Premium
Psychotherapy and phosphodiesterase‐5 inhibitor in early rehabilitation after radical prostatectomy: a prospective randomised controlled trial
Author(s) -
Naccarato A. M. E. P.,
Reis L. O.,
Ferreira U.,
Denardi F.
Publication year - 2016
Publication title -
andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.633
H-Index - 59
eISSN - 1439-0272
pISSN - 0303-4569
DOI - 10.1111/and.12557
Subject(s) - medicine , prostatectomy , quality of life (healthcare) , prostate cancer , erectile dysfunction , randomized controlled trial , urology , rehabilitation , cgmp specific phosphodiesterase type 5 , patient satisfaction , sexual function , physical therapy , surgery , cancer , nursing
Summary The aim of this study was to evaluate the impact of group psychotherapy and the use of a phosphodiesterase‐5 inhibitor ( PDE ‐5i) in the early rehabilitation stage of patients with prostate cancer undergoing radical prostatectomy ( RP ). Fifty‐six patients undergoing RP for prostate cancer were randomised into four groups, and 53 completed the protocol: Group 1 – control ( n = 11), Group 2 – group psychotherapy ( n = 16), Group 3 – lodenafil 80 mg/one tablet per week ( n = 12) and Group 4 – group psychotherapy + lodenafil 80 mg/one tablet per week ( n = 14). The groups were individually evaluated for erectile function ( IIEF ‐5) and quality of life – QoL ( SF ‐36) weekly, with two meetings held a week apart before the RP and 12 weekly meetings after surgery. The ages ranged from 39 to 76 years, average 61.84. There were no significant medication side effects. Only Group 4 showed improvement in intimacy with a partner and satisfaction with their sex life ( P = 0.045 and P = 0.013 respectively), and with no significant worsening of the IIEF ‐5 ( P = 0.250) reported. All groups showed worsening in the final result of the role limitations caused by physical problems ( P = 0.009) and role limitations caused by emotional problems ( P = 0.002) of the SF ‐36, but Group 4 had a significantly higher score for the role limitations caused by physical problems ( P = 0.009) than the other groups. In conclusion, precocious integral treatment involving group psychotherapy and PDE ‐5i before and after RP led to less deterioration of erectile function and other domains related to physical aspects ( SF ‐36), with improvement in intimacy with their partner and satisfaction in their sex life, being superior to single treatments.