Could Viagra cure chronic pelvic pain?

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Could Viagra cure chronic pelvic pain?

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Could Viagra cure chronic pelvic pain?

From the Daily Mail
Daily Mail, UK wrote:Could Viagra cure chronic pelvic pain?
By ROGER DOBSON
28th February 2007

The impotence drug Viagra could help men suffering from pelvic pain. As many as one in ten men in the UK have pelvic pain syndrome, with symptoms including lower back and groin pain, and bladder problems.

A trial has been looking at the use of the drug — originally developed to help angina patients, but now widely used to treat impotence — to see if it can help to open the constricted blood vessels that may be the source of the discomfort.
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Re: Could Viagra cure chronic pelvic pain?

Post by popburner »

I was wondering if anyone has heard of how this study went. In doing a little research, it looks like the Richard Berger study of Viagra at Washington University was suspended for administrative reasons. I know there is a presentation listed at the upcoming AUA conference looking at Cialis' impact on CPPS. Apparently there was also this study in England - I can't find it anywhere. Has anyone noticed a difference by taking viagra or cialis (or levitra?) over time? I assume it would help with my ED issues from pelvic pain, but I'm curious about pain outcomes.
:ideias:
Age:29 | Onset Age:29 | Symptoms: ORIGINALLY - rectal pain, penis tip pain, perineal spasms, golf ball feeling in perineum, painful ejacualation ONGOING - rectal pain, penis tip hypersensitivity, urethral pain at beginning of urination, ejaculatory pain, burning skin around legs and buttox | Helped By: warm baths, NO catastrophic thinking, Physical Therapy; Stanford/Wise-Anderson Protocol; Mirtazipine (Remeron) for anxiety and sleep, dry needling of TPs (NOT injections), PAIN PSYCHOLOGIST (CBT and Commitment and Acceptance Therapy), diet changes - so far eggs are out doing an elimination diet now :) | Worsened By: ANXIETY, FEAR, STRESS, CATASTROPHIC THINKING,heavy weight lifting , sitting too long
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Re: Could Viagra cure chronic pelvic pain?

Post by J Dimitrakov »

There have been anecdotal reports and a study sponsored by a pharmaceutical company (I was not involved in this study but am aware of it). I think this is a very interesting class of medications (again, no specific recommendation for anyone and no conflict of interest with any of the companies). Based on a recent experiment we performed and long-term experience of one of our collaborators, it appears that a trial might be feasible. It appears that dose and duration of treatment are important. Moreover, study end-points, different from the traditional, should be employed.

You might be interested in revisiting our recent discussion on nitric oxide in another thread remembering, again, that the effects of this class of drugs goes well beyond simple phosphodiesterase inhibition

Best,
JD
This communication provides general information, and is not a substitute for face-to-face medical care. A doctor-patient relationship should not be assumed by the reader.
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Re: Could Viagra cure chronic pelvic pain?

Post by boulder »

I have been taking the FDA-approved maximum daily dose of Cialis, 5mg, for about a month. It has definitely helped w/ED, but I would hesitate to say what other effects it has had on my condition, as I have been changing many things in my treatment and in my larger life over the past month as well. I previously tried a higher dose of Calis- 20mg- and wow, does that ever work for ED! My entire genital area also had increased warmth and sensation while on 20mg Cialis (which would make sense, with the increased blood flow). However, the FDA has not approved any dosage above 5mg for daily use. I'll report back after a few more months of daily 5mg Cialis, but keep in mind I am just one patient (and also not a doctor and not offering medical advice :) )
Age: 36 | Onset Age: 29 (Summer 2005) Main Symptoms (all intermittent): penile/anal/rectal/perineum pain/numbness/tingling/coldness, LUTS, ED | Helped By: duloxetine (Cymbalta), topical benzocaine, occasional benzodiazepines, hot weather, hot baths, understanding friends & family, pushing myself to be more sociable and active, psychotherapy (mostly CBT), diaphragmatic breathing, relaxation, meditation (concentration and mindfulness), adequate sleep | Worsened By: cold weather, stress, inadequate sleep, prolonged sitting or standing in place, walking uphill, heavy exercise, erection/ejaculation (sometimes)
Last But Not Least: I am not a medical/health professional of any kind. This is not medical advice.
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Re: Could Viagra cure chronic pelvic pain?

