Trial of pentoxifylline for diabetic impotence.

ABSTRACT

OBJECTIVE: To test the effectiveness of pentoxifylline as a therapy for diabetic impotence. RESEARCH DESIGN AND METHODS: A 3-month placebo-controlled double-blind treatment study was conducted at a single center. Therapeutic response was assessed subjectively by serial self-appraisals of erectile function and objectively by nocturnal penile tumescence (NPT) monitoring. RESULTS: This cohort of impotent diabetic men displayed substantial neurological and penile vascular dysfunction. Age, body mass index, duration of diabetes, duration of impotence, glycemic control, mode of therapy for non-insulin-dependent diabetes, mean testosterone, mean prolactin, and penile brachial indexes were similar in the treatment (n = 34) and placebo groups (n = 26). NPT monitoring revealed infrequent erectile events, diminished average rigidity, and decreased tumescence. Pentoxifylline did not alter overall glycemic control and did not improve neurological, vascular, or erectile function. In fact, a slight decrease in average percent rigidity from 22 +/- 3 to 17 +/- 2% (mean +/- SE, P < 0.05) was observed in the pentoxifylline-treated group. Although eight (24%) pentoxifylline-treated and five (19%) placebo-treated men reported benefit, no objective improvement was observed in nocturnal tumescence. CONCLUSIONS: Pentoxifylline is not an effective treatment for diabetic erectile dysfunction.