Efficacy of Viagra After Prostatectomy

Radical prostatectomy is a leading cause of ED in men. The ED sets in due to neurogenic reasons  – post operative injury to the neurovascular nerve bundles around the prostate. Men with ED after radical retropubic prostatectomy have been observed in order to study how efficient and safe sildenafil is under those circumstances.

Clinical Study

In one of the prominent clinical studies – The patients were divided into 2 groups. One was the ‘experimental group’ and the other the control group’. The control group would not receive sildenafil and this fact was not disclosed to the patients. The other ‘experimental group received low dose sildenafil regularly.

This continued for many weeks and the patients in both groups were randomly evaluated after 36-52 weeks.  It came to light that 47% of the men in the ‘experimental group’ reported normal or close to normal erectile function while only 28% of the ‘control group’ (no sildenafil) reported normal erectile potency. When on-demand higher dose(50mg) sildenafil was introduced to both groups,  39% more men in the experimental group reported normal erectile function which meant that overall 86% achieved acceptable erectile function. When on-demand higher dose was introduced to the control group, additional 38% of men in that group showed normal erectile function to finish at overall 66%.

In other studies, it also came to light that the degree of nerve sparing was an important predictor for the response of sildenafil. When both nerves were not intact, a vast majority of men suffered from ED and even sildenafil proved rarely effective. It is also to be noted that the erectile function of men with atleast a single nerve bundle intact improved with time showing greater response to sildenafil with time.

Conclusion

Sildenafil(Viagra) exhibited good results in the treatment of erectile dysfunction in men post radical retropubic prostatectomy. Patients who were treated with long-term low dose sildenafil and later on switched to higher dose showed better response. Sildenafil did not show sufficient potency when both nerve bundles were damaged during prostatectomy.

 

References:
Montorsi F, Maga T, Strambi LF et al. Sildenafil taken at bedtime significantly increases nocturnal erections: results of a placebo-controlled study. Urology 2000; 20: 906–11


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