Preoperative erectile function is the only predictor of the use of a high number of phosphodiesterase type-5 inhibitors after bilateral nerve-sparing radical prostatectomy.
It is well known that the administration of phosphodiesterase type-5 inhibitors (PDE5-Is) may improve erectile function (EF) recovery after bilateral nerve-sparing radical prostatectomy (BNSRP). The aim of our study was to identify predictors of the use of a high number of PDE5-Is (one or more per week) after surgery among 184 patients taking proerectile medications on demand. At a mean follow-up of 22.7 months, 116 patients (63%) recovered EF. Overall, EF recovery rates at 1- and 2- year follow-up were 47.3% and 65.4%, respectively. Overall, 43 (23.4%) patients used one or more PDE5-Is per week. Preoperative EF was the only predictor of the use of one or more PDE5-Is per week after BNSRP. This held true even after adjusting our analyses for age at surgery, body mass index and EF at 1 month after surgery. Particularly, patients fully potent before surgery had roughly 2.1-fold higher probability of using one or more pills per week compared with their counterparts with some degree of preoperative erectile dysfunction (ED; odds ratio: 2.16; 95% confidence interval: 1.03-4.37). In conclusion, preoperative EF represents the only determinant of the use of a higher number of PDE5-Is after surgery. Patients with better preoperative EF might represent individuals more motivated to achieve satisfactory sexual function after surgery. These observations should provide physicians with better preoperative patient counseling and management of postoperative ED.
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy.
G
G
Gandaglia
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy.
A
A
Gallina
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy.
N
N
Suardi
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy.
F
F
Abdollah
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy.
N
N
Passoni
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy.
M
M
Bianchi
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy.
E
E
Zaffuto
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy.
A
A
Nini
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy.
D
D
Vizziello
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy.
A
A
Salonia
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy.
F
F
Montorsi
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy.
A
A
Briganti
D000368:Aged; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000502:physiology*; D010413:Penis / Q000294:innervation*; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D057234:Preoperative Period; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D020127:Recovery of Function
D058986:Phosphodiesterase 5 Inhibitors