Adult urologyLong-term effect of sildenafil citrate on erectile dysfunction after radical prostatectomy: 3-year follow-up1
Section snippets
Initial study: patient recruitment
We obtained and reviewed the records of two experienced surgeons (C.Z., E.K.) who, between 1994 and 1998, performed RP on 350 sexually active patients with localized prostate cancer. At a mean follow-up of 3 months, 208 (68%) of 350 patients experienced severe ED, with no patient able to achieve vaginal penetration. All 208 patients with ED were initially evaluated by an internist in our group (M.L.) who took a comprehensive sexual history and performed a physical examination. At that time, the
Results
No statistically significant differences were found between the non-NS and NS groups in age, interval between RP and start of sildenafil, preoperative and predrug erectile status, nocturnal erections, and ability to penetrate, as assessed by our retrospective chart review (Table I).
Comment
Our 3-year follow-up study of the effect of sildenafil citrate after RP demonstrates its long-term efficacy and compliance. Most patients who responded at 1 year (72%) continued to have effective erections with sildenafil citrate at 3 years. The SHIM (IIEF-5) and EDITS scores were comparable at 1 and 3 years. When the responses at 1 and 3 years were stratified according to neurovascular bundle status, the magnitude of improvement in SHIM (IIEF-5) was still greater in the bilateral NS group than
Conclusions
After NS RP, patients who initially respond to sildenafil continued to show excellent long-term efficacy and compliance at 3 years by SHIM analysis. The degree of neurovascular preservation continued to determine the response rates to sildenafil. Discontinuation was primarily due to a return of natural erections (15%) and loss of efficacy (12%), with no patient stopping because of adverse side effects.
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Cited by (83)
Xybilun<sup>®</sup> for erectile dysfunction; A 2018 update
2018, SexologiesPharmacotherapy for Erectile Dysfunction: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015)
2016, Journal of Sexual MedicineCitation Excerpt :There is consistent evidence that sildenafil not only is efficacious in the treatment of ED but also significantly improves several psychosocial outcomes. These include (i) the IIEF satisfaction domain, (ii) the ED Effect on Quality of Life Questionnaire, (iii) broadly based psychometric questionnaires, (iv) the Beck Depression Inventory, (v) the Fugl-Meyer Life Satisfaction Checklist, (vi) the ED Inventory of Treatment Satisfaction (EDITS) for patient and partner, (vii) the Hamilton Depression (HAM-D) score, (viii) the Center for Epidemiologic Studies Depression (CESD) Scale, (ix) the Arizona Sexual Experience Scale, (x) the Erectile Distress Scale, and (xi) the Self-Esteem and Relationship Questionnaire.35–58,60–63,65–68,70–72,74–80,82–91,99–101 The most common adverse events associated with sildenafil include headache, flushing, dyspepsia, and nasal congestion.
Erectile function rehabilitation after laparoscopic radical prostatectomy
2015, Revista Internacional de AndrologiaErectile dysfunction following radical prostatectomy: A review
2011, British Journal of Medical and Surgical Urology
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C. D. Zippe is a member of the speaker’s bureau for Pfizer. M. M. Lakin is a consultant to, and a member of the speaker’s bureau for, Pfizer.