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The objectives of this study were to evaluate the efficacy and tolerability of high dose sildenafil as a salvage therapy for patients refractory to the maximum recommended dose of sildenafil. Erectile function was quantified using the erectile function domain of the international index of erectile function (iief) before treatment, with sildenafil 100 mg and with maximal dose of sildenafil and a global efficacy question after 4 weeks of treatment. Mean iief question 3 and 4 scores were 1.

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