title: Phosphodiesterase-5 Inhibitors and Vacuum Erection Device for Penile Rehabilitation After Laparoscopic Nerve-Preserving Radical Proctectomy for Rectal Cancer: A Prospective Controlled Trial.
abstract: The current study sought to clarify the role of phosphodiesterase type 5 inhibitors (PDE-5i) and a vacuum erection device (VED) in penile rehabilitation after laparoscopic nerve-preserving radical proctectomy (LNRP) for rectal cancer. Participants were assigned to one of the following arms-no-intervention, nightly use of sildenafil 25 mg for 3 months after surgery, or concurrent use of nightly sildenafil 25 mg/day for 3 months and a vacuum erection device (VED) 10 to 15 minutes/day for 3 months-in a nonrandomized fashion. All participants had a follow-up of over 12 months prospectively, and patients had baseline, 3-, 6-, and 12-month assessment based on the International Index of Erectile Function-5 (IIEF-5). Seventy-one cases were included in final analyses. In the no-intervention group, the mean baseline IIEF-5 score of 21.9 decreased rapidly to 5.0 at 3 months ( p < .001), 9.2 at 6 months ( p < .001), and stayed at 10.9 at 12 months ( p < .001). In the single therapy group, the mean baseline IIEF-5 score of 22.4 decreased dramatically to 9.0 at 3 months ( p < .001), 14.9 at 6 months ( p = .005), and stayed at 15.1 at 12 months ( p = .005). In the combined therapy group, the mean baseline IIEF-5 score of 23.0 decreased slightly to 15.0 at 3 months ( p = .005), 18.0 at 6 months ( p = .038), and maintained at 18.7 at 12 months ( p = .163). Findings suggested an over 50% decline in the quality of erection function of the patients after LNRP. The early use of PDE-5i alone or combined use of PDE-5i and VED after LNRP maintained erectile function at 12 months.
authors: 1 NanFang Hospital, Southern Medical University, Guangzhou, China.
authors: Haijun
authors: H
authors: Deng
authors: 1 NanFang Hospital, Southern Medical University, Guangzhou, China.
authors: Dong
authors: D
authors: Liu
authors: 2 Peking University Shenzhen Hospital, Shenzhen, China.
authors: Xiangming
authors: X
authors: Mao
authors: 1 NanFang Hospital, Southern Medical University, Guangzhou, China.
authors: Xiaoliang
authors: X
authors: Lan
authors: 1 NanFang Hospital, Southern Medical University, Guangzhou, China.
authors: Hao
authors: H
authors: Liu
authors: 1 NanFang Hospital, Southern Medical University, Guangzhou, China.
authors: Guoxin
authors: G
authors: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D007172:Erectile Dysfunction / Q000534:rehabilitation*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage*; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D014618:Vacuum; D055815:Young Adult
chemical_list: D058986:Phosphodiesterase 5 Inhibitors
keywords: erectile dysfunction; laparoscopic surgery; penile rehabilitation; rectal cancer