Recovery of erectile function after nerve-sparing radical prostatectomy:: improvement with nightly low-dose sildenafil
Recovery of erectile function after nerve-sparing radical prostatectomy:: improvement with nightly low-dose sildenafil
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DOI：
10.1111/j.1464-410x.2008.07515.x
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发表时间：
2008-05-01
影响因子：
4.5
通讯作者：
Juenemann, Kalus-Peter
中科院分区：
文献类型：
--
作者：
Bannowsky, Andreas;Schulze, Heiko;Juenemann, Kalus-Peter
目的评价小剂量西地那非在保留神经的前列腺癌根治术(NSRP)后对勃起功能恢复的效果，目前对NSRP后勃起功能恢复的延迟仍有争议。患者和方法43例性活跃患者有NSRP；在术后7-14天，他们进行了Rigiscan(R)(明尼阿波利斯，明尼阿波利斯，明尼苏达州，美国)的夜间阴茎肿胀和僵硬(NPTR)测量。为支持勃起功能的恢复，23例有夜间勃起障碍的患者在夜间服用西地那非25 mg/日。对照组18名患者随后接受了随访，但没有使用磷酸二酯酶-5抑制剂。分别于拔管后6周、12周、24周、36周、52周完成国际勃起功能指数(IIEF-5)问卷调查。结果43例患者中，41例(95%)在拔管后第一晚勃起1~5次。在每日使用西地那非的组中，IIEF-5平均评分从NSRP前的20.8分下降到NSRP后6、12、24、36和52周的3.6、3.8、5.9、9.6和14.1。对照组分别为21.2分、2.4分、3.8分、5.3分、6.4分和9.3分。两组间勃起功能恢复时间和勃起功能评分差异有统计学意义(P<；0.001)，勃起功能恢复的有效率分别为86%和66%。在早期勃起的情况下，每天小剂量的西地那非能显著改善勃起功能的恢复。
OBJECTIVETo evaluate the effect of low-dose sildenafil for rehabilitating erectile function after nerve-sparing radical prostatectomy (NSRP), as the delay to recovery of erectile function after NSRP remains under debate.PATIENTS AND METHODSForty-three sexually active patients had a NSRP; at 7-14 days after surgery they had a Rigiscan (R) (Dacomed Corporation, Minneapolis, MN, USA) measurement of nocturnal penile tumescence and rigidity (NPTR). To support the recovery of spontaneous erectile function, 23 patients with preserved nocturnal erections received sildenafil 25 mg/day at night. A control group of 18 patients were then followed but had no phosphodiesterase-5 inhibitors. The International Index of Erectile Function (IIEF)-5 questionnaire was completed 6, 12, 24, 36 and 52 weeks after NSRP.RESULTSOf the 43 patients, 41 (95%) had one to five erections during the first night after catheter removal. In the group using daily sildenafil the mean IIEF-5 score decreased from 20.8 before NSRP to 3.6, 3.8, 5.9, 9.6 and 14.1 at 6, 12, 24, 36 and 52 weeks after NSRP, respectively. In the control group the respective scores were 21.2, decreasing to 2.4, 3.8, 5.3, 6.4 and 9.3. There was a significant difference in IIEF-5 score and time to recovery of erectile function between the groups (P < 0.001), with potency rates of 86% vs 66%.CONCLUSIONThe measurement of NPTR after NSRP showed erectile function even the 'first' night after catheter removal. In cases of early penile erection, daily low-dose sildenafil leads to a significant improvement in the recovery of erectile function.