370 Increasing the Dose of Vardenafil on a Daily Base Doesn't Improve Erectile Function in the Longer Follow-up of 2 Years After Nerve-sparing Radical Prostatectomy

Abstract

Several pathophysiologies are postulated for postoperative erectile function rehabilitation and several treatment regimens for rehabilitation of erectile function after nerve-sparing radical prostatectomy (nsRP) are currently discussed and performed. In previous prospective studies it was shown that using daily low dose PDE-5 inhibitors after nsRP leads to an improvement of erectile function. But the “optimal” regimen and dosage of PDE5-inhibitors for rehabilitation programs is still unknown. 36 sexual active patients were operated by nerve-sparing retropubic radical prostatectomy. All patients completed an IIEF-5 questionnaire concerning erectile function preoperatively. Group 1 (n=12 patients) received vardenafil 5mg/d versus group 2 (n=12) who received vardenafil 10mg/d at night beginning the day of catheter removal. A control of 12 patients underwent follow up without PDE-5-inhibitors. IIEF-5 questionnaire was performed 3, 6, 12, 18 and 24 months after operation. In the group of daily 5mg vardenafil (group 1) the IIEF-5 score decreased from preoperative 22.4 mean score to 4.2 at 3 months, 8.9 at 6 months, 13.4 at 12 months, 15.2 at 18 months and 18.3 mean score at 24 months after nsRP versus preoperative 22.8, 4.1 at 3 months, 7.9 at 6 months, 12.8 at 12 months, 14.9 at 18 months and 18.4 mean score at 24 months in group 2 (10mg/d vardenafil). In the control group preoperative IIEF-5 mean score 21.9 decreased to 3.8 at 3 months, 6.1 at 6 months, 8.9 at 12 months, 10.2 at 18 months and 11.3 at 24 months. Statistical evaluation showed significant difference in IIEF-5 score and time to recovery of erectile function between the groups 1 and 3 and between the groups 2 and 3 (p<0.05). No statistical differences were found between the groups 1 and 2.