Effects of Phosphodiesterase type 5 inhibitor on sexual and urinary functions after radical prostatectomy

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The effects of phosphodiesterase type 5 inhibitor (PDE5i) on recovery of sexual and urinary function (SUF) after radical prostatectomy were evaluated. Scores of SUF initially deteriorated to the lowest values soon after surgery and gradually improved thereafter. Patients taking PDE5i from a median of 3 months after surgery showed better recovery of SUF compared with patients taking no medication. What is interesting in the study was that the postoperative temporary deterioration in urinary continence was prominent in patients taking PDE5i immediately (the next day) after the surgery. Our basic research has revealed that PDE5i, tadalafil, dose-dependently attenuated the urethral continence reflex by relaxing the external urethral sphincter. So we concluded that PDE5i could contribute to recovery of SUF after radical prostatectomy. However, the likelihood of a temporary deterioration in urinary incontinence when PDE5i is administered immediately after surgery must be kept in mind.