Comparisons of regular and on-demand regimen of PED5-Is in the treatment of ED after nerve-sparing radical prostatectomy for Prostate Cancer.
Phosphodiesterase type-5 inhibitors (PDE5-Is) have been recommended as first line therapy for erectile dysfunction for patients received nerve-sparing radical prostatectomy for prostate cancer. We examed the efficiency of PDE5-Is and considered the optimal application. Systematic search of PubMed, Embase and the Cochrane Library was performed to identify all the studies. We identified 103 studies including 3175 patients, of which 14 were recruited for systematic review. Compared with placebo, PDE5-Is significantly ameliorated the International Index of Erectile Function-Erectile Function domain score (IIEF) scores (MD 4.89, 95% CI 4.25-5.53, p < 0.001). By network meta-analysis, sildenafil seems to be the most efficiency with a slightly higher rate of treatment-emergent adverse events (TEATs), whereas tadalafil had the lowest TEATs. In terms of IIEF scores, regular regimen was remarkably better than on-demand (MD 3.28, 95% CI 1.67-4.89, p < 0.001). Regular use was not associated with higher proportion of patients suffering TEATs compared with on-demand (RR 1.02, 95% CI 0.90-1.16, p = 0.72). Compared with placebo, PDE5-Is manifested significantly improved treatment outcomes. Overall, regular regimen demonstrated statistically pronounced better potency than on-demand. Coupled with the comparable rate of side effects, these findings support the regular delivery procedure to be a cost-effective option for patients.
Department of Urology, Institute of Urology, West China Hospital, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China.
Shi
S
Qiu
Department of Urology, Institute of Urology, West China Hospital, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China.
Zhuang
Z
Tang
Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China.
Linghui
L
Deng
Department of Urology, Institute of Urology, West China Hospital, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China.
Liangren
L
Liu
Department of Urology, Institute of Urology, West China Hospital, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China.
Ping
P
Han
Department of Urology, Institute of Urology, West China Hospital, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China.
Lu
L
Yang
Department of Urology, Institute of Urology, West China Hospital, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China.
Qiang
Q
Wei
D000293:Adolescent; D000328:Adult; D000368:Aged; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D058986:Phosphodiesterase 5 Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery; D000068677:Sildenafil Citrate / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000068581:Tadalafil / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
D058986:Phosphodiesterase 5 Inhibitors; D000068581:Tadalafil; D000068677:Sildenafil Citrate