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The Utility of PDE5 Inhibitors After Radical Prostatectomy

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Sexual Function in the Prostate Cancer Patient

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Radical prostatectomy of any form (open, laparoscopic, or robotic) has become a widely performed procedure for patients with clinically localized prostate cancer. This procedure may be associated with treatment-specific sequelae affecting health-related quality of life, with urinary incontinence and erectile dysfunction being the most prevalent. The importance of postoperative erectile dysfunction has assumed greater importance in recent years, because the diagnosis of prostate cancer is becoming ever more frequent in younger patients, who are motivated to preserve their sexual function and the couple’s sexual health. Phosphodiesterase type 5 inhibitor therapy is the most frequently used first-line, on-demand treatment for patients who have undergone radical prostatectomy, reaching the highest effectiveness in patients younger than 65 years of age who were preoperatively objectively fully potent and surgically treated with a nerve-sparing anatomic approach to ensure preservation of at least one neurovascular bundle. Although recent evidence suggests the presence of residual erectile function as early as the first night after catheter removal when a nerve-sparing procedure has been done, data have also suggested that some time after radical prostatectomy is needed for the best response to on-demand phosphodiesterase type 5 inhibitors. Pharmacological prophylaxis with phosphodiesterase type 5 inhibitors may have a significantly expanding role in future strategies aimed at preserving postoperative erectile function.

We used Ovid and PubMed (updated April 2007) to conduct an electronic literature search on Medline that included peer-reviewed English-language studies of phosphodiesterase type 5 inhibitor use for either the recovery of erectile function or the treatment of postoperative erectile dysfunction in patients who underwent radical prostatectomy.

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  1. Universita Vita Saluta San Raffaele, Milan, Italy

    Andrea Salonia, Alberto Briganti, Andrea Gallina & Francesco Montorsi

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    Salonia, A., Briganti, A., Gallina, A., Montorsi, F. (2009). The Utility of PDE5 Inhibitors After Radical Prostatectomy. In: Mulhall, J. (eds) Sexual Function in the Prostate Cancer Patient. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60327-555-2_12

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