scholarly journals Results of tadalafil treatment in patients following an open nerve-sparing radical prostatectomy

2016 ◽  
Vol 88 (1) ◽  
pp. 4
Author(s):  
Erkan Hirik ◽  
Aliseydi Bozkurt ◽  
Mehmet Karabakan ◽  
Özkan Onuk ◽  
Mustafa Bahadır Can Balcı ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Adverse Effects ◽  
Erectile Function ◽  
Nerve Sparing ◽  
Ultrasound Evaluation ◽  
Significant Difference ◽  
Daily Dose ◽  
The Mean ◽  
Positive Effect

Purpose: To evaluate the effect of postoperatively administering a low daily dose of tadalafil on the erectile function of patients who underwent a nerve-sparing radical prostatectomy(NSRP) due to localized prostate cancer (PCa). Materials and Methods: Of 138 patients, who underwent NSRP due to PCa between 2012 and 2014, 55 patients who had not had pre-operative erectile dysfunction (ED) were included in the study. The mean age of the patients was 64 (54-72). On the 15th day after surgery, after ultrasound evaluation, all 55 patients started on a daily dose of 5 mg tadalafil that was continued for 2.5 months. The erectile function of patients was evaluated pre-operatively, post-operatively, and at the 3rd and 6th month after surgery using the International Index of Erectile Function (IIEF-5) test. None of the patients was treated with hormonal therapy or radiotherapy before or after surgery. Results: Three patients were excluded from the study due to the adverse effects of tadalafil and two patients elected to discontinue the treatment. Of the remaining 50 patients whose pre-operative erectile function had been found normal, at 3 months after surgery, 36 (72%) had normal erectile function; of the remaining patients in the study six (12%) presented with mild, two (4%) with moderate, and six (12%) with severe ED. Six months after surgery, 35 patients (70%) had normal erectile function while seven (14%) had mild, three (6%) moderate and five (10%) severe ED. There was no statistically significant difference between the results obtained at the 3rd and 6thmonth follow-up (p > 0.05). Three patients reported adverse effects with tadalafil including flushes in 2 (3.6%) and a headache in 1 (1.8%). Conclusions: The administration of a 5 mg post-operative dose of tadalafil to patients that had undergone a bilateral NSRP was found to have a positive effect on the recovery and maintenance of erectile function. However, there is still a need to investigate a larger series of cases.

1172: Improved Recovery of Erectile Function with Nightly Low dose Sildenafil - 18 Months Follow-Up After Nerve-Sparing Radical Prostatectomy

2007 ◽  
Vol 177 (4S) ◽  
pp. 386-387
Author(s):  
Andreas Bannowsky ◽  
Heiko Schulze ◽  
Christof van der Horst ◽  
Stefan Hautmann ◽  
Klaus P. Juenemann
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Low Dose ◽  
Nerve Sparing

scholarly journals Immediate post-operative PDE5i Therapy improves early Erectile Function Outcomes after Robot Assisted Radical Prostatectomy (RARP)

2020 ◽  
Author(s):  
Arjun Nathan ◽  
Shivani Shukla ◽  
Amil Sinha ◽  
Sailantra Sivathasan ◽  
Amir Rashid ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Phosphodiesterase Inhibitor ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Readmission Rates ◽  
Early Therapy ◽  
Tertiary Centre ◽  
Unilateral Group

Objectives To assess whether the timing of post-operative Phosphodiesterase Inhibitor (PDE5i) therapy after Robot Assisted Radical Prostatectomy (RARP) is associated with a change in early erectile function outcomes. Additionally, to determine whether there are differences in continence or safety outcomes. Subjects/patients and methods Data was prospectively collected from a single surgeon in one tertiary centre and retrospectively evaluated. 158 patients were treated with PDE5i therapy post RARP over a two-year period. PDE5i therapy was started: immediately (day 1-2) post-op in 29%, early (day 3-14) post-op in 37% and late (after day 14) post-op in 34%. EPIC-26 Erectile Function (EF) scores were collected pre-op and post-op with a median follow-up time of 43 days. Results The median age was 64 and the median BMI was 27. 9% of the series had Charlson Co-Morbidities. There were no significant differences in pre-operative characteristics between the therapy groups. Patients that had bilateral nerve sparing had a mean drop in Erectile Function (EF) score by 5.4 compared to 8.8 in the unilateral group. Additionally, 34.9% of bilateral nerve sparing patients returned to baseline compared to 12.1% of unilateral. Drop in EF scores and percentage return to baseline for unilateral nerve sparing was respectively 9 and 11.1% of immediate therapy, 7 and 14.8% of early therapy and 9.7 and 9.5% of late therapy (p=0.9 and p=0.6). For bilateral nerve sparing this was respectively 3.5 and 42.9% immediate therapy, 5.5 and 35.5% early therapy and 7.3 and 25% late therapy (p=0.017 and p=0.045). Pad free and social continence was achieved in 54% and 37% of those receiving immediate therapy, 60% and 33% for early therapy and 26% and 54% for late therapy. There were no differences in compliance, complication or readmission outcomes. Conclusion In patients with bilateral nerve sparing RARP, immediate post-operative PDE5i therapy may protect EF. Early onset (3-14 days) may also provide a benefit compared to initiating PDE5i therapy later (after 14 days). Expediting therapy for patients undergoing unilateral nerve sparing may also provide a benefit; however, the differences are less pronounced. Immediate or early PDE5i therapy also improved early continence outcomes for patients with bilateral nerve sparing, compared to late therapy. There were no differences in compliance, complication or readmission rates between the groups. Therefore, immediate PDE5i therapy should be considered in patients following nerve sparing RARP in order to maximise functional outcomes, especially in those undergoing bilateral nerve spare.