Post by popburner »

Thanks Boulder - my urologist has prescribed me 10mg for erectile dysfunction (ED), but not for daily use...keep us updated :)
Age:29 | Onset Age:29 | Symptoms: ORIGINALLY - rectal pain, penis tip pain, perineal spasms, golf ball feeling in perineum, painful ejacualation ONGOING - rectal pain, penis tip hypersensitivity, urethral pain at beginning of urination, ejaculatory pain, burning skin around legs and buttox | Helped By: warm baths, NO catastrophic thinking, Physical Therapy; Stanford/Wise-Anderson Protocol; Mirtazipine (Remeron) for anxiety and sleep, dry needling of TPs (NOT injections), PAIN PSYCHOLOGIST (CBT and Commitment and Acceptance Therapy), diet changes - so far eggs are out doing an elimination diet now :) | Worsened By: ANXIETY, FEAR, STRESS, CATASTROPHIC THINKING,heavy weight lifting , sitting too long
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Re: Could Viagra cure chronic pelvic pain?

Post by boulder »

Will do. Very interesting that your doctor prescribed 10mg Cialis for occasional use, as I actually found 20mg to be a bit too much- felt like my penis was going to explode, it was so engorged when erect (OK, I'm exaggerating a bit :) )! I've been thinking that 10mg would probably be perfect, but, unfortunately, that dosage has not been deemed safe for daily use, and I'm trying the daily route for now. I'd be very curious to hear what Cialis dosages were discussed at the AUA meeting, and I also wonder what dosage of Viagra Dr. Berger was planning to evaluate in his (sadly suspended) study?
Age: 36 | Onset Age: 29 (Summer 2005) Main Symptoms (all intermittent): penile/anal/rectal/perineum pain/numbness/tingling/coldness, LUTS, ED | Helped By: duloxetine (Cymbalta), topical benzocaine, occasional benzodiazepines, hot weather, hot baths, understanding friends & family, pushing myself to be more sociable and active, psychotherapy (mostly CBT), diaphragmatic breathing, relaxation, meditation (concentration and mindfulness), adequate sleep | Worsened By: cold weather, stress, inadequate sleep, prolonged sitting or standing in place, walking uphill, heavy exercise, erection/ejaculation (sometimes)
Last But Not Least: I am not a medical/health professional of any kind. This is not medical advice.
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Re: Could Viagra cure chronic pelvic pain?

Post by popburner »

Does anyone on this board see Dr. Berger or part of the study I wonder?
Age:29 | Onset Age:29 | Symptoms: ORIGINALLY - rectal pain, penis tip pain, perineal spasms, golf ball feeling in perineum, painful ejacualation ONGOING - rectal pain, penis tip hypersensitivity, urethral pain at beginning of urination, ejaculatory pain, burning skin around legs and buttox | Helped By: warm baths, NO catastrophic thinking, Physical Therapy; Stanford/Wise-Anderson Protocol; Mirtazipine (Remeron) for anxiety and sleep, dry needling of TPs (NOT injections), PAIN PSYCHOLOGIST (CBT and Commitment and Acceptance Therapy), diet changes - so far eggs are out doing an elimination diet now :) | Worsened By: ANXIETY, FEAR, STRESS, CATASTROPHIC THINKING,heavy weight lifting , sitting too long
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Re: Could Viagra cure chronic pelvic pain?

Post by neis »

Took 10mg Levitra 3 days ago, had a rock hard erection with little effort and a strong ejaculation, and best of all complete reduction in perineal and penile pain and pressure that was building up for days prior to taking the meds. Had some resumption of pressure tonight while sitting on a very deep couch, one of my previous top triggers. Will take another 10mg tomorrow and report any changes.
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Re: Could Viagra cure chronic pelvic pain?

