Erectile dysfunction following nerve-sparing radical retropubic prostatectomy and its treatment with sildenafil.
BACKGROUND
We retrospectively evaluated the erectile function after nerve-sparing radical retropubic prostatectomy (RRP) and the efficacy of sildenafil for erectile dysfunction (ED) following RRP according to the preoperative erectile function.


METHODS
We evaluated 48 Japanese patients who underwent nerve-sparing RRP at the Sapporo Medical University School of Medicine, Sapporo, Japan, between January 1996 and December 2001. Erectile function following nerve-sparing RRP was assessed by a simple mailed questionnaire that was constructed for the study.


RESULTS
Of the 48 patients, 36 had normal erectile function preoperatively, but for 12, function was not sufficient to penetrate. The overall estimated recovery rates of any degree of erection were 50.6% at 36 months and 94.3% at 60 months. However, that of erection sufficient to penetrate was only 17.7% at 36 months and was only seen in bilateral nerve-sparing patients. Sildenafil was effective in 9 of 13 ED patients (69.2%) in both nerve-sparing groups. When patients were divided according to preoperative erectile function, no difference was found in the efficacy rate between patients with normal function and those with ED.


CONCLUSIONS
Even bilateral nerve-sparing RRP can not always guarantee a sufficient erection. However, sildenafil is effective for ED following nerve-sparing RRP regardless of the nerve-sparing procedure or preoperative erectile function. Thus, preoperative function alone, although depending on its severity, may not necessarily be a reason for exclusion from receiving nerve-sparing RRP if patients want to have the operation.
Shimizu
Takashi
T
Department of Urology, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido 060-8543, Japan.
Hisasue
Shin-Ichi
S
Sato
Yoshikazu
Y
Kato
Ryuichi
R
Kobayashi
Ko
K
Tsukamoto
Taiji
T
D000368:Aged; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology*; D005837:Genitalia, Male / Q000294:innervation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009420:Nervous System / Q000503:physiopathology; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011184:Postoperative Period; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D011687:Purines; D020127:Recovery of Function; D012189:Retrospective Studies; D000068677:Sildenafil Citrate; D013450:Sulfones; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate