1628 AT LEAST ONE PHOSPHODIESTERASE TYPE 5 INHIBITOR DOSE PER WEEK SHOULD BE TAKEN IN ORDER TO IMPROVE ERECTILE FUNCTION RECOVERY AFTER BILATERAL NERVE SPARING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 20111628 AT LEAST ONE PHOSPHODIESTERASE TYPE 5 INHIBITOR DOSE PER WEEK SHOULD BE TAKEN IN ORDER TO IMPROVE ERECTILE FUNCTION RECOVERY AFTER BILATERAL NERVE SPARING RADICAL PROSTATECTOMY Andrea Gallina, Alberto Briganti, Nazareno Suardi, Marco Bianchi, Manuela Tutolo, Umberto Capitanio, Antonino Saccà, Fabio Castiglione, Andrea Salonia, Lorenzo Rocchini, Valerio Di Girolamo, Giorgio Guazzoni, Patrizio Rigatti, and Francesco Montorsi Andrea GallinaAndrea Gallina Milan, Italy More articles by this author , Alberto BrigantiAlberto Briganti Milan, Italy More articles by this author , Nazareno SuardiNazareno Suardi Milan, Italy More articles by this author , Marco BianchiMarco Bianchi Milan, Italy More articles by this author , Manuela TutoloManuela Tutolo Milan, Italy More articles by this author , Umberto CapitanioUmberto Capitanio Milan, Italy More articles by this author , Antonino SaccàAntonino Saccà Milan, Italy More articles by this author , Fabio CastiglioneFabio Castiglione Milan, Italy More articles by this author , Andrea SaloniaAndrea Salonia Milan, Italy More articles by this author , Lorenzo RocchiniLorenzo Rocchini Milan, Italy More articles by this author , Valerio Di GirolamoValerio Di Girolamo Milan, Italy More articles by this author , Giorgio GuazzoniGiorgio Guazzoni Milan, Italy More articles by this author , Patrizio RigattiPatrizio Rigatti Milan, Italy More articles by this author , and Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1737AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES No study tested the association between the number of phosphodiesterase type 5 inhibitors (PDE5-I) doses (a proxy of sexual activity) and erectile function (EF) recovery after bilateral nerve sparing radical prostatectomy (BNSRP). We hypothesized that the number of sexual attempts is a major determinant of EF recovery after BNSRP. METHODS The study included 927 consecutive patients treated with BNSRP between 2005 and 2010 at a tertiary referral center. Of these, 238 (25.7%) used PDE5-I on demand and represented the study cohort. All patients were assessed post-operatively every 3 months and were asked to complete the International Index of Erectile Function (IIEF) during each visit. Moreover, the number of PDE5-I doses taken per week during each time interval was recorded. Complete data on the number of doses were available for 187 out of 238 (78.6%) pts. Post-operative EF recovery was defined as an EF domain score of the IIEF (IIEF-EF) ≥22. Kaplan-Meier curves assessed the time to EF recovery according to the number of doses dichotomized according to the most-informative cut-off for EF recovery. The association between the number of pills and EF recovery was also assessed in univariable and multivariable Cox regression analyses after accounting for age at surgery and pre-operative EF. RESULTS Pre-op IIEF-EF assessment showed severe, moderate, mild to moderate, mild and no ED in 21.1,2.7,2.7,13.6 and 59.9% of pts, respectively. Overall, 116/187 (62%) pts reached a IIEF-EF≥22 after a mean follow-up of 22.7 months (median 19). The mean number of doses taken over the entire period of therapy was 0.9 per week. When pts were dichotomized according to the most informative cut-off (namely ≥ 1 pill per week vs <1), significantly higher EF recovery rates were found at 1 and 2 year follow-up in pts taking at least 1 dose per week (n= 43) vs those taking <1 dose per week (n=144; 88 and 95% vs 29 and 56%, respectively; p<0.001). The same results were obtained in pre-operatively fully potent (IIEF-EF≥26) patients (EF recovery at 1 and 2 year-follow-up: 90 and 93% vs 36 and 62%, respectively; p<0.001). This association was confirmed at multivariable analyses after adjusting for age and pre-operative EF (p<0.001; HR 4.0). CONCLUSIONS The number of PDE5-I doses taken on demand represents a major determinant of EF recovery in pts treated with BNSRP. At least 1 dose of PDE5-I per week should be taken to improve EF recovery after surgery regardless of pre-operative erectile status. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e653 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrea Gallina Milan, Italy More articles by this author Alberto Briganti Milan, Italy More articles by this author Nazareno Suardi Milan, Italy More articles by this author Marco Bianchi Milan, Italy More articles by this author Manuela Tutolo Milan, Italy More articles by this author Umberto Capitanio Milan, Italy More articles by this author Antonino Saccà Milan, Italy More articles by this author Fabio Castiglione Milan, Italy More articles by this author Andrea Salonia Milan, Italy More articles by this author Lorenzo Rocchini Milan, Italy More articles by this author Valerio Di Girolamo Milan, Italy More articles by this author Giorgio Guazzoni Milan, Italy More articles by this author Patrizio Rigatti Milan, Italy More articles by this author Francesco Montorsi Milan, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...