Phosphodiesterase Inhibitor (Sildenafil) in the Management ofHoney Moon Impotence

Background and Aims: Honeymoon impotence or first night erectile dysfunction (ED) is one kind ofpsychogenic ED which is not uncommon. Prevalence of this kind of ED is higher in conservative communitiesespecially the Muslim population. We assessed the role of Sildenafil, a phosphodiesterase inhibitor (PDE-5) inthe management of honeymoon (psychogenic) impotence.Methods: All patients having erectile dysfunction (ED) after marriage with normal nocturnal erections wereenrolled in this prospective study from 01-09-2006 to 31-08-2008. Reassurance Sildenafil 100 mg at bedtime was given to every patient and dose reduced to 50 mg after 3 successful intercourses. Patients who didnot respond to PDE-5 inhibitor (3 doses), were given intracavernosal injection alprostadil and shifted to PDE-5inhibitor after successful intercourse.Results: Total number of patients was 45 with age range of 20-39 years. Mean duration elapsed beforeseeking medical advice was 10±14 days. Eighty percent patients had successful intercourse on first doseof Sildenafil with 95% confidence interval (CI) and 13% patients responded to 2nd dose of Sildenafil. Twelvepercent patients suffered mild, well tolerable complications.Conclusions: Honeymoon impotence is not an uncommon condition in some special population. Sildenafilproved to be effective, with high success rate and few tolerable complications.