MP48-12 EVALUATION OF NOCTURNAL TUMESCENCE AND ITS RESPONSE TO NIGHTLY SILDENAFIL CITRATE FOLLOWING RADICAL PROSTATECTOMY: A RANDOMIZED, DOUBLE BLIND, PLACEBO-CONTROLLED STUDY

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Medical and Non-surgical1 Apr 2014MP48-12 EVALUATION OF NOCTURNAL TUMESCENCE AND ITS RESPONSE TO NIGHTLY SILDENAFIL CITRATE FOLLOWING RADICAL PROSTATECTOMY: A RANDOMIZED, DOUBLE BLIND, PLACEBO-CONTROLLED STUDY Daniel Kim, Dorota Hawksworth, Judith Travis, Jennifer Cullen, Lauren Hurwitz, Stephen Brassell, Inger Rosner, Tom Lue, and Robert Dean Daniel KimDaniel Kim More articles by this author , Dorota HawksworthDorota Hawksworth More articles by this author , Judith TravisJudith Travis More articles by this author , Jennifer CullenJennifer Cullen More articles by this author , Lauren HurwitzLauren Hurwitz More articles by this author , Stephen BrassellStephen Brassell More articles by this author , Inger RosnerInger Rosner More articles by this author , Tom LueTom Lue More articles by this author , and Robert DeanRobert Dean More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1486AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Sildenafil citrate has been found efficacious therapy for post-prostatectomy impotence. In this study, we evaluated patterns of erectile function recovery following radical prostatectomy, and response to nightly therapy with Sildenafil citrate. Methods Ninety-four patients who underwent nerve sparing radical prostatectomy for localized prostate cancer were randomized to receive either a nightly 50mg dose of Sildenafil or placebo, starting on the first post-operative day and continuing for one year. Their erectile function was evaluated prior to surgery and at 2 weeks, 3, 6, 9, 12 and 13 months post-operatively. Both subjective, self-reported International Index of Erectile Function Questionnaire (IIEF) scores and objective, nocturnal penile tumescence and rigidity (NPT/ RigiScan™) measures were obtained and analyzed. Results Baseline clinical and demographic characteristics were not statistically different between the treatment groups. Seventy of the 94 patients (74.5%) completed the study. A total of 518 NPTR evaluations were performed using RigiScan™ recorder. Pre-operatively, all patients had normal erections documented with RigiScan™ defined as greater than 60% rigidity for at least 10 minutes. Fourteen of 34 (41.2%) patients had normal erections in the placebo group versus14 of 36 (38.9%) patients in the Sildenafil group at the conclusion of the study (13 months). Multivariable generalized estimating equations (GEE) used to model sexual function over time, revealed that both IIEF (p-value<0.0001) and RigiScan™ (p-value=0.0005) scores improved over time, but scores were not affected by treatment intervention. African-American men were found to be less likely than Caucasians to demonstrate higher RigiScan™ scores over time (OR: 0.44, p-value=0.0167). Conclusions This study demonstrates that nightly use of Sildenafil citrate does not provide therapeutic benefit in the erectile function recovery post-prostatectomy. Regardless of therapy, both subjective and objective measurements of erectile function improve over time. Differences in objective recovery parameters based on patients’ ethnicity may warrant further investigation. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e531-e532 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Daniel Kim More articles by this author Dorota Hawksworth More articles by this author Judith Travis More articles by this author Jennifer Cullen More articles by this author Lauren Hurwitz More articles by this author Stephen Brassell More articles by this author Inger Rosner More articles by this author Tom Lue More articles by this author Robert Dean More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...