title: Psychotherapy and phosphodiesterase-5 inhibitor in early rehabilitation after radical prostatectomy: a prospective randomised controlled trial.
abstract: The aim of this study was to evaluate the impact of group psychotherapy and the use of a phosphodiesterase-5 inhibitor (PDE-5i) in the early rehabilitation stage of patients with prostate cancer undergoing radical prostatectomy (RP). Fifty-six patients undergoing RP for prostate cancer were randomised into four groups, and 53 completed the protocol: Group 1 - control (n = 11), Group 2 - group psychotherapy (n = 16), Group 3 - lodenafil 80 mg/one tablet per week (n = 12) and Group 4 - group psychotherapy + lodenafil 80 mg/one tablet per week (n = 14). The groups were individually evaluated for erectile function (IIEF-5) and quality of life - QoL (SF-36) weekly, with two meetings held a week apart before the RP and 12 weekly meetings after surgery. The ages ranged from 39 to 76 years, average 61.84. There were no significant medication side effects. Only Group 4 showed improvement in intimacy with a partner and satisfaction with their sex life (P = 0.045 and P = 0.013 respectively), and with no significant worsening of the IIEF-5 (P = 0.250) reported. All groups showed worsening in the final result of the role limitations caused by physical problems (P = 0.009) and role limitations caused by emotional problems (P = 0.002) of the SF-36, but Group 4 had a significantly higher score for the role limitations caused by physical problems (P = 0.009) than the other groups. In conclusion, precocious integral treatment involving group psychotherapy and PDE-5i before and after RP led to less deterioration of erectile function and other domains related to physical aspects (SF-36), with improvement in intimacy with their partner and satisfaction in their sex life, being superior to single treatments.
authors.affiliation: Division of Urologic Oncology, State University of Campinas-UNICAMP, Campinas, Brazil.
authors.forename: A M E P
authors.initials: AM
authors.lastname: Naccarato
authors.affiliation: Pontifical Catholic University of Campinas- PUC-Campinas, Campinas, Brazil.
authors.forename: L O
authors.initials: LO
authors.lastname: Reis
authors.affiliation: Division of Urologic Oncology, State University of Campinas-UNICAMP, Campinas, Brazil.
authors.forename: U
authors.initials: U
authors.lastname: Ferreira
authors.affiliation: Division of Urologic Oncology, State University of Campinas-UNICAMP, Campinas, Brazil.
authors.forename: F
authors.initials: F
authors.lastname: Denardi
mesh_terms: D000328:Adult; D000368:Aged; D002254:Carbonates / Q000494:pharmacology / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000187:drug effects* / Q000523:psychology; D058986:Phosphodiesterase 5 Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D010879:Piperazines / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects* / Q000523:psychology; D011471:Prostatic Neoplasms / Q000523:psychology / Q000601:surgery; D011613:Psychotherapy; D011743:Pyrimidines / Q000494:pharmacology / Q000627:therapeutic use*; D011788:Quality of Life / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D002254:Carbonates; D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D011743:Pyrimidines; C532120:lodenafil carbonate
keywords: Erectile dysfunction; group psychotherapy; phosphodiesterase-5 inhibitors; prostate cancer; quality of life; radical prostatectomy