Early experience on the effects of sildenafil citrate for treating erectile dysfunction after radical retropubic prostatectomy

Purpose: We assess the efficacy of using sildenafil for treating erectile dysfunction (ED) in Korean men after they had undergone radical retropubic prostatectomy for localized prostate cancer. Materials and methods: Between January 2002 and November 2004, 61 patients underwent RRP and post-operative sildenafil treatment for ED, and 50 patients were finally enrolled in this study. The subjects were divided into three groups according to the nerve sparing status (non-nerve sparing, unilateral nerve sparing and bilateral nerve sparing). Medication was initiated at 50mg, and if this was ineffective, then we added 50mg to the initial dosage. The patients were asked to fill out the self-administrated International Index of Erectile Function-5 (IIEF-5) for determining their response to sildenafil. Results: Of the 14 patients who underwent bilateral nerve sparing (NS) procedures, 4 (28%) had improved ability for intercourse. Of the 8 patients who underwent unilateral NS procedures, 2 (25%) had improved ability for intercourse. 1 of 28 patients who underwent non-NS procedures had a positive response. PDE5Is significantly improved the IIEF-5 (2.44 ± 1.89 vs 8.81 ± 8.24, respectively, p < 0.001). Two factors, i.e., age and preoperative sexual activity, correlated with the return of sexual function. No patient discontinued the drug because of side effects. Conclusions: For Korean men who have undergone bilateral and unilateral NS procedures, Sildenafil is effective for treating erectile dysfunction, and it may aid the recovery of erectile function after radical retropubic prostatectomy. However, non-NS procedure patients had less of a response to sildenafil. This study suggested that sildenafil is well tolerated and could be initially used for treating Korean men with erectile dysfunction after radical retropubic prostatectomy.