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Impact of penile rehabilitation with phosphodiesterase‐5 inhibitors on recovery of erectile function in patients undergoing robot‐assisted radical prostatectomy: A propensity score‐matched analysis
Author(s) -
Kimura Yusuke,
Honda Masashi,
Teraoka Shogo,
Yumioka Tetsuya,
Iwamoto Hideto,
Morizane Shuichi,
Hikita Katsuya,
Takenaka Atsushi
Publication year - 2021
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.14527
Subject(s) - medicine , prostatectomy , erectile dysfunction , tadalafil , urology , prostate cancer , rehabilitation , erectile function , propensity score matching , cgmp specific phosphodiesterase type 5 , sexual function , sildenafil , surgery , physical therapy , cancer
Objective To investigate the impact of penile rehabilitation on the recovery of erectile function after robot‐assisted radical prostatectomy. Methods Patients who underwent robot‐assisted radical prostatectomy in our department from 2010 to 2019 were included. For penile rehabilitation, a phosphodiesterase‐5 inhibitor (tadalafil 20 mg) was administered twice a week for 1–6 months postoperatively. The International Index of Erectile Function questionnaire (question 1 and erectile function domain) and the Expanded Prostate Cancer Index Composite questionnaire (sexual function) were used. Results After propensity score matching, there were 79 patients in the penile rehabilitation group and 79 patients in the non‐penile rehabilitation group. There was no significant difference in baseline characteristics between the two groups. Significantly higher scores were seen in the penile rehabilitation group compared with the non‐penile rehabilitation group at postoperative 3, 6 and 9 months in the International Index of Erectile Function questionnaire‐question 1, at 3, 6, 9 and 12 months in erectile function domain, and at 3, 6, 12 and 24 months in Expanded Prostate Cancer Index Composite questionnaire sexual function ( P < 0.05). There were significant improvements in the erectile recovery rate in the penile rehabilitation group compared with the non‐penile rehabilitation group in the nerve sparing ( P = 0.006) and partial nerve sparing ( P = 0.037) groups. Conclusions The present findings suggest that robot‐assisted radical prostatectomy patients who undergo not only nerve sparing, but also those who undergo patial nerve sparing could benefit from penile rehabilitation using a phosphodiesterase‐5 inhibitor.