Effect of statin therapy on early return of potency after nerve sparing radical retropubic prostatectomy.
OBJECTIVE
We prospectively investigated whether postoperative statin use would contribute to earlier recovery of erectile function in men who underwent bilateral nerve sparing radical retropubic prostatectomy for clinically localized prostate cancer.


METHODS
A total of 50 potent men without hypercholesterolemia undergoing bilateral nerve sparing radical retropubic prostatectomy for clinically localized prostate cancer were prospectively randomized into 2 equal groups. Group 1 patients were instructed to ingest only 50 mg sildenafil per day if needed following hospital discharge after radical retropubic prostatectomy. Group 2 patients were prescribed atorvastatin at a dose of 10 mg daily from postoperative days 1 to 90 and they were also instructed to ingest sildenafil, as in group 1. Patient status regarding potency and adverse events were assessed 6 months after surgery.


RESULTS
The 2 groups demonstrated no significant differences regarding various baseline factors, including International Index of Erectile Function-5 scores. Group 2 had a significantly higher postoperative International Index of Erectile Function-5 score than group 1 at 6 months postoperatively (p = 0.003). Meanwhile, as judged by a preset definition, the incidence of potent patients 6 months after prostatectomy was 26.1% in group 1 and 55% in group 2 (p = 0.068). Also, 17.4% and 40% of the men reported achieving intercourse by vaginal penetration without a phosphodiesterase 5 inhibitor in groups 1 and 2, respectively (p = 0.172). No serious adverse events associated with medication were reported.


CONCLUSIONS
Postoperative treatment with atorvastatin in men who report normal erectile function preoperatively may contribute to earlier recovery of erectile function after nerve sparing radical retropubic prostatectomy.
Hong
Sung Kyu
SK
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
Han
Byung Kyu
BK
Jeong
Seong Jin
SJ
Byun
Seok-Soo
SS
Lee
Sang Eun
SE
D015106:3',5'-Cyclic-GMP Phosphodiesterases / Q000627:therapeutic use; D000368:Aged; D000069059:Atorvastatin; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; D003714:Denervation; D004359:Drug Therapy, Combination; D007172:Erectile Dysfunction / Q000188:drug therapy*; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010410:Penile Erection / Q000187:drug effects; D010525:Peripheral Nerves / Q000601:surgery*; D010879:Piperazines / Q000627:therapeutic use; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D011467:Prostate / Q000294:innervation*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D011687:Purines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use*; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010879:Piperazines; D011687:Purines; D011758:Pyrroles; D013450:Sulfones; D014665:Vasodilator Agents; D000069059:Atorvastatin; D000068677:Sildenafil Citrate; D015106:3',5'-Cyclic-GMP Phosphodiesterases; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; C517381:PDE5A protein, human