Erectile dysfunction following nerve-sparing radical retropubic prostatectomy and its treatment with sildenafil.

Abstract

BACKGROUND:

We retrospectively evaluated the erectile function after nerve-sparing radical retropubic prostatectomy (RRP) and the efficacy of sildenafil for erectile dysfunction (ED) following RRP according to the preoperative erectile function.

METHODS:

We evaluated 48 Japanese patients who underwent nerve-sparing RRP at the Sapporo Medical University School of Medicine, Sapporo, Japan, between January 1996 and December 2001. Erectile function following nerve-sparing RRP was assessed by a simple mailed questionnaire that was constructed for the study.

RESULTS:

Of the 48 patients, 36 had normal erectile function preoperatively, but for 12, function was not sufficient to penetrate. The overall estimated recovery rates of any degree of erection were 50.6% at 36 months and 94.3% at 60 months. However, that of erection sufficient to penetrate was only 17.7% at 36 months and was only seen in bilateral nerve-sparing patients. Sildenafil was effective in 9 of 13 ED patients (69.2%) in both nerve-sparing groups. When patients were divided according to preoperative erectile function, no difference was found in the efficacy rate between patients with normal function and those with ED.

CONCLUSIONS:

Even bilateral nerve-sparing RRP can not always guarantee a sufficient erection. However, sildenafil is effective for ED following nerve-sparing RRP regardless of the nerve-sparing procedure or preoperative erectile function. Thus, preoperative function alone, although depending on its severity, may not necessarily be a reason for exclusion from receiving nerve-sparing RRP if patients want to have the operation.

• Authors: Takashi Shimizu, Shin-Ichi Hisasue, Yoshikazu Sato, Ryuichi Kato, Ko Kobayashi, Taiji Tsukamoto
• Journal: International journal of urology : official journal of the Japanese Urological Association (Int J Urol) Vol. 12 Issue 6 Pg. 552-7 (Jun 2005) ISSN: 0919-8172 [Print] Australia
• PMID: 15985077 (Publication Type: Journal Article)

Chemical References

• Phosphodiesterase Inhibitors
• Piperazines
• Purines
• Sulfones
• Sildenafil Citrate

Topics

• Aged
• Erectile Dysfunction (drug therapy, etiology)
• Genitalia, Male (innervation)
• Humans
• Male
• Middle Aged
• Nervous System (physiopathology)
• Phosphodiesterase Inhibitors (therapeutic use)
• Piperazines (therapeutic use)
• Postoperative Period
• Prostatectomy (adverse effects, methods)
• Purines
• Recovery of Function
• Retrospective Studies
• Sildenafil Citrate
• Sulfones
• Surveys and Questionnaires
• Treatment Outcome