Elsevier

Sexual Medicine

Volume 6, Issue 2, June 2018, Pages 108-114
Sexual Medicine

Original Research
Erectile Dysfunction
Efficacy and Safety of Tadalafil 5 mg Once Daily for the Treatment of Erectile Dysfunction After Robot-Assisted Laparoscopic Radical Prostatectomy: A 2-Year Follow-Up

https://doi.org/10.1016/j.esxm.2017.12.005Get rights and content
Under a Creative Commons license
open access

Abstract

Background

Although nerve-sparing robot-assisted radical prostatectomy (NS-RALP) is performed, a large number of patients still experience erectile dysfunction (ED) after surgery.

Aim

To evaluate the efficacy and safety of tadalafil 5 mg once daily (OaD) in ED treatment over 2 years and investigate the cause of vascular ED after NS-RARP.

Methods

We retrospectively evaluated 95 men who underwent NS-RARP and had a penile rehabilitation treatment with tadalafil 5 mg OaD. They were classified into 3 groups: tadalafil 5 mg OaD for 2 years (group I), tadalafil 5 mg OaD for 1 year (group II), and no tadalafil (group III). All patients in group I underwent penile color duplex ultrasound to evaluate the cause of vascular ED.

Outcomes

Patients were surveyed using the abridged 5-item International Index of Erectile Function (IIEF-5).

Results

Statistically significant improvements were observed in group I for all IIEF-5 domain scores (P = .000). There was no statistically significant difference in recovery of erectile function (EF) the 2-year follow-up between groups I and II. Sub-analysis based on NS status showed no difference in recovery of EF. However, group I showed better trends in EF improvement. Those with venogenic ED had poor responses compared with those with arteriogenic ED or unremarkable findings with tadalafil 5-mg OaD treatment (14.2% vs 55.0% vs 53.3%). The overall side effects included hot flushing in 9.5%, headache in 7.1%, and dizziness in 2.3% of patients.

Clinical Implications

Long-term usage of tadalafil 5 mg OaD after RARP can be an effective option for penile rehabilitation.

Strengths and Limitations

The present study is a retrospective study with a relatively small sample.

Conclusions

Although the responses of patients with venogenic ED were limited compared with those with arteriogenic ED, tadalafil 5-mg OaD treatment was well tolerated and significantly improved EF up to 2 years after NS-RARP.

Kim S, Sung GT. Efficacy and Safety of Tadalafil 5 mg Once Daily for the Treatment of Erectile Dysfunction After Robot-Assisted Laparoscopic Radical Prostatectomy: A 2-Year Follow-Up. Sex Med 2018;6:108–114.

Key Words

Erectile Dysfunction
Penile Rehabilitation
Phosphodiesterase Type 5 Inhibitor
Robot-Assisted Radical Prostatectomy

Cited by (0)

Conflicts of Interest: The authors report no conflicts of interest.

Funding: This study was supported by research funds from Dong-A University.