Phosphodiesterase-5 Inhibitors Could Be Efficacious in the Treatment of Erectile Dysfunction after Radiotherapy for Prostate Cancer: A Systematic Review and Meta-Analysis

Abstract

Objective: This systematic review was performed to evaluate the efficacy and safety of phosphodiesterase-5 inhibitors (PDE5i) in the treatment of erectile dysfunction (ED) after radiotherapy for prostate cancer (PCa). Methods: A systematic search of PubMed, Embase and the Cochrane Library was performed to identify all randomized controlled trials (RCTs). All relevant studies on the outcomes and complications of PDE5i in the treatment of ED after radiotherapy for PCa were assessed. The outcomes and complications analyzed for this study included the International Index of Erectile Function (IIEF) questionnaire, Global Efficacy Questions (GEQs), Sexual Encounter Profile (SEP) diary and side effects. The Cochrane Collaboration Review Manager software (RevMan 5.1.4) was used for statistical analysis of the outcomes and complications. Results: A total of 4 RCTs were identified from the search strategy. Compared with placebo, the trials indicated that PDE5i significantly improved the IIEF scores, with the exception of two questions (questions 6 and 13), and statistically significantly more positive answers for the GEQs and SEP diary were acquired in intervention groups. Furthermore, almost all the side effects in both groups were mild or moderate, transient and well tolerated. Except for headache, flushing and dyspepsia, all other adverse events did not differ significantly between the two groups. Conclusions: The systematic review suggested significant advantages in the efficacy and safety of PDE5i in the treatment of ED after radiotherapy for PCa. PDE5i should be considered as the first choice for the treatment of PCa patients with ED after radiotherapy.

THERAPY OF ENDOCRINE DISEASE: Effects of chronic use of phosphodiesterase inhibitors on endothelial markers in type 2 diabetes mellitus: a meta-analysis

“…Furthermore, several studies evaluated the sexual function of diabetic patients, generally using the international index of erectile function (31). However, also in this area, no agreement exists on the questionnaire to use, as other studies report the sexual encounter profile (32) or the structured interview of erectile dysfunction (SIEDY) (33).…”

Efficacy and safety of phosphodieterase-5 inhibitors for treatment of erectile dysfunction secondary to spinal cord injury: a systemic review and meta-analysis

“…As a result, with a corresponding increase in cavernosal tumescence and rigidity, smooth muscle relaxation is enhanced and blood inflow into the corpora cavernosa. 6,15 As the first oral selective phosphodieterase type5 (PDE5) inhibitor, the introduction of sildenafil in 1998 is an important advance in the treatment of ED. 16 Two other PDE5 inhibitors, vardenafil and tadalafil, were also developed in recent years.…”

A Systematic Review of the Role of Penile Rehabilitation in Prostate Cancer Patients Receiving Radiotherapy and Androgen Deprivation Therapy

“…Study outcomes vary considerably among patients on ADT, making recommendations for this group problematic. There have been mixed findings of sildenafil usage in this group [45] although a 2013 article concluded that PDE5 inhibitors were safe and efficacious [46]. Low libido and motivation may limit recruitment into these trials compared with postradical prostatectomy studies [47].…”