The last epidemiological data were gathered in Russian Federation based on the questionnaire survey of 1225 respondents in year 2012. MIEF-5 analysis shows that only 10.1% are not having the erectile dysfunction (ED) with mild ED in 71.3%, moderate ED – 6.6% and severe ED in 12% of respondents. Thus, 1101 / 1225 patients (89.9%) had the symptoms of ED.

Nowadays the optimal treatment modality would be least invasive method promoting physiological way to sexual contacts given the age of the patient. FDE-5 inhibitors were revolutionary in urological practice. Sildenafil acts through the increase of the cGMP concentration in smooth muscle cells of corpora cavernosa, which leads to the growth of nitric oxide concentration in the cells and muscle relaxation.

Different studies show that sildenafil ameliorate the endothelium-dependent flow-related dilatation of the brachial artery in patients with heart insufficiency and diabetes mellitus type 2. In patients with heart insufficiency due to ischemic or non-ischemic cardiopathy without concurrent lung diseases sildenafil in the dosage 50 mg was effective with regard to increase of the cardiac index and decrease of pulmonic vascular resistance both in rest and in active state. In patients with diseases of coronary vessels it was shown that microcirculation in the nail bed was improved while on sildenafil. This contemporary data let the multidisciplinary specialist team be sure, that the safety profile of the sildenafil and its efficacy are acceptable for use in patients with comorbidities.