423 The impact of preoperative daily PDE5 inhibitors on the early recovery of erectile function following robot-assisted radical prostatectomy

Abstract

Preoperative erectile function is one of contributing factors for the recovery of erectile function (EF) following robot-assisted radical prostatectomy (RARP). PDE5-inhibitors hardly recover erectile function as a rehabilitation modality. We hypothesized that preoperative daily PDE5-inhibitor might enhance the functional recovery after RARP. We evaluated the EF in the patients with preoperative daily PDE5 inhibitor following RARP. Of 91 pts who underwent RARP at Chiba-Nishi General Hospital between May 2016 and Aug 2017, we evaluated 34 patients who had preoperative erectile function with EHS 3 or 4, underwent nerve-sparing procedures (unilateral or bilateral), did not take androgen deprivation therapy, had observation period over 3 months, and took daily PDE5 inhibitors for their lower urinary tract symptoms before surgery. Median patients’ age was 69 years, median PSA level was 7.85ng/ml, median EHS was 3. Nerve-sparing procedures were done in 19 unilaterally, and 15 bilaterally. Preoperative daily tadalafil users were 11 and non-users were 23. Median EHS at 6 months following RARP was significantly higher in tadalafil-users than non-tadalafil-users (1.73 vs. 0.69, p=0.018; Student’s t-test).