title: Efficacy and safety of phosphodiesterase type 5 (PDE5) inhibitors in treating erectile dysfunction after bilateral nerve-sparing radical prostatectomy.
abstract: We carried out a systematic review and meta-analysis to assess the efficacy and safety of phosphodiesterase type 5 (PDE5) inhibitors for treating erectile dysfunction (ED) after bilateral nerve-sparing radical prostatectomy (BNSRP). A literature review was performed to identify all published randomised double-blind, placebo-controlled trials of PDE5 inhibitors for the treatment of ED after BNSRP. The search included the following databases: MEDLINE, EMBASE and the Cochrane Controlled Trials Register. The reference lists of the retrieved studies were also investigated. Six publications involving a total of 1678 patients were used in the analysis, including six RCTs that compared PDE5 inhibitors (tadalafil, sildenafil, avanafil and vardenafil) with placebo. Co-primary efficacy end points: International Index of Erectile Function-Erectile Function (IIEF-EF) domain score [the standardised mean difference (SMD) = 4.04, 95% confidence interval (CI) = 2.87-5.22, P < 0.00001]; successful vaginal penetration (SEP2) [the odds ratio (OR) = 14.87, 95%CI = 4.57-48.37, P < 0.00001]; and successful intercourse (SEP3) (OR = 47, 95%CI = 3-13.98, P < 0.00001) indicated that PDE5 inhibitors was more effective than the placebo. Specific adverse events with PDE5 inhibitors included headache (12.08%), dyspepsia (6.76%) and flushing (6.52%), which were significantly less likely to occur with placebo. This meta-analysis indicates that PDE5 inhibitors to be an effective and well-tolerated treatment for ED after BNSRP.
authors: Department of Urology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, China.
authors: Y
authors: Y
authors: Cui
authors: Department of Urology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, China.
authors: X
authors: X
authors: Liu
authors: Department of Urology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, China.
authors: L
authors: L
authors: Shi
authors: Department of Urology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, China.
authors: Z
authors: Z
authors: Gao
mesh_terms: D007172:Erectile Dysfunction / Q000188:drug therapy*; D006801:Humans; D008297:Male; D059351:Organ Sparing Treatments; D010525:Peripheral Nerves; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy*; D011468:Prostatectomy / Q000379:methods*; D011743:Pyrimidines / Q000627:therapeutic use; D000068677:Sildenafil Citrate / Q000627:therapeutic use; D000068581:Tadalafil / Q000627:therapeutic use; D016896:Treatment Outcome; D000069058:Vardenafil Dihydrochloride / Q000627:therapeutic use
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D011743:Pyrimidines; D000069058:Vardenafil Dihydrochloride; D000068581:Tadalafil; D000068677:Sildenafil Citrate; C553414:avanafil
keywords: Bilateral nerve-sparing radical prostatectomy; erectile dysfunction sexual (penile) rehabilitation; meta-analysis; phosphodiesterase type 5 inhibitors