The Efficacy and Safety of Tadalafil 5 mg Once Daily in the Treatment of Erectile Dysfunction After Robot-Assisted Laparoscopic Radical Prostatectomy: 1-Year Follow-up

Abstract

PurposeTo evaluate the efficacy and safety of tadalafil 5 mg once daily use in the treatment of erectile dysfunction (ED) after robot-assisted laparoscopic radical prostatectomy (RALP).Materials and MethodsThe study retrospectively evaluated 92 patients who underwent RALP at Dong-A University Hospital. The patients were surveyed by use of the abridged five-item version of the International Index of Erectile Function (IIEF-5) questionnaire, which was self-administered before surgery and at 6 months and 1 year after surgery. The 92 patients were classified into the tadalafil group (n=47) and the non-tadalafil group (n=45). Each group was then classified depending on the nerve-sparing (NS) procedure used: bilateral NS or unilateral NS.ResultsAt 6 months, the total IIEF-5 scores of the tadalafil group and the non-tadalafil group were 10.0±3.4 and 7.0±4.0, respectively. At 1 year, the total IIEF-5 score in the tadalafil group was significantly greater than that in the non-tadalafil group (13.2±5.6 vs. 7.7±4.8, p<0.0001). Statistically significant improvements (p<0.05) were observed in the tadalafil group for all 5 domains of the IIEF-5 score, whereas in the non-tadalafil group there was no significant improvement in any of the domains at 1 year. The reported side effects were flushing (8.5%, n=4), headache (4.3%, n=2), and dizziness (2.1%, n=1).ConclusionsIn ED patients after NS RALP, a once-daily dose of tadalafil 5 mg was well tolerated and significantly improved EF compared with that in the non-tadalafil group.

Efficacy and safety of phosphodiesterase type 5 (PDE5) inhibitors in treating erectile dysfunction after bilateral nerve-sparing radical prostatectomy

“…Five articles lacked useful data. In all, six articles involving a total of 1678 patients (Montorsi et al ., , , ; Padma‐Nathan et al ., ; Mulhall et al ., ; Seo et al ., ), reporting data from a total of six RCTs, were included in the analysis: two RCTs compared PDE5 inhibitors (tadalafil 20 mg on demand and avanafil 100 mg on demand) with a placebo over the short term (≤6 months), and four RCTs compared PDE5 inhibitors (sildenafil 50 mg once daily, avanafil 10 mg nightly or 10 mg on demand and tadalafil 20 mg on demand or 5 mg once daily) with a placebo over the long term (9–12 months) (Fig. ).…”

Penile erection induces angiogenic, survival, and antifibrotic signals: molecular events associated with penile erection induced by cavernous nerve stimulation in mice

“…4,5 Recently, much attention has focused on penile rehabilitation through the use of oral phosphodiesterase type 5 inhibitors or intracavernous injection of vasoactive agents in patients with ED after radical prostatectomy, because the prolonged hypoxia resulting from the neurogenic elimination of nocturnal erections might lead to cavernous endothelial and smooth muscle apoptosis and fibrosis. 6,7 Daily sildenafil administration was reported to improve nocturnal penile tumescence and rigidity, and erectile function in men who underwent nerve-sparing radical prostatectomy for prostate cancer. 8 However, the exact molecular mechanisms by which the restoration of nocturnal penile erection affects erectile function remain unexplored.…”

Effects of tadalafil once daily or on demand versus placebo on time to recovery of erectile function in patients after bilateral nerve-sparing radical prostatectomy

“…For the long-acting PDE5-inhibitor tadalafil, an initial retrospective study in 92 patients showed that tadalafil OaD started early after robot-assisted laparoscopic nsRP was well tolerated and significantly improved EF compared to patients without PDE5-inhibitor treatment [ 14 ].…”