Vol. 43 (3): 385-389, May – June, 2017
DIFFERENCE OF OPINION
Laith M. Alzweri 1, Arthur L. Burnett 1
1 The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD, USA
Keywords: Phosphodiesterase 5 Inhibitors; Erectile Dysfunction; Penile Erection; Prostatectomy
Despite significant improvement in surgical techniques of radical prostatectomy (RP) since the nerve-sparing approach was introduced in 1982 (1), erectile dysfunction (ED) post RP remains a challenge for patients and urologists (2). Although most patients experience some degree of ED post RP, erectile function recovery rates vary according to age, baseline erectile function, comorbidities, and extent of nerve-sparing techniques (3, 4). The concept of penile rehabilitation has been evolving over the last two decades, in parallel with a better understanding of the basic scientific basis for ED post RP. In a recent systematic review of 11 randomized, controlled clinical trials (RCTs) on erection rehabilitation post RP in general, there was no significant improvement in spontaneous erectile function (unassisted by erection aids) rate of 20-25%. This rate was obtained from data in the control arm of trials after nerve sparing radical prostatectomy (NSRP) over the last two decades (5).