{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:03:51Z","timestamp":1785510231226,"version":"3.56.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,7,2]],"date-time":"2019-07-02T00:00:00Z","timestamp":1562025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Erectile dysfunction is defined as inability to achieve or maintain penile erection sufficient for sexual satisfaction. It is a serious problem that increases by age. The physiology of penile erection depends mainly on nitric oxide release.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Compare the efficacy and safety of oral sildenafil 50\u00a0mg alone or in combination with <jats:sc>l<\/jats:sc>\u2010arginine 3\u00a0g\/day orally on the treatment of erectile dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Randomized controlled study with two parallel groups of erectile dysfunction patients; One group received sildenafil 50\u00a0mg every other day, while the other group received a combination of sildenafil (every other day)\/<jats:sc>l<\/jats:sc>\u2010arginine on a daily base. Efficacy was assessed using International Index of Erectile Function\u20105 score at the baseline and after 8\u00a0weeks. Side effects were evaluated across the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age was 56.3\u00a0\u00b1\u00a05 and 56.2\u00a0\u00b1\u00a04.4\u00a0years in sildenafil and combination groups, respectively. International Index of Erectile Function\u20105 score was comparable between the two groups at the baseline (<jats:italic>p<\/jats:italic> value 0.44). International Index of Erectile Function\u20105 score was improved from 15.3\u00a0\u00b1\u00a02.5 at baseline to 19.2\u00a0\u00b1\u00a02.3 after treatment, and this was statistically significant with <jats:italic>p<\/jats:italic> value &lt;0.0001. The score was slightly better in combination group in which the average International Index of Erectile Function\u20105 score was (19.8\u00a0\u00b1\u00a02.2) vs. (18.5\u00a0\u00b1\u00a02.3) in sildenafil group with <jats:italic>p<\/jats:italic> value 0.05. Side effects were more or less the same between the two groups except for gastritis which was more common on combination group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adding <jats:sc>l<\/jats:sc>\u2010arginine to sildenafil demonstrated more efficacy than sildenafil alone for treatment of erectile dysfunction patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.12671","type":"journal-article","created":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T06:28:00Z","timestamp":1562135280000},"page":"143-147","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Efficacy and tolerability of sildenafil\/<scp>l<\/scp>\u2010arginine combination relative to sildenafil alone in patients with organic erectile dysfunction"],"prefix":"10.1111","volume":"8","author":[{"given":"L. M.","family":"El\u2010Wakeel","sequence":"first","affiliation":[{"name":"Faculty of Pharmacy Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. A.","family":"Fouad","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. D.","family":"Saleem","sequence":"additional","affiliation":[{"name":"Department of Urology Sohag University Hospital Sohag University Sohag Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2056-093X","authenticated-orcid":false,"given":"M.","family":"Saber\u2010Khalaf","sequence":"additional","affiliation":[{"name":"Department of Urology Sohag University Hospital Sohag University Sohag Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,2]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1","article-title":"Efficacy and safety of oral combination of yohimbine and L\u2010arginine (SX) for the treatment of erectile dysfunction: a multicenter, randomized, double blind, placebo\u2010controlled clinical trial","volume":"5","author":"Akhondzadeh S","year":"2010","journal-title":"Iran J Psychiatry"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/02656736.2017.1367846"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ptr.3462"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2605.2005.00587.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/andr.12293"},{"key":"e_1_2_6_7_1","first-page":"47","article-title":"Sildenafil: an orally active type 5 cyclic GMP\u2010specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction","volume":"8","author":"Boolell M","year":"1996","journal-title":"Int J Impot Res"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410X.1996.10220.x"},{"key":"e_1_2_6_9_1","first-page":"748","article-title":"The effects of long\u2010term oral L\u2010arginine on the erectile response of rabbits with alloxan\u2010induced diabetes","volume":"84","author":"Cartledge J","year":"1999","journal-title":"BJU Int"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b1732"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410x.1999.00906.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007990903138416"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199805143382001"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410X.1997.00206.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.090422"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000030454"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0302-2838(02)00175-6"},{"key":"e_1_2_6_18_1","first-page":"285","article-title":"[Erectile dysfunction after non\u2010nerve sparing radical pelvic surgery. 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