Intracavernous Injection of Onabotulinumtoxin-A 100 U For Treatment of Phosphodiesterase Type 5 Inhibitors-Inconvenient Patients With Erectile Dysfunction: A Randamized Controlled Trial.
Overview
- Phase
- Phase 2
- Intervention
- Trimix
- Conditions
- Erectile Dysfunction
- Sponsor
- Benha University
- Enrollment
- 124
- Locations
- 1
- Primary Endpoint
- International Index of Erectile Function (IIEF)
- Last Updated
- 3 years ago
Overview
Brief Summary
There is a new emerging concept that Botulinum Toxin Type A may have a potential role in treatment of erectile dysfunction with a longer duration of action. So, the investigators opted to perform this study to compare ICI of Botulinum Toxin Type A versus Trimix for treatment of ED.
Detailed Description
Background: Direct Intracavernosal injections of vasoactive agents to treat erectile dysfunction were first described in 1982 using papaverine. Later on many agents have been introduced for ICI. one of most newly introduced ICI agents for treatment of ED is Botulinum Toxin Type A. Purpose: The aim of this study will to compare the safety, efficacy, tolerability and adverse events s of ICI of BTX-A 100 unit in comparison with ICI Trimix in the treatment of Erectile Dysfunction for PDE5Is non-responders. Design, Settings, and Participants: This study will be conducted on 124 patients at minimum, complain of erectile dysfunction not responding to different PDE5Is therapy presenting to Urology department and outpatient clinic at Banha University Hospital. patients will be randomized into 2 equal groups: The treatment group A: will receive a single ICI of BTX-A 100 units . The treatment group B: will receive on-demand ICI of Trimix . Assessment for all groups will be done by Sexual Health Inventory for men (SHIM), Sexual Encounter Profile questions 2 and 3 (SEP 2 \& SEP 3), and the global assessment question (GAQ) based on pre-treatment, 2 weeks, 3 months and every 3 months after treatment.
Investigators
Waleed El-Shaer, MD
Principal Investigator
Benha University
Eligibility Criteria
Inclusion Criteria
- •Age more than 40 years with ED not responding to PDE5Is, non compliant or contraindicated to PDE5Is. A "No" response on Sexual encounter profile questions (SEP 2 \& 3)
Exclusion Criteria
- •psychiatric condition Any presence of penile anatomical abnormalities (e.g. penile fibrosis) that would significantly impair erectile function.
Arms & Interventions
Trimix group
ICI of Trimix
Intervention: Trimix
BTX100 group
ICI of Botox 100 U
Intervention: OnabotulinumtoxinA
Outcomes
Primary Outcomes
International Index of Erectile Function (IIEF)
Time Frame: baseline, 2 weeks post treatment then every 3 months post treatment
Changes in the Erectile Function (EF) domain score of the International Index of change of Erectile Function measured by (IIEF) between treatment periods and baseline in the 2 study arms. It ranges between 0 to 25
Dopller study
Time Frame: baseline, 2 weeks post treatment then every 3 months post treatment
measurement of Cavernosal artery peak systolic and end diastolic velocities before and after ICI
Erection hardness score [ Time Frame: 2 weeks ] [ Designated as safety issue: No ] Clinical assessment of the Erection hardness score by the investigators in both Erection hardness score
Time Frame: baseline, 2 weeks post treatment then every 3 months post treatment
Erection hardness score which is ranged 0 to 4
Secondary Outcomes
- Sexual Encounter Profile 2&3(baseline, 2 weeks post treatment then every 3 months post treatment)
- Global Assessment Questionnaire(baseline, 2 weeks post treatment then every 3 months post treatment)