LOW-DOSE SILDENAFIL FOR REHABILITATION OF ERECTILE FUNCTION AFTER NERVE-SPARING RADICAL PROSTATECTOMY – A TWO YEAR FOLLOW-UP

2008 ◽  
Vol 7 (3) ◽  
pp. 163
Author(s):  
A. Bannowsky ◽  
H. Schulze ◽  
C. Van Der Horst ◽  
S. Hautmann ◽  
K.P. Jünemann
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Low Dose ◽  
Nerve Sparing

scholarly journals 31 Immediate Post-Operative Phosphodiesterase-5 Inhibitors (PDE5i) Therapy Improves Early Erectile Function Outcomes After Robot Assisted Radical Prostatectomy (RARP)

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Nathan ◽  
S Shukla ◽  
A Sinha ◽  
S Sivathasan ◽  
A Rashid ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Phosphodiesterase 5 Inhibitors ◽  
Tertiary Centre ◽  
Safety Outcomes ◽  
Phosphodiesterase 5

Abstract Introduction To assess whether the timing of post-RARP PDE5i therapy affects early erectile function, continence, or safety outcomes. Method Data from 158 patients treated with PDE5is post-RARP was prospectively collected over two years from a single surgeon at one tertiary centre and retrospectively evaluated. Therapy was started: immediately (day 1-2) in 29%, early (day 3-14) in 37% and late (after day 14) post-op in 34%. EPIC-26 Erectile Function (EF) scores were collected pre-op and post-op after a median 43-day follow-up interval. Results Drop in EF scores and percentage return to baseline post unilateral nerve sparing (UNS) compared to bilateral nerve sparing (BNS) RARP was respectively 9 and 11.1% versus 3.5 and 42.9% of immediate therapy, 7 and 14.8% versus 5.5 and 35.5% of early and 9.7 and 9.5% versus 7.3 and 25% of late. Pad free and social continence was achieved in 54% and 37% of those receiving immediate therapy, 60% and 33% for early and 26% and 54% for late. Conclusions Immediate post RARP PDE5i therapy may protect EF and should be considered clinically, with more benefits for BNS than UNS patients. Immediate or early, rather than late, PDE5i therapy improved early continence in BNS patients.

TWO YEARS FOLLOW-UP AFTER NERVE-SPARING RADICAL PROSTATECTOMY – IMPROVEMENT OF ERECTILE FUNCTION WITH NIGHTLY LOW DOSE SILDENAFIL

2008 ◽  
Vol 179 (4S) ◽  
pp. 429-429
Author(s):  
Andreas Bannowsky ◽  
Heiko Schulze ◽  
Christof van der Horst ◽  
Stefan Hautmann ◽  
Klaus-Peter Junemann
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Low Dose ◽  
Nerve Sparing

scholarly journals The effect of vesicourethral anostomosis technique on functional results in retropubic radical prostatectomy

2021 ◽  
Author(s):  
Fuat Kizilay ◽  
Serdar Kalemci ◽  
Adnan Simsir
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Functional Results ◽  
Decisive Factor ◽  
Significant Difference ◽  
Retropubic Radical Prostatectomy ◽  
Continence Status ◽  
Oncological Results ◽  
The Mean ◽  
Mean Time

Aim We aimed to compare the functional results of two different vesicourethral anostomosis (VUA) techniques used in retropubic radical prostatectomy (RRP). Methods A total of 476 patients including the first group with 4 focal VUA at 12-, 3-, 6-, and 9-o’clock positions (n = 288) and the second group with 6 focal VUA at 12-, 2-, 4-, 6-, 8- and 10-o’clock (n = 188) were included in the study. Perioperative data and erectile function and continence status over a 12-month period were compared. Results Demographic and perioperative data were similar between the two groups. The proportion of patients with VUA stricture in the first group was significantly higher than in the second group (5.1% vs 3.2%, p = 0.017). The mean time to stricture development was also shorter in the first group (48.9 vs 74.3 days, p = 0.002). In the second group, the proportion of continent patients at the sixth and twelfth months was higher than the first group (79.3% vs 62.8%, p <0.001; 92.4% vs 81.3%, p = 0.032, respectively). There was no significant difference between the two groups in terms of the proportions of potent patients (p = 0.194 for 6 months and p = 0.351 for 12 months). Conclusions Better continence results can be obtained with the six-focus VUA compared to the four-focus technique. The number of anostomotic sutures in VUA can affect functional results and may be a decisive factor for surgeons who focus on functional results as well as oncological results.

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