MP42-07 IMPACT OF SURGICAL APPROACH ON ERECTILE FUNCTION RECOVERY FOLLOWING BILATERAL NERVE SPARING-RADICAL PROSTATECTOMY: RESULTS FROM A RANDOMIZED CONTROLLED TRIAL OF TADALAFIL VERSUS PLACEBO (REACTT)

Abstract

You have accessJournal of UrologyProstate Cancer: Localized I1 Apr 2015MP42-07 IMPACT OF SURGICAL APPROACH ON ERECTILE FUNCTION RECOVERY FOLLOWING BILATERAL NERVE SPARING-RADICAL PROSTATECTOMY: RESULTS FROM A RANDOMIZED CONTROLLED TRIAL OF TADALAFIL VERSUS PLACEBO (REACTT) Martin Schostak, Markus Graefen, Christian Kriegel, Uwe Michl, Antonio Martin Morales, Peter J. Pommerville, Martina Manning, Hartwig Büttner, Carsten Henneges, and Jens-Uwe Stolzenburg Martin SchostakMartin Schostak More articles by this author , Markus GraefenMarkus Graefen More articles by this author , Christian KriegelChristian Kriegel More articles by this author , Uwe MichlUwe Michl More articles by this author , Antonio Martin MoralesAntonio Martin Morales More articles by this author , Peter J. PommervillePeter J. Pommerville More articles by this author , Martina ManningMartina Manning More articles by this author , Hartwig BüttnerHartwig Büttner More articles by this author , Carsten HennegesCarsten Henneges More articles by this author , and Jens-Uwe StolzenburgJens-Uwe Stolzenburg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1592AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Erectile function (EF) after nerve-sparing radical prostatectomy (nsRP) may be impacted by the type of surgical approach. We report pre-specified and exploratory analyses on the effect of different surgical approaches on recovery of EF obtained from the multicenter, randomized, double-blind, REACTT trial of tadalafil once a day (OaD) or on demand (pro re nata, PRN) versus placebo. METHODS Patients ≤(pts)68yrs with normal preoperative EF who underwent nsRP for localized prostate cancer were randomized post-nsRP 1:1:1 to 9 month double-blind, double-dummy treatment (DBT) with tadalafil 5mg OaD, tadalafil 20mg PRN, or placebo, followed by 6-week drug-free washout and 3-month open-label OaD treatment. EF-recovery was defined as an International Index of Erectile Function (IIEF)-EF domain score ≥22, and normal orgasmic function was defined as IIEF Question 10 item score ≥4. Both parameters were analyzed after washout using logistic regression including terms for: treatment, country, visit, visit-by-treatment interaction, age group, nerve-sparing score, and surgical approach. Time to EF-recovery was analyzed post-hoc with a Cox proportional-hazards model including terms for: treatment, age-group, country, nerve-sparing score, surgical approach, and surgery-by-treatment interaction. RESULTS Of 422 pts enrolled at 50 centers, 189 had open surgery, 115 robot-assisted laparoscopy (lap), 88 conventional lap, and 30 surgeries classified as “other” (endoscopic extraperitoneal nsRP). The odds of achieving EF-recovery at the end of drug-free washout were approximately twice as high for the robot-assisted laparoscopy group compared with the open surgery group (odds ratio: 2.42; 95%CI 1.24, 4.72; p=0.029). Pts who underwent robot-assisted laparoscopy were significantly more likely to recover during DBT compared with pts who had open surgery (hazard ratio: 1.9; 95%CI 1.18, 3.18; p=0.009). A favorable effect of conventional laparoscopy compared with open surgery could not be observed. CONCLUSIONS Although the trial was not primarily designed for these analyses, the results may provide further insights into the impact of surgery on EF-recovery post-nsRP. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e510-e511 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Martin Schostak More articles by this author Markus Graefen More articles by this author Christian Kriegel More articles by this author Uwe Michl More articles by this author Antonio Martin Morales More articles by this author Peter J. Pommerville More articles by this author Martina Manning More articles by this author Hartwig Büttner More articles by this author Carsten Henneges More articles by this author Jens-Uwe Stolzenburg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...