STOCKHOLM, SWEDEN (UroToday.com) - In this study, 124 patients aged ≥ 50 years with preoperative International Index of Erectile Function (IIEF)-5 score ≥ 17 were randomized to either an early group (A) or delayed group (B). In group A, sildenafil 100mg was administered twice a week for 3 months immediately after urethral catheter removal. In group B, sildenafil 100mg twice a week for 3 months was initiated from 3 months after surgery. After that time, patients took medication on an as needed basis. IIEF-5, sexual encounter profile (SEP)-2, and SEP-3 were assessed at each follow-up.
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Each group consisted of 62 individuals. At baseline, no differences in age and IIEF-5 scores were reported between the 2 groups groups. Within the first year after surgery, Group A demonstrated improvement of IIEF-5 score more rapidly and the percent of patients with IIEF-5 ≥ 17 was significantly higher in group A at 9 and 12 months, compared to group B. In the logistic regression analysis, at 12 months after surgery, the early administration of sildenafil 100mg independently affected the recovery of potency.
Animal studies have shown that phosphodiesterase-5 (PDE-5) inhibitors reduce the severity of fibrosis in the cavernosum after nerve injury. Authors should be commended on their effort in conducting such a study because few studies have looked at the differences of the effects of PDE-5 inhibitors according to the start time. These results may imply that early start of sildenafil 100mg is more effective to improve the recovery of potency at 12 months after nerve-sparing RALP.
Presented by B. K. Lee at the 29th Annual European Association of Urology (EAU) Congress - April 11 - 15, 2014 - Stockholmsmässan - Stockholm, Sweden.
Seoul National University Bundang Hospital, Department of Urology, Seongnam, Korea
Written by Reza Mehrazin, MD, medical writer for UroToday.com