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The impact of preoperative daily PDE5 inhibitors on the early recovery of erectile function following robot-assisted radical prostatectomy

Hisasue, S1; Takeuchi, H1; Ota, S1; Natsuyama, T1; Shiozawa, S1; Matsumoto, S1; Mitsui, Y2

1: Chiba-Nishi General Hospital, Japan; 2: Toho University, Japan

Objective; Preoperative erectile function is one of contributing factors for the recovery of erectile function (EF) following robot-assisted radical prostatectomy (RARP). PDE5-inhibitors hardly recover erectile function as a rehabilitation modality. We hypothesized that preoperative daily PDE5-inhibitor might enhance the functional recovery after RARP. We evaluated the EF in the patients with preoperative daily PDE5 inhibitor following RARP.

Material and Method; Of 91 pts who underwent RARP at Chiba-Nishi General Hospital between May 2016 and Aug 2017, we evaluated 34 patients who had preoperative erectile function with EHS 3 or 4, underwent nerve-sparing procedures (unilateral or bilateral), did not take androgen deprivation therapy, had observation period over 3 months, and took daily PDE5 inhibitors for their lower urinary tract symptoms before surgery.

Result(s); Median patients’ age was 69 years, median PSA level was 7.85ng/ml, median EHS was 3. Nerve-sparing procedures were done in 19 unilaterally, and 15 bilaterally. Preoperative daily tadalafil users were 11 and non-users were 23. Median EHS at 6 months following RARP was significantly higher in tadalafil-users than non-tadalafil-users (1.73 vs. 0.69, p=0.018; Student’s t-test).

Conclusions; This preliminary report showed preoperative PDE5 inhibitors may contribute to the early recovery of erectile function following RARP. Preoperative PDE5 inhibitors might become the new strategy for the ED rehabilitation following radical prostatectomy.


Work supported by industry: no.

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