Hong Sung Kyu, Han Byung Kyu, Jeong Seong Jin, Byun Seok-Soo, Lee Sang Eun
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
J Urol. 2007 Aug;178(2):613-6. doi: 10.1016/j.juro.2007.03.132. Epub 2007 Jun 13.
We prospectively investigated whether postoperative statin use would contribute to earlier recovery of erectile function in men who underwent bilateral nerve sparing radical retropubic prostatectomy for clinically localized prostate cancer.
A total of 50 potent men without hypercholesterolemia undergoing bilateral nerve sparing radical retropubic prostatectomy for clinically localized prostate cancer were prospectively randomized into 2 equal groups. Group 1 patients were instructed to ingest only 50 mg sildenafil per day if needed following hospital discharge after radical retropubic prostatectomy. Group 2 patients were prescribed atorvastatin at a dose of 10 mg daily from postoperative days 1 to 90 and they were also instructed to ingest sildenafil, as in group 1. Patient status regarding potency and adverse events were assessed 6 months after surgery.
The 2 groups demonstrated no significant differences regarding various baseline factors, including International Index of Erectile Function-5 scores. Group 2 had a significantly higher postoperative International Index of Erectile Function-5 score than group 1 at 6 months postoperatively (p = 0.003). Meanwhile, as judged by a preset definition, the incidence of potent patients 6 months after prostatectomy was 26.1% in group 1 and 55% in group 2 (p = 0.068). Also, 17.4% and 40% of the men reported achieving intercourse by vaginal penetration without a phosphodiesterase 5 inhibitor in groups 1 and 2, respectively (p = 0.172). No serious adverse events associated with medication were reported.
Postoperative treatment with atorvastatin in men who report normal erectile function preoperatively may contribute to earlier recovery of erectile function after nerve sparing radical retropubic prostatectomy.
我们前瞻性地研究了术后使用他汀类药物是否有助于接受双侧保留神经的耻骨后根治性前列腺切除术治疗临床局限性前列腺癌的男性患者勃起功能的早期恢复。
共有50名无高胆固醇血症且性功能正常的男性患者接受了双侧保留神经的耻骨后根治性前列腺切除术治疗临床局限性前列腺癌，他们被前瞻性地随机分为两组，每组人数相等。第1组患者在耻骨后根治性前列腺切除术后出院后，如有需要，仅被指示每天服用50毫克西地那非。第2组患者从术后第1天至90天每天服用10毫克阿托伐他汀，他们也被指示像第1组一样服用西地那非。在术后6个月评估患者的性功能状态和不良事件。
两组在包括国际勃起功能指数-5评分在内的各种基线因素方面无显著差异。术后6个月时，第2组的国际勃起功能指数-5评分显著高于第1组（p = 0.003）。同时，根据预先设定的定义判断，前列腺切除术后6个月时第1组性功能正常患者的发生率为26.1%，第2组为55%（p = 0.068）。此外，第1组和第2组分别有17.4%和40%的男性报告在未使用5型磷酸二酯酶抑制剂的情况下通过阴道插入实现性交（p = 0.172）。未报告与药物相关的严重不良事件。
术前勃起功能正常的男性患者术后使用阿托伐他汀治疗可能有助于双侧保留神经的耻骨后根治性前列腺切除术后勃起功能的早期恢复。
