title: Results of tadalafil treatment in patients following an open nerve-sparing radical prostatectomy.
abstract: OBJECTIVE
  To evaluate the effect of postoperatively administering a low daily dose of tadalafil on the erectile function of patients who underwent a nerve-sparing radical prostatectomy (NSRP) due to localized prostate cancer (PCa).
  
  
  METHODS
  Of 138 patients, who underwent NSRP due to PCa between 2012 and 2014, 55 patients who had not had pre-operative erectile dysfunction (ED) were included in the study. The mean age of the patients was 64 (54-72). On the 15th day after surgery, after ultrasound evaluation, all 55 patients started on a daily dose of 5 mg tadalafil that was continued for 2.5 months. The erectile function of patients was evaluated pre-operatively, post-operatively, and at the 3rd and 6th month after surgery using the International Index of Erectile Function (IIEF-5) test. None of the patients was treated with hormonal therapy or radiotherapy before or after surgery.
  
  
  RESULTS
  Three patients were excluded from the study due to the adverse effects of tadalafil and two patients elected to discontinue the treatment. Of the remaining 50 patients whose pre-operative erectile function had been found normal, at 3 months after surgery, 36 (72%) had normal erectile function; of the remaining patients in the study six (12%) presented with mild, two (4%) with moderate, and six (12%) with severe ED. Six months after surgery, 35 patients (70%) had normal erectile function while seven (14%) had mild, three (6%) moderate and five (10%) severe ED. There was no statistically significant difference between the results obtained at the 3rd and 6th month follow-up (p > 0.05). Three patients reported adverse effects with tadalafil including flushes in 2 (3.6%) and a headache in 1 (1.8%).
  
  
  CONCLUSIONS
  The administration of a 5 mg post-operative dose of tadalafil to patients that had undergone a bilateral NSRP was found to have a positive effect on the recovery and maintenance of erectile function. However, there is still a need to investigate a larger series of cases.
authors.affiliation: Erzincan University Mengücek Gazi Education and Research Hospital, Urology Clinic. ehirik@gmail.com.
authors.forename: Erkan
authors.initials: E
authors.lastname: Hirik
authors.forename: Aliseydi
authors.initials: A
authors.lastname: Bozkurt
authors.forename: Mehmet
authors.initials: M
authors.lastname: Karabakan
authors.forename: Özkan
authors.initials: Ö
authors.lastname: Onuk
authors.forename: Mustafa Bahadır Can
authors.initials: MB
authors.lastname: Balcı
authors.forename: Memduh
authors.initials: M
authors.lastname: Aydın
authors.forename: Murat
authors.initials: M
authors.lastname: Çakan
authors.forename: Barıs
authors.initials: B
authors.lastname: Nuhoglu
mesh_terms: D000368:Aged; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000187:drug effects; D058986:Phosphodiesterase 5 Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery; D000068581:Tadalafil / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D000068581:Tadalafil