Recovery of Erectile Function After Nerve Sparing Radical Prostatectomy and Penile Rehabilitation With Nightly Intraurethral Alprostadil Versus Sildenafil Citrate
2010; Lippincott Williams & Wilkins; Volume: 183; Issue: 6 Linguagem: Inglês
10.1016/j.juro.2010.01.062
ISSN1527-3792
AutoresAndrew McCullough, Wayne J.G. Hellstrom, Run Wang, Herbert Lepor, Kristofer R. Wagner, Jason D. Engel,
Tópico(s)Genital Health and Disease
ResumoNo AccessJournal of UrologyInvestigative Urology1 Jun 2010Recovery of Erectile Function After Nerve Sparing Radical Prostatectomy and Penile Rehabilitation With Nightly Intraurethral Alprostadil Versus Sildenafil Citrate Andrew R. McCullough, Wayne G. Hellstrom, Run Wang, Herbert Lepor, Kristofer R. Wagner, and Jason D. Engel Andrew R. McCulloughAndrew R. McCullough , Wayne G. HellstromWayne G. Hellstrom , Run WangRun Wang , Herbert LeporHerbert Lepor , Kristofer R. WagnerKristofer R. Wagner , and Jason D. EngelJason D. Engel View All Author Informationhttps://doi.org/10.1016/j.juro.2010.01.062AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To our knowledge we report the first large, randomized, prospective penile rehabilitation clinical trial to compare the effectiveness of nightly intraurethral alprostadil vs sildenafil citrate after nerve sparing prostatectomy. Materials and Methods: We performed a prospective, randomized, open label, multicenter American study in men with normal erectile function who underwent bilateral nerve sparing radical prostatectomy. The International Index of Erectile Function erectile function domain was the primary end point. Subjects initiated nightly treatment within 1 month of surgery with intraurethral alprostadil or oral sildenafil citrate (50 mg) for 9 months. After 1-month washout and before sexual activity subjects self-administered sildenafil citrate (100 mg) for a total of 6 attempts in 1 month. Secondary end points were the global assessment question, sexual encounter profile, Erectile Dysfunction Inventory of Treatment Satisfaction and measured stretched penile length. Results: Of 139 men who started intraurethral alprostadil and 73 who started sildenafil citrate, 97 and 59, respectively, completed the trial. There were no statistically significant differences in International Index of Erectile Function erectile function domain and intercourse success rates to intraurethral alprostadil. The global assessment question was significantly better only at 6 months for intraurethral alprostadil (p <0.028). At completion there were no differences between treatments for any of the end points. Conclusions: This is the first study to directly compare the ability of alprostadil and a phosphodiesterase-5 inhibitor to enhance penile recovery subsequent to bilateral nerve sparing radical prostatectomy. The use of nightly subtherapeutic intraurethral alprostadil is well tolerated after radical prostatectomy. The benefit to return of erectile function of nightly sildenafil citrate and subtherapeutic intraurethral alprostadil appears to be comparable within the first year of surgery. 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Google Scholar Department of Urology, New York University School of Medicine, New York, New York, Division of Urology, University of Texas-Houston, Houston and Division of Urology, Department of Surgery, Texas A&M University, Temple, Texas, and Department of Urology, George Washington University, Washington, D.C© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited bySari Motlagh R, Abufaraj M, Yang L, Mori K, Pradere B, Laukhtina E, Mostafaei H, Schuettfort V, Quhal F, Montorsi F, Amjadi M, Gratzke C and Shariat S (2021) Penile Rehabilitation Strategy after Nerve Sparing Radical Prostatectomy: A Systematic Review and Network Meta-Analysis of Randomized TrialsJournal of Urology, VOL. 205, NO. 4, (1018-1030), Online publication date: 1-Apr-2021.Chiles K, Staff I, Johnson-Arbor K, Champagne A, McLaughlin T and Graydon R (2017) A Double-Blind, Randomized Trial on the Efficacy and Safety of Hyperbaric Oxygenation Therapy in the Preservation of Erectile Function after Radical ProstatectomyJournal of Urology, VOL. 199, NO. 3, (805-811), Online publication date: 1-Mar-2018.Zelefsky M, Shasha D, Branco R, Kollmeier M, Baser R, Pei X, Ennis R, Stock R, Bar-Chama N and Mulhall J (2014) Prophylactic Sildenafil Citrate Improves Select Aspects of Sexual Function in Men Treated with Radiotherapy for Prostate CancerJournal of Urology, VOL. 192, NO. 3, (868-874), Online publication date: 1-Sep-2014. Volume 183Issue 6June 2010Page: 2451-2456 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Keywordserectile dysfunctionpenisalprostadilprostatectomyrehabilitationMetricsAuthor Information Andrew R. McCullough Financial interest and/or other relationship with Vivus, Pfizer and Med Reviews. More articles by this author Wayne G. Hellstrom Financial interest and/or other relationship with American Medical Systems, Auxilium, Coloplast, Cook, GlaxoSmithKline/Schering Plough, Indevus, Johnson&Johnson, Medtronic, National Institute of Health, Plethora, Sanofi-Aventis, Solvay and Theralogix. More articles by this author Run Wang Financial interest and/or other relationship with American Medical Systems, Coloplast, Timm Medical, Augusta Medical and Vivus. More articles by this author Herbert Lepor Financial interest and/or other relationship with Watson, Aeterna-Zentaris, Med Reviews, Steba-Pharma, Serenity and USOHIFU. More articles by this author Kristofer R. Wagner Financial interest and/or other relationship with Vivus. More articles by this author Jason D. Engel More articles by this author Expand All Advertisement PDF downloadLoading ...
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