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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
124
a single ICI of BTX-A 100 units one day after the penile Doppler/trimix test.
on demand ICI of Trimix
Banha University Hospitals
Banhā, Kalubiaya, Egypt
RECRUITINGInternational Index of Erectile Function (IIEF)
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
Time frame: baseline, 2 weeks post treatment then every 3 months post treatment
Dopller study
measurement of Cavernosal artery peak systolic and end diastolic velocities before and after ICI
Time frame: baseline, 2 weeks post treatment then every 3 months post treatment
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
Erection hardness score which is ranged 0 to 4
Time frame: baseline, 2 weeks post treatment then every 3 months post treatment
Sexual Encounter Profile 2&3
Assessment of SEP before and after ICI. patient answer ' Yes' or 'No'.
Time frame: baseline, 2 weeks post treatment then every 3 months post treatment
Global Assessment Questionnaire
Global Assessment Questionnaire with Yes/No response
Time frame: baseline, 2 weeks post treatment then every 3 months post treatment
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