International Urology and Nephrology

, Volume 50, Issue 12, pp 2113–2121 | Cite as

Is there a relationship between phosphodiesterase type 5 inhibitors and biochemical recurrence after radical prostatectomy: a systematic review and meta-analysis

  • Qing He
  • Bang-Hua Liao
  • Kai-Wen Xiao
  • Liang Zhou
  • Shi-Jian Feng
  • Hong Li
  • Kun-Jie WangEmail author
Urology - Review



Conduct a systematic review and meta-analysis of studies to evaluate the association between the use of PDE5I and biochemical recurrence (BCR) after radical prostatectomy (RP).


We searched Embase (from 1996 to Feb 2018), PubMed (from 1996 to Feb 2018), and Cochrane library (from 1999 to Feb 2018), then manually searched the reference lists of key retrieved articles. Original studies that reported the risk of postoperative BCR for PDE5I users, as compared with non-PDE5I users, were included. Data including the characteristic of participants, the risk of BCR after RP and key criteria of study quality were collected. The pooled relative risks (RRs) were calculated with random-effects model.


A total of 5 cohort studies and 1 case–control study were conducted for data analysis (a total of 17752 participants). Only 1 cohort study reported adjusted RR greater than 1 (range for all derived RRs, 0.7–1.47). The meta-analysis revealed that the PDE5I users had no higher risk of BCR after RP (RR = 1.04, 95% confidence interval [CI], 0.79–1.36). Sensitivity analysis showed that the remaining pooled RR and 95% CI were not changed significantly by omitting each study. In addition, the 5-year BCR rate had no significant difference between PDE5I users and non-PDE5I users.


Our meta-analysis indicated that PDE5I treatment in men following RP did not increase the risk of BCR. The results preliminarily suggested that the use of PDE5I for erectile dysfunction after RP was oncologically safe. Nevertheless, more large sample cohort studies are needed to validate this conclusion.


Phosphodiesterase type 5 inhibitors Biochemical recurrence Radical prostatectomy 



This study was supported by Grant Nos. 81770703 and 81470927 from the National Natural Science Foundation of China and Grant No. 16PI294 from Project of the Health and Family Planning Committee of Sichuan Province.

Author contributions

Q He: Project development, Data analysis, Quality assessment, Manuscript writing. BH Liao: Data analysis, Quality assessment, Manuscript editing. KW Xiao: Data collection, Chart production. L Zhou: Protocol development. SJ Feng: Data collection. H Li: Manuscript editing. KJ Wang: Project development, Data management, Manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare that no conflict of interest exists.

Ethical approval

This meta-analysis was based on published studies. Therefore, ethical approval and informed consent are not required for this type of study.


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Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China HospitalSichuan UniversityChengduPeople’s Republic of China

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