263 Penile Rehabilitation Program with “early” low-dose tadalafil after nerve-sparing radical prostatectomy - increased “early” nocturnal penile tumescence 8 days after nerve-sparing radical prostatectomy is correlated with further erectile function r

Abstract

Cytotoxic factors in the corpora cavernosa released within the first 48 to 72 hours after surgery seem to play a major role for developing persistent erectile dysfunction. Several pathophysiologies are postulated for postoperative erectile function rehabilitation. In previous prospective studies nocturnal penile tumescense and rigidity (NPTR) in the acute phase during the first night after catheter removal was shown in 93% of the patients after nerve-sparing radical prostatectomy (nsRP) and the improvement of erectile function by using daily low dose PDE5-inhibitors. But the “optimal” time to initiate a rehabilitation program with PDE5-inhibitors is still unknown. 24 sexual active patients were operated by nerve-sparing retropubic radical prostatectomy. All patients completed an IIEF-5 questionnaire concerning erectile function preoperatively. To maintain and support recovery of spontaneous erectile function 12 patients received tadalafil 5mg/d at night starting at the 3rd night after surgery (group 1). A control of 12 patients received tadalafil 5mg/d at night beginning one day after catheter removal (group 2). 8 days after surgery the transurethral catheter was removed and an erectometer measurement of NPTR (Rigi-Scan®) was carried out on each patient at the following night. All patients completed an IIEF-5 questionnaire concerning erectile function at 3, 6, 12 and 18 months after surgery to evaluate further erectile function recovery.