Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

Laura Levy, DHSc, PA-C


OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is sildenafil citrate effective in treating erectile dysfunction secondary to upper motor neuron spinal cord injury?”

STUDY DESIGN: A systematic review of three peer-reviewed primary studies published in English between the years of 2008 and 2010.

DATA SOURCES: Two double-blind, randomized, placebo-controlled trials and one open, before-after study, evaluating if sildenafil citrate is effective in treating erectile dysfunction secondary to upper motor neuron (UMN) spinal cord injury (SCI). Data sources collected using Alt HealthWatch, CINAHL Plus and PubMed.

OUTCOME(S) MEASURED: The clinical outcome of erectile function achieved with sildenafil was measured in these selected studies via the International Index of Erectile Function (IIEF) and the Five-Point Qualitative Scale for Subjective Assessment of Erectile Response.

RESULTS: In each randomized control trial (RCT), statistical significance was determined using a p-value < 0.05. The RCT conducted by Ergin et al. demonstrated a significant improvement in erectile function in patients with erectile dysfunction (ED) secondary to UMN SCI when treated with sildenafil, in comparison to placebo (p= 0.001). In a RCT by Khorrami et al. men with UMN SCI saw a statistically significant increase in erectile function in comparison to placebo when treated with sildenafil citrate (p < 0.05). The open, before-after study by Soler et al. showed statistical improvement in erectile dysfunction, among this population, when treated with sildenafil (change from baseline= 12.8).

CONCLUSIONS: This review concludes that sildenafil citrate is effective in treating ED secondary to UMN SCI. Further studies with standardized patient education and a universal scale for dose titration should be conducted for better generalizability of these results.

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