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. 2018 Jun;6(2):108-114.
doi: 10.1016/j.esxm.2017.12.005. Epub 2018 Mar 27.

Efficacy and Safety of Tadalafil 5 mg Once Daily for the Treatment of Erectile Dysfunction After Robot-Assisted Laparoscopic Radical Prostatectomy: A 2-Year Follow-Up

Soodong Kim  1 , Gyung Tak Sung  2
Affiliations

Efficacy and Safety of Tadalafil 5 mg Once Daily for the Treatment of Erectile Dysfunction After Robot-Assisted Laparoscopic Radical Prostatectomy: A 2-Year Follow-Up

Soodong Kim et al. Sex Med. 2018 Jun.

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Sex Med. 2018 Sep;6(3):272. doi: 10.1016/j.esxm.2018.06.001. Epub 2018 Jul 27. Sex Med. 2018. PMID: 30061061 Free PMC article. No abstract available.

Abstract

Background: Although nerve-sparing robot-assisted radical prostatectomy (NS-RALP) is performed, a large number of patients still experience erectile dysfunction (ED) after surgery.

Aim: To evaluate the efficacy and safety of tadalafil 5 mg once daily (OaD) in ED treatment over 2 years and investigate the cause of vascular ED after NS-RARP.

Methods: We retrospectively evaluated 95 men who underwent NS-RARP and had a penile rehabilitation treatment with tadalafil 5 mg OaD. They were classified into 3 groups: tadalafil 5 mg OaD for 2 years (group I), tadalafil 5 mg OaD for 1 year (group II), and no tadalafil (group III). All patients in group I underwent penile color duplex ultrasound to evaluate the cause of vascular ED.

Outcomes: Patients were surveyed using the abridged 5-item International Index of Erectile Function (IIEF-5).

Results: Statistically significant improvements were observed in group I for all IIEF-5 domain scores (P = .000). There was no statistically significant difference in recovery of erectile function (EF) the 2-year follow-up between groups I and II. Sub-analysis based on NS status showed no difference in recovery of EF. However, group I showed better trends in EF improvement. Those with venogenic ED had poor responses compared with those with arteriogenic ED or unremarkable findings with tadalafil 5-mg OaD treatment (14.2% vs 55.0% vs 53.3%). The overall side effects included hot flushing in 9.5%, headache in 7.1%, and dizziness in 2.3% of patients.

Clinical implications: Long-term usage of tadalafil 5 mg OaD after RARP can be an effective option for penile rehabilitation.

Strengths and limitations: The present study is a retrospective study with a relatively small sample.

Conclusions: Although the responses of patients with venogenic ED were limited compared with those with arteriogenic ED, tadalafil 5-mg OaD treatment was well tolerated and significantly improved EF up to 2 years after NS-RARP. Kim S, Sung GT. Efficacy and Safety of Tadalafil 5 mg Once Daily for the Treatment of Erectile Dysfunction After Robot-Assisted Laparoscopic Radical Prostatectomy: A 2-Year Follow-Up. Sex Med 2018;6:108-114.

Keywords: Erectile Dysfunction; Penile Rehabilitation; Phosphodiesterase Type 5 Inhibitor; Robot-Assisted Radical Prostatectomy.

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Figures

Figure 1
Figure 1
Results of penile color duplex U/S with vasoactive intracavernosal injection analysis. ED = erectile dysfunction; IIEF-5 = 5-item International Index of Erectile Function; NS RALP = nerve-sparing robot-assisted laparoscopic radical prostatectomy; Tx = treatment; U/S = ultrasound.
Figure 2
Figure 2
Comparison of IIEF-5 total scores between nerve-sparing groups after nerve-sparing robot-assisted laparoscopic radical prostatectomy. IIEF-5 = 5-item International Index of Erectile Function.
See this image and copyright information in PMC

Comment in

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