Post by popburner »

This relates to CIALIS (Tadalafil)
The Efficacy Of Tadalafil For Chronic Prostatitis/Chronic Pelvic Pain Syndrome In Young And Middle Aged Patients

Hyun Jun Park*, Nam-Cheol Park, Bu-Kyung Park, Chang-Soo Park, Won-Hee Cheon, Jeong-Moon Heo, Busan, Republic of Korea

INTRODUCTION AND OBJECTIVE: It has been speculated that PDE5 inhibitors may have an effect on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The aim of this study was to investigate the efficacy of tadalafil in young and middle aged patients with CP/CPPS.

METHODS: Seventy-eight men with CP/CPPS were randomized, in a single-blind fashion, to receive either levofloxacin (500mg/d)(group 1; 40 patients) or levofloxacin (500mg/d) and tadalafil (10mg/d)(group 2; 38 patients) for 4 weeks. The International Prostate Symptom Score (IPSS), NIH chronic prostatitis symptom index (NIH-CPSI) and International Index of Erectile Function-5(IIEF-5) were used to grade the symptoms and the quality of life (QoL) at the baseline and 4 weeks into the study.

RESULTS: The mean ages of the two groups were 41.26.7 and 43.37.1 years, respectively. There was no significant difference between group 1 and 2 with regard to age, duration and scores of IPSS, NIH-CPSI and IIEF-5 at the baseline. Tadalafil significantly improved the mean change from baseline in the IPSS at 4 weeks (group 1; -1.0 vs. group 2; -2.6, p<0.05). Significant improvements were also seen in the IPSS obstructive domains (group 1; -0.6 vs. group 2; -2.4, p<0.05). Larger changes from the baseline in the NIH-CPSI at 4 weeks were observed in group 2 (group 1; -1.2 vs. group 2; -2.7, p<0.05). Significant improvements were also seen in the NIH-CPSI urinary domains (group 1; -0.46 vs. group 2; -0.8, p<0.05) and the QoL domains (group 1;-0.4 vs. group 2;-1.4, p<0.05). Group 2 showed a greater increase in the IIEF-5 total score and this difference was significant (group 1; +0.2 vs. group 2; +3.7, p<0.05). Commonly reported (1 case or greater) treatment adverse events in group 2 were frequent erections, dyspepsia, back pain, and headache (for each, 2 cases or less); however, no patient discontinued treatment due to adverse events.

CONCLUSIONS: Tadalafil once daily was well tolerated and showed significant symptomatic improvement in young and middle aged patients with CP/CPPS.

From AUA podium speeches - ie not yet PEER REVIEWED :happy:
Saturday, May 17, 2008 4:20 PM

Podium Session 3: Infections/Inflammation of the Genitourinary Tract: Prostate Genitalia (3:30 PM-5:30 PM)

Age:29 | Onset Age:29 | Symptoms: ORIGINALLY - rectal pain, penis tip pain, perineal spasms, golf ball feeling in perineum, painful ejacualation ONGOING - rectal pain, penis tip hypersensitivity, urethral pain at beginning of urination, ejaculatory pain, burning skin around legs and buttox | Helped By: warm baths, NO catastrophic thinking, Physical Therapy; Stanford/Wise-Anderson Protocol; Mirtazipine (Remeron) for anxiety and sleep, dry needling of TPs (NOT injections), PAIN PSYCHOLOGIST (CBT and Commitment and Acceptance Therapy), diet changes - so far eggs are out doing an elimination diet now :) | Worsened By: ANXIETY, FEAR, STRESS, CATASTROPHIC THINKING,heavy weight lifting , sitting too long
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Re: Could Viagra cure chronic pelvic pain?

Post by boulder »

Wow. That's the same dosage (10mg) I was thinking of and everything! And, actually, I was wrong earlier when I said the FDA hadn't approved Cialis 10mg for daily use. Technically, the FDA allows up to 20mg/day:

November 21, 2003
FDA Approves Third Drug To Treat Erectile Dysfunction
http://www.fda.gov/bbs/topics/ANSWERS/2 ... 01265.html
The recommended starting dose for most patients is 10 mg taken prior to anticipated sexual activity. A higher dose of 20mg is available for patients whose response to the 10mg dose is not adequate. A lower dose (5 mg) is also available and may be necessary for patients taking other medicines or having medical conditions that may decrease the body’s ability to metabolize tadalafil. Cialis should not be used more than once per day.
Age: 36 | Onset Age: 29 (Summer 2005) Main Symptoms (all intermittent): penile/anal/rectal/perineum pain/numbness/tingling/coldness, LUTS, ED | Helped By: duloxetine (Cymbalta), topical benzocaine, occasional benzodiazepines, hot weather, hot baths, understanding friends & family, pushing myself to be more sociable and active, psychotherapy (mostly CBT), diaphragmatic breathing, relaxation, meditation (concentration and mindfulness), adequate sleep | Worsened By: cold weather, stress, inadequate sleep, prolonged sitting or standing in place, walking uphill, heavy exercise, erection/ejaculation (sometimes)
Last But Not Least: I am not a medical/health professional of any kind. This is not medical advice.
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Re: Could Viagra cure chronic pelvic pain?

Post by boulder »

Hmm, and this one relates to both Cialis and Uroxatral (alfuzosin) in combination...
[1251] COMBINATION OF AN ALFUZOSIN XL AND TADALAFIL IS SUPERIOR TO MONOTHERAPY IN TREATING ERECTILE DYSFUCTION (ED) AND LOWER URINARY TRACT SYMPTOMS (LUTS)

Gyung-woo Jung*, Jun Heo, Busan, Republic of Korea

INTRODUCTION AND OBJECTIVE: The potential role of PDE-5 inhibitors in treating voiding dysfunction and alpha blockers in enhancing erectile function is fertile area of research. This study was designed to ascertain the safety and efficacy of the combination of an alpha blocker, alfuzosin XL and a PDE-5 inhibitor, tadalafil on LUTS and ED versus monotherapy.

METHODS: 151 consecutive men with previously untreated LUTS and ED were randomized into 3 treatment groups. A group (n=50) was alfuzosin XL(10mg qd) monotherapy, B group (n=52) was tadalafil (20mg 3 times a week) monotheraphy and C group (n=49) was combination of alfuzosin XL and tadalafil for a 3 month trial. We included men with ED and BPH who scored 16 on the international index of erectile function-5 (IIEF-5) and an international prostate symptom score (IPSS) 8. The IIEF-5, IPSS, quality of life (QoL), maximum urinary flow rate (Qmax), and global assessment question (GAQ/ED, LUTS) were assessed. Data was analyzed using the paired t-test for statistical validation.

RESULTS: At 3 months, the improvements of IIEF-5 scores in each group were +2.9, +8.1, and +10.4 (p<0.0001 vs A, P<0.005 vs B) compared to the baseline, respectively. IPSS in each group were reduced -3.5, -2.1 and -4.2 (p<0.005 vs A, p<0.001 vs B) compared to the baseline, respectively. QoL in each group were reduced -1.1, -0.8, and -1.32 (p<0.005 vs A, p<0.001 vs B) compared to the baseline, respectively. Qmax in each group were increased +3.4, +2.1, and + 4.12 (p<0.005 vs A, p<0.001 vs B) compared to the baseline, respectively. ED GAQ in each group was 53%, 89% and 93%, respectively. LUTS GAQ in each group was 76%, 59% and 84%, respectively.

CONCLUSIONS: Treatment with a combination of an alpha blocker and a PDE-5 inhibitor was the most effective therapy to enhance both voiding and erectile function in men at risk. Larger scale, placebo controlled studies are needed to further elucidate

