Role of pharmacologic rehabilitation in the recovery of sexual function following radical prostatectomy.
OBJECTIVE
The aim of the present study is to evaluate the role of pharmacological postoperative sexual rehabilitation in the recovery of erectile function following radical retropubic prostatectomy.


METHODS
Following radical retropubic prostatectomy 113 patients were divided into 2 groups: 77 (group 1) underwent pharmacologic rehabilitation with intracavernous PGE1 starting with 5 mg once or twice weekly beginning 1 month after surgery, followed by oral sildenafil 50-100 mg twice a week after recovery of spontaneous erections, while 36 (group 2) acted as controls. The 2 groups were homogeneous for age and preoperative IIEF5 score, while nerve-sparing techniques were used more frequently in group 1.


RESULTS
With 1 year follow-up 42% of group 1 patients have recovered sexual function, versus 8% of group 2 (P < 0.001). The mean recovery time was 7 months, and 56% of rehabilitated patients with bilateral preservation of the neurovascular bundles recovered sexual function, compared to 37.5% of those with unilateral preservation and 28.5% of those operated with non nerve-sparing technique. Intracavernous PGE1 caused pain in 27% of cases.


CONCLUSIONS
Pharmacologic rehabilitation significantly impacts on the recovery of sexual function following radical prostatectomy, and the optimal treatment schedule is still to be defined.
Dinelli
N
N
Urology Unit, Department of Surgery, University of Pisa, Pisa, Italy.
Salinitri
G
G
Pomara
G
G
Menchini Fabris
F
F
Morelli
G
G
Selli
C
C
D000368:Aged; D000527:Alprostadil / Q000627:therapeutic use*; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011468:Prostatectomy / Q000009:adverse effects; D011687:Purines; D020127:Recovery of Function; D000068677:Sildenafil Citrate; D013450:Sulfones; D014665:Vasodilator Agents / Q000627:therapeutic use*
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate; D000527:Alprostadil