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. 2024 Nov 25:51:e20243757.
doi: 10.1590/0100-6991e-20243757-en. eCollection 2024.

Phosphodiesterase-5 inhibitors for erectile function rehabilitation in patients undergoing nerve sparing radical prostatectomy: a scoping review

[Article in English, Portuguese]
Gabriel Carvalho Andrade Gadelha  1 , Arlindo Monteiro DE Carvalho Júnior  2
Affiliations

Phosphodiesterase-5 inhibitors for erectile function rehabilitation in patients undergoing nerve sparing radical prostatectomy: a scoping review

[Article in English, Portuguese]
Gabriel Carvalho Andrade Gadelha et al. Rev Col Bras Cir. .

Abstract
in English, Portuguese

Introduction: The aim of this study was to conduct a scoping review on the efficacy of phosphodiesterase-5 inhibitors (PDE-5Is) in rehabilitating erectile function in patients undergoing cavernous nerve sparing radical prostatectomy (NSRP).

Methods: The databases used were MEDLINE, EMBASE, CENTRAL, LILACS and Web of Science. Systematic reviews with meta-analyses on the subject were included until March 5, 2024, with no language restrictions. Publications that did not address any of the aforementioned relationships were excluded. The data was organized into tables for descriptive analysis. The methodological quality of the included studies was assessed using the ROBIS tool.

Results: Eight studies were selected and all concluded that the use of PDE-5Is is effective in penile rehabilitation. Only one of the reviews found that use for more than six months was superior to short-term use, and another concluded that daily use was superior to on-demand use. In addition, the articles identified more adverse effects in the experimental group compared to the control group, but without compromising therapeutic adherence. Six of the studies were classified as low risk of bias, while the other two had uncertain risk.

Conclusion: PDE-5Is are effective in restoring erectile function in patients undergoing NSRP, especially when used regularly and over the long term, and follow-up is not hampered by adverse effects. However, due to the scarcity of data, new studies should be carried out to determine the best form of use of these drugs.

Introdução:: O objetivo deste estudo foi realizar uma revisão de escopo sobre a eficácia dos inibidores da fosfodiesterase-5 (PDE-5Is) na reabilitação da função erétil em pacientes submetidos à prostatectomia radical preservadora de nervos cavernosos (PRPN).

Métodos:: As bases de dados utilizadas foram MEDLINE, EMBASE, CENTRAL, LILACS e Web of Science. Foram incluídas revisões sistemáticas com meta-análise sobre o tema, até 5 de Março de 2024, sem restrição de idioma. Foram excluídas publicações que não abordassem alguma das relações citadas. Os dados foram organizados em tabelas para realização de análise descritiva. A qualidade metodológica dos estudos incluídos foi avaliado por meio da ferramenta ROBIS.

Resultados:: Foram selecionados 8 estudos e todos concluíram que o uso dos PDE-5Is é eficaz na reabilitação peniana. Apenas uma das revisões verificou que o uso por mais de seis meses foi superior ao curto prazo e, outra concluiu que o uso de forma diária foi superior em relação ao uso sob demanda. Além disso, os artigos identificaram mais efeitos adversos no grupo experimental em relação ao grupo controle, mas sem comprometer a adesão terapêutica. Seis dos estudos foram classificados como baixo risco de viés, enquanto os outros dois tiveram risco incerto.

Conclusão:: Os PDE-5Is são eficazes na recuperação da função erétil em pacientes submetidos à PRPN, sobretudo quando utilizados de forma regular e a longo prazo, cujo seguimento não é prejudicado pelos efeitos adversos. No entanto, devido à escassez de dados, novos estudos devem ser realizados para determinar a melhor forma de utilização dessas medicações.

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Conflict of interest statement

Conflict of interest: no.

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