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Combined Sildenafil and Dapoxetine versus Sildenafil Alone in the Treatment of Dapoxetine Non-Responding Mono-symptomatic Premature Ejaculation: A Randomized Comparative Study

Mohammed Salem, Mohammed Elgammal, Ahmed Solyman, Abdullah Dawoud

Al-Azhar International Medical Journal /Al-Azhar International Medical Journal, 2025

Abstract

Background: Magnetic resonance cholangiopancreatography (MRCP) has evolved over the past decades to evaluate the biliary tract and diagnose pancreato-biliary disease. Diffusion-weighted imaging (DWI) is an auxiliary method utilized to assess the molecular functionality and micro-architecture of the body of a human. Objectives: To evaluate the supplementary benefit of DWI to magnetic resonance cholangiopancreatography (MRCP) for diagnosing bile duct obstruction, whether malignant or benign. Patients and methods: This research was performed on 100 cases of obstructive jaundice who underwent MRCP between January 2022 and May 2023. Cases have been recruited from the Radiology Department, National Liver Institute, Menoufia University. Results: According to the ADC value of malignant bile duct obstruction, the mean of ADC value was 1.34 ± 0.20, and the median was 1.35 (1.25 – 1.44). According to diffusion restrictions a statistically significant variance was observed among examined groups regarding diffusion restriction, which was positive and negative. Regarding the final diagnosis method, a statistically significant variance has been observed among examined groups regarding CNB, MRCP + Clinical picture and medical history, and ERCP. Conclusion: The use of diffusion-weighted imaging in conventional MRCP significantly enhanced the diagnostic precision in distinguishing between malignant and benign biliary strictures.

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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.

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