Hirik Erkan, Bozkurt Aliseydi, Karabakan Mehmet, Onuk Özkan, Balcı Mustafa Bahadır Can, Aydın Memduh, Çakan Murat, Nuhoglu Barıs
Erzincan University Mengücek Gazi Education and Research Hospital, Urology Clinic.
Arch Ital Urol Androl. 2016 Mar 31;88(1):4-6. doi: 10.4081/aiua.2016.1.4.
To evaluate the effect of postoperatively administering a low daily dose of tadalafil on the erectile function of patients who underwent a nerve-sparing radical prostatectomy (NSRP) due to localized prostate cancer (PCa).
Of 138 patients, who underwent NSRP due to PCa between 2012 and 2014, 55 patients who had not had pre-operative erectile dysfunction (ED) were included in the study. The mean age of the patients was 64 (54-72). On the 15th day after surgery, after ultrasound evaluation, all 55 patients started on a daily dose of 5 mg tadalafil that was continued for 2.5 months. The erectile function of patients was evaluated pre-operatively, post-operatively, and at the 3rd and 6th month after surgery using the International Index of Erectile Function (IIEF-5) test. None of the patients was treated with hormonal therapy or radiotherapy before or after surgery.
Three patients were excluded from the study due to the adverse effects of tadalafil and two patients elected to discontinue the treatment. Of the remaining 50 patients whose pre-operative erectile function had been found normal, at 3 months after surgery, 36 (72%) had normal erectile function; of the remaining patients in the study six (12%) presented with mild, two (4%) with moderate, and six (12%) with severe ED. Six months after surgery, 35 patients (70%) had normal erectile function while seven (14%) had mild, three (6%) moderate and five (10%) severe ED. There was no statistically significant difference between the results obtained at the 3rd and 6th month follow-up (p > 0.05). Three patients reported adverse effects with tadalafil including flushes in 2 (3.6%) and a headache in 1 (1.8%).
The administration of a 5 mg post-operative dose of tadalafil to patients that had undergone a bilateral NSRP was found to have a positive effect on the recovery and maintenance of erectile function. However, there is still a need to investigate a larger series of cases.
评估术后每日低剂量服用他达拉非对因局限性前列腺癌（PCa）接受保留神经的根治性前列腺切除术（NSRP）患者勃起功能的影响。
在2012年至2014年间因PCa接受NSRP的138例患者中，纳入55例术前无勃起功能障碍（ED）的患者。患者的平均年龄为64岁（54 - 72岁）。术后第15天，经超声评估后，所有55例患者开始每日服用5毫克他达拉非，并持续2.5个月。使用国际勃起功能指数（IIEF - 5）测试在术前、术后以及术后第3个月和第6个月对患者的勃起功能进行评估。所有患者在手术前后均未接受激素治疗或放射治疗。
3例患者因他达拉非的不良反应被排除在研究之外，2例患者选择停止治疗。在其余50例术前勃起功能正常的患者中，术后3个月时，36例（72%）勃起功能正常；研究中的其余患者中，6例（12%）表现为轻度勃起功能障碍，2例（4%）为中度，6例（12%）为重度。术后6个月时，35例（70%）患者勃起功能正常，7例（14%）为轻度，3例（6%）为中度，5例（10%）为重度。在第3个月和第6个月随访结果之间无统计学显著差异（p > 0.05）。3例患者报告了他达拉非的不良反应，包括2例（3.6%）出现潮红和1例（1.8%）出现头痛。
对接受双侧NSRP的患者术后给予5毫克剂量的他达拉非被发现对勃起功能的恢复和维持有积极作用。然而，仍需要对更大系列的病例进行研究。
