الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Erectile dysfunction is a common disorder of male sexual function. It is defined as the inability to achieve and/or maintain an erection sufficient to permit satisfactory sexual intercourse.
The penile vascular endothelium is involved in numerous physiologic functions and its dysfunction leads to impaired vasodilatation. This is attributed to decreased bioavailability of nitric oxide (NO) which is a molecule with a key role in vascular tone regulation and thus impaired NO bioactivity is a major pathogenic mechanism of ED.
Endothelin‐1 (ET-1) has a potent and prolonged vasoconstrictor activity. Endothelin receptors have been found in human corporal smooth muscle membranes. ED was suggested to be the result of impaired endothelium‐dependent smooth muscle relaxation due to increased release of ET-1.
Avanafil is a new highly selective phosphodiesterase 5 inhibitor (PDE5i) approved for the treatment of ED by both the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) in April 2012 and in June 2013, respectively.
The most important characteristic of avanafil, in comparison to the first-generation PDE5 inhibitors, is its high selectivity for PDE5, particularly in relation to PDE6, PDE1, and PDE11.
The aim of this study was to investigate the impact of daily avanafil on levels of some plasma markers of endothelial function in men with erectile dysfunction.
The present study was carried out on forty five patients with erectile dysfunction and other common systemic diseases that affect endothelial function such as diabetes mellitus, hypertension and dyslipidemia. They were randomly divided into two groups:
group A: included thirty five adult males treated with daily 50mg avanafil for four weeks.
group B (control group): included ten adult males treated with placebo tablets instead.
All patients were subjected to five item questionnaire in order to assess their erectile function at baseline and after treatment.
Markers of endothelial function measured in plasma at baseline and end of treatment using standard methods and commercially available ELISA kits.