Sildenafil Citrate After Radical Retropubic Prostatectomy

Abstract

Sildenafil improved erectile function and the ability to have intercourse in more than half of men after radical retropubic prostatectomy. Baseline postoperative erectile function, which is dependent on the degree of nerve sparing technique, significantly impacts the likelihood that patients will respond to sildenafil.

Randomized, Double-Blind, Placebo-Controlled Trial of Sildenafil (Viagra®) for Erectile Dysfunction After Rectal Excision for Cancer and Inflammatory Bowel Disease

“…Recent small studies reporting the use of sildenafil after radical prostatectomy suggest that response to sildenafil is less impressive than in patients with mixed erectile dysfunction, with the response greater after bilateral nerve-sparing surgery (80 percent) than after unilateral (50 percent) or non-nerve-sparing surgery (0 percent). [8][9][10] Animal studies have shown that bilateral cavernous nerve transection ablates, whereas unilateral nerve sparing preserves, erectile function in the presence of sildenafil. 11 There is a theoretical explanation for this poor response after parasympathetic nerve damage (Fig.…”

“…[5][6][7] The response to sildenafil after radical prostatectomy in which cavernous nerve damage is causal is modest, ranging from 50 to 80 percent. [8][9][10] Animal studies have shown that bilateral cavernous nerve transection ablates erectile function despite the presence of sildenafil. 11 In the absence of a neural signal, sildenafil cannot induce cavernous smooth muscle relaxation and thus an erection.…”

Die nerverhaltende radikale retropubische Prostatektomie

“…B. mit Sildenafil, erfolgversprechend, da dieses Medikament die Erektion verbessern kann [9]. Insbesondere nach unilateraler Nerverhaltung verspricht eine additive Therapie unter den gegebenen Vorsichtsmaßnahmen bei dieser Form der Nerverhaltung einen Gewinn an Lebensqualität für den Patienten.…”

Cons�quences sexuelles potentielles dans la prise en charge th�rapeutique des cancers localis�s de prostate

“…Ces DE sont accessibles à 70 % des cas à un traitement pharmacologique de relance soit par voie orale soit par voie intracaverneuse [15,16]. Ce traitement pharmacologique peut conduire dans 20 % des cas à une guérison surtout chez les patients jeunes (moins de 60 ans) au statut érectile normal avant l'intervention, et ce d'autant qu'on aura pu leur proposer une intervention avec préservation bilatérale des bandelettes et un traitement des érections administré pré-cocement dans le post-opératoire, voire initialisé dans les semaines pré-opératoires [13,15,28].…”