Effects of Tadalafil Treatment on Erectile Function Recovery Following Bilateral Nerve-sparing Radical Prostatectomy: A Randomised Placebo-controlled Study (REACTT)

Montorsi, Francesco; Brock, Gerald; Stolzenburg, J.U.; Mulhall, John P.; Moncada, Ignacio; Patel, Hitendra; Chevallier, D.; Krajka, K; Henneges, Carsten; Dickson, R. A.; Büttner, H.

doi:10.1016/j.eururo.2013.09.051

Cited by 221 publications

(218 citation statements)

References 25 publications

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“…A number of RCTs have reported on the effects of daily PDE5i use on postoperative erectile function with discordant results. 5,6,14,15 In addition, there is strong evidence demonstrating that PDE5i affect and improve LUTS. 16 Moreover, an association between LUTS and erectile dysfunction has been clearly established, and recently reviewed by Mouli and McVary.…”

Section: Discussionmentioning

confidence: 99%

Nightly sildenafil use after radical prostatectomy has adverse effects on urinary convalescence: Results from a randomized trial of nightly vs on-demand dosing regimens

Hyndman

Bivalacqua

Mettee

et al. 2015

CUAJ

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Introduction: This is a report on potency results from a randomized trial of nightly versus on-demand sildenafil after nerve-sparing radical prostatectomy (RP). A secondary objective was to analyze the effects of these sildenafil administration schemes on urinary health-related quality of life after RP. Methods: In total, 100 potent men were equally randomized to nightly and on-demand sildenafil 50 mg after minimally-invasive RP for 1 year. Health-related quality of life questionnaires were administered at various postoperative intervals. Urinary function was assessed using appropriate expanded prostate cancer index composite (EPIC) subscales. Analyses of covariance and linear mixed-effects modeling were used to compare the effects of treatment over time on urinary recovery, controlling for age, nervesparing score, and time from surgery. Results: The nightly (n = 50) and on-demand (n = 50) sildenafil groups were well-matched at baseline. Nightly sildenafil patients had worse EPIC urinary bother and urinary irritative/obstructive subscale scores at 3 and 6 months after RP, even after controlling for multiple variables. On mixed-model analyses, the differences between groups for these EPIC subscales (4.9 and 2.5, respectively) were greater than documented thresholds for clinical significance. Increasing nerve-sparing score was associated with improvements in EPIC urinary summary, bother, incontinence, and function scores; time from surgery was associated with improvements in all EPIC urinary health-related quality of life subscales. Conclusions: In this specific population and drug dose, we found that on-demand short-acting phosphodiesterase-5 inhibitor (PDE5i) dosing may be more effective after RP to maximize early urinary and erectile health-related quality of life. In preoperatively potent men, nightly sildenafil 50 mg impaired urinary health-related quality of life more than on-demand use in the early months after nerve-sparing RP, independent of effects on urinary continence.

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Section: Discussionmentioning

confidence: 99%

Nightly sildenafil use after radical prostatectomy has adverse effects on urinary convalescence: Results from a randomized trial of nightly vs on-demand dosing regimens

Hyndman

Bivalacqua

Mettee

et al. 2015

CUAJ

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“…Treatment with 10 mg vardenafil ODT, taken on demand, significantly improved erectile function and was effective and well tolerated in a broad population of men with ED [16]. Tadalafil once daily was most effective on drug-assisted erectile function in men with erectile dysfunction following none nerve sparing prostatectomy, however, data was similar to placebo [15].…”

Section: Introductionmentioning

confidence: 70%

“…This gives enhanced benefit and improved outcomes. However, the potential rehabilitative and protective effect of phosphodiesterase type 5 inhibitors on penile function after nerve-sparing radical prostatectomy remains unclear [15].…”

Section: Introductionmentioning

confidence: 99%

Erectile Function Post Robotic Radical Prostectomy: What are the Technical Tips and Tricks?

Ss¹,

Persad²

2016

Med Surg Urol

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“…Early treatment with pde5i medications could also be beneficial for this outcome. The evidence base for these recommendations consists of three publications of moderate quality 60,74,88 .…”

Section: Body Imagementioning

confidence: 99%

“…Counselling could be used to help couples integrate interventions into their usual sexual activities. The evidence base for these recommendations consists of nine publications of low-tomoderate quality 34,51,60,75,89,[95][96][97][98] .…”

Section: Overall Sexual Function and Satisfactionmentioning

confidence: 99%

Interventions to Address Sexual Problems in People with Cancer

et al. 2017

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Effects of Tadalafil Treatment on Erectile Function Recovery Following Bilateral Nerve-sparing Radical Prostatectomy: A Randomised Placebo-controlled Study (REACTT)

Cited by 221 publications

References 25 publications

Nightly sildenafil use after radical prostatectomy has adverse effects on urinary convalescence: Results from a randomized trial of nightly vs on-demand dosing regimens

Nightly sildenafil use after radical prostatectomy has adverse effects on urinary convalescence: Results from a randomized trial of nightly vs on-demand dosing regimens

Erectile Function Post Robotic Radical Prostectomy: What are the Technical Tips and Tricks?

Interventions to Address Sexual Problems in People with Cancer

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