Tuesday, May 20, 2008 8:00 AM

Moderated Poster Session 45: Sexual Function/Dysfunction/Andrology: Medical Nonsurgical Therapy (8:00 AM-10:00 AM)
There appears to be major skepticism about the value of alpha blocker therapy in general, and alfuzosin in particular ( viewtopic.php?f=4&t=5768 ), but this study claims a combination of alfuzosin and tadalafil is superior in relieving LUTS and ED than either drug alone. The mystery continues...
Age: 36 | Onset Age: 29 (Summer 2005) Main Symptoms (all intermittent): penile/anal/rectal/perineum pain/numbness/tingling/coldness, LUTS, ED | Helped By: duloxetine (Cymbalta), topical benzocaine, occasional benzodiazepines, hot weather, hot baths, understanding friends & family, pushing myself to be more sociable and active, psychotherapy (mostly CBT), diaphragmatic breathing, relaxation, meditation (concentration and mindfulness), adequate sleep | Worsened By: cold weather, stress, inadequate sleep, prolonged sitting or standing in place, walking uphill, heavy exercise, erection/ejaculation (sometimes)
Last But Not Least: I am not a medical/health professional of any kind. This is not medical advice.
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Re: Could Viagra cure chronic pelvic pain?

Post by boulder »

Taking another look at the above study (Cialis/alfuzosin combo therapy), my layman's eye noticed that the dosing of Cialis seems odd: 20mg 3 times a week? Even with Cialis' relatively long half-life, you'd think that would give you widely fluctuating levels of the drug in the body...
Age: 36 | Onset Age: 29 (Summer 2005) Main Symptoms (all intermittent): penile/anal/rectal/perineum pain/numbness/tingling/coldness, LUTS, ED | Helped By: duloxetine (Cymbalta), topical benzocaine, occasional benzodiazepines, hot weather, hot baths, understanding friends & family, pushing myself to be more sociable and active, psychotherapy (mostly CBT), diaphragmatic breathing, relaxation, meditation (concentration and mindfulness), adequate sleep | Worsened By: cold weather, stress, inadequate sleep, prolonged sitting or standing in place, walking uphill, heavy exercise, erection/ejaculation (sometimes)
Last But Not Least: I am not a medical/health professional of any kind. This is not medical advice.
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Re: Could Viagra cure chronic pelvic pain?

Post by Rufus »

For what it's worth a poster by the name of stevo on the old prostatitis--dot--org board (which is shut down thank the good lord), went to see Dr Bahn and is currently using levitra and claims to be doing great.
Age:37 | Onset Age: 35 | Symptoms: pain in testicles that comes and goes that also switches sides-trying to find a pattern as to "why" this happens/Rectal Burn at the 6 O'clock position at my anus which tends to flare around the periphery of my anus typically after defication but no perineum pain-no "golf ball" pain. Pain in testicles worsens as I sit but not always...Pain is not always present but depresses me. Pain used to be at a very high level but has subsided in time to a low level but has not gone away. Pain used to flare after sex but not as much as before although it still like playing russian roulette./
/Lack of SleepHelped By: I haven't found anything that has helped to my knowledge. Tried many many sessions of PT, accupuncture and chiropractic care but still have not found steady relief that takes me back to a pre CPPS state.
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Re: Could Viagra cure chronic pelvic pain?

Post by webslave »

Stevo from that forum is called "neis" here, and he has promised to update us 6 months after his treatment with Dr Bahn, once the steroids from the injections have worn off.
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Re: Could Viagra cure chronic pelvic pain?

Post by boulder »

Just a dosage update for anyone who's curious: I am now taking Cialis 10mg/day, as prescribed by my doctor. As I said before, I'll wait a few months to report on my experience.
Age: 36 | Onset Age: 29 (Summer 2005) Main Symptoms (all intermittent): penile/anal/rectal/perineum pain/numbness/tingling/coldness, LUTS, ED | Helped By: duloxetine (Cymbalta), topical benzocaine, occasional benzodiazepines, hot weather, hot baths, understanding friends & family, pushing myself to be more sociable and active, psychotherapy (mostly CBT), diaphragmatic breathing, relaxation, meditation (concentration and mindfulness), adequate sleep | Worsened By: cold weather, stress, inadequate sleep, prolonged sitting or standing in place, walking uphill, heavy exercise, erection/ejaculation (sometimes)
Last But Not Least: I am not a medical/health professional of any kind. This is not medical advice.
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