Erectile Function (IIEF) questionnaire. Male hormonal panel, SMA7, and penile Doppler examination were ordered when clinically indicated. Patients received educational material on ED and all its treatment options. Sexual counseling was initiated when clinically appropriate. Reversible causes of ED were managed for all patients, and they were started on sildenafil 50 mg. At follow-up, efficacy, compliance, and side effects were assessed. IIEF and Erectile Dysfunction Inventory of Treat ment Satisfaction (EDITS) questionnaires were administered at all visits. Patients were followed up at 1-, 3-, 6-, and 12-month intervals. Those reporting partial or no response were increased to sildenafil 100 mg. Patients who failed maximum dosages were switched to other treatment options based on patient and partner preference. Data were available for 111 patients. 63% reported successful response (mean follow-up 113.4 months) as defined by treating physician's clinical assessment and patient satisfaction, with TIEF Q3: (3.24 mean), Q4: (3.07 mean). 8% of patients were switched to other modalities of treatment with successful outcome. 19% dropped out due to failure or low response to sildenafil or other modalities of treatment. Sildenafil is a highly effective first-line treatment for ED in large community practice. The use of a goal-oriented, comprehensive disease management protocol is an effective tool to ensure successful outcome for ED patients and to minimize drop-out rate.