童綜合醫院 外科部 泌尿科
Effect of tadalafil once daily on erectile function in patients after robotic assisted radical prostatectomy with bilateral nerve sparing
I-Yen Lee, Yen-Chuan Ou, Min-Che Tung, Chao-Yu Hsu, Jue-Hawn Yin, Wei-Chun Weng, Li-Hua Huang, Zhon-Min Huang
Divisions of Urology, Department of Surgery, Tungs’ Taichung MetroHarbor Hospital, Taichung, Taiwan
Purpose: The erectile function post nerve-sparing radical prostatectomy remains a problem to resolve. We measured the erectile function in patients who using Tadalafil 5 mg once daily for 6 months after receiving nerve-sparing radical prostatectomy.
Materials and Methods: A total of 69 patients less than 70 years of age who had adenocarcinoma of prostate with normal preoperative EF undergoing nerve-sparing Robotic assisted radical prostatectomy were included in our trial. They used Tadalafil 5mg once daily for 6 months after surgery. The “Internal Index of Erectile Function-Erectile Function domain (IIEF-EF)” score was used to measure the erectile function in patients who took tadalafil 5 mg once daily for 6 months after receiving bilateral or unilateral nerve-sparing robotic assisted radical prostatectomy. The baseline of IIEF score before and after prostatectomy was recorded.
Results: After using Tadalafil 5mg once daily for 6 months, 48 patients (69.6%) had higher or equal IIEF score than preoperative evaluation. However, 21 patients (30.4%) had lower IIEF score than preoperative score. Twenty-four (35%) patients had complaint of flank soreness but the symptom mostly alleviating after 5 weeks usage. One patient could not tolerate the side effect of insomnia after 2 months of tadalafil usage and was excluded in this trial.
Conclusions: Phosphodiesterase 5 inhibitor (tadalafil 5 mg) is safe and tolerable in patients who receive bilateral or unilateral nerve-sparing robotic assisted radical prostatectomy. Tadalafil 5 mg once daily was proven to be effective in restoring erectile function and was suggested to use in patients after radical prostatectomy. The effect after cessation of tadalafil 5 mg once daily need to be evaluated in the future.