Recovery of erectile function after nerve‐sparing radical prostatectomy: improvement with nightly low‐dose sildenafil
- 18 February 2008
- journal article
- research article
- Published by Wiley in BJU International
- Vol. 101 (10), 1279-1283
- https://doi.org/10.1111/j.1464-410x.2008.07515.x
Abstract
To evaluate the effect of low-dose sildenafil for rehabilitating erectile function after nerve-sparing radical prostatectomy (NSRP), as the delay to recovery of erectile function after NSRP remains under debate. Forty-three sexually active patients had a NSRP; at 7-14 days after surgery they had a Rigiscan (Dacomed Corporation, Minneapolis, MN, USA) measurement of nocturnal penile tumescence and rigidity (NPTR). To support the recovery of spontaneous erectile function, 23 patients with preserved nocturnal erections received sildenafil 25 mg/day at night. A control group of 18 patients were then followed but had no phosphodiesterase-5 inhibitors. The International Index of Erectile Function (IIEF)-5 questionnaire was completed 6, 12, 24, 36 and 52 weeks after NSRP. Of the 43 patients, 41 (95%) had one to five erections during the first night after catheter removal. In the group using daily sildenafil the mean IIEF-5 score decreased from 20.8 before NSRP to 3.6, 3.8, 5.9, 9.6 and 14.1 at 6, 12, 24, 36 and 52 weeks after NSRP, respectively. In the control group the respective scores were 21.2, decreasing to 2.4, 3.8, 5.3, 6.4 and 9.3. There was a significant difference in IIEF-5 score and time to recovery of erectile function between the groups (P < 0.001), with potency rates of 86% vs 66%. The measurement of NPTR after NSRP showed erectile function even the 'first' night after catheter removal. In cases of early penile erection, daily low-dose sildenafil leads to a significant improvement in the recovery of erectile function.Keywords
This publication has 21 references indexed in Scilit:
- Nocturnal Tumescence: A Parameter for Postoperative Erectile Integrity After Nerve Sparing Radical ProstatectomyJournal of Urology, 2006
- Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile functionInternational Journal Of Impotence Research, 2005
- The Use of an Erectogenic Pharmacotherapy Regimen Following Radical Prostatectomy Improves Recovery of Spontaneous Erectile FunctionThe Journal of Sexual Medicine, 2005
- Patient satisfaction with treatment decisions for clinically localized prostate carcinoma. Results from the Prostate Cancer Outcomes StudyCancer, 2003
- Penile Weight and Cell Subtype Specific Changes in a Post-Radical Prostatectomy Model of Erectile DysfunctionJournal of Urology, 2003
- Acute and Prolonged Effects of Sildenafil on Brachial Artery Flow-Mediated Dilatation in Type 2 DiabetesDiabetes Care, 2002
- REPLY BY AUTHORSJournal of Urology, 2002
- Intracavernous injection in the treatment of erectile dysfunction after radical prostatectomy: an observational studySao Paulo Medical Journal, 2001
- FACTORS PREDICTING RECOVERY OF ERECTIONS AFTER RADICAL PROSTATECTOMYJournal of Urology, 2000
- RECOVERY OF SPONTANEOUS ERECTILE FUNCTION AFTER NERVE-SPARING RADICAL RETROPUBIC PROSTATECTOMY WITH AND WITHOUT EARLY INTRACAVERNOUS INJECTIONS OF ALPROSTADILJournal of Urology, 1997