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Human Reproduction, Vol. 15, No. 11, 2375-2378, November 2000
© 2000 European Society of Human Reproduction and Embryology

Thalassaemic men affected by erectile dysfunction treated with transurethral alprostadil: Case report

T. Lombardo1, B. Giammusso4, V. Frontini1, S. D'Arpa1, C. Pafumi2 and S. Caruso2,3,5

1 Division of Thalassaemia and 2 Department of Microbiological Science and Gynaecological Science, Ospedale S.Bambino, Catania, 3 Research Group for Sexology, Section of Dept for Gynaecological Science, University of Catania, Ospedale S.Bambino, Catania and 4 Division of Urology, Ospedale Vittorio Emanuele, Catania, Italy

The aim of this controlled clinical study, performed in a specialized institutional unit for thalassaemic men, was to consider the possibility of restoring erection in ß-thalassaemic patients with erectile dysfunction by administering E1 prostaglandins (alprostadil) transurethrally. Four patients affected by ß-thalassaemia, aged between 32 and 52 years, and having an erectile dysfunction were included in the study. Each patient was given 500 µg alprostadil in the distal urethra. Response was evaluated by the erection assessment scale. The main outcome measures were: (i) the clinical study; (ii) FSH, LH, total and free testosterone plasma concentrations; and (iii) basal and dynamic Doppler sonography of cavernous arteries. The treatment produced a response of 3–4 on the erection assessment scale. Average minimum response time was 20 min, while average maximum response time was about 60 min. There was no evidence of significant side effects. Our hypothesis is that the delayed reaction was due to organ damage induced by iron load, causing a reduction or absence of elasticity in the interstitial tissue of the corpora cavernosa. Thus, we believe that treatment with alprostadil can be considered an effective, non-invasive therapy for thalassaemic patients with erectile dysfunction.

Key words: erectile dysfunction/fertility/haemochromatosis/iron load/thalassaemia

5 To whom correspondence should be addressed at: Department of Gynaecological Science, Università di Catania-Via Torre del Vescovo, Catania 95124, Italy. E-mail scaruso{at}mbox.unict.it


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