[Treatment of erectile dysfunction after nerve-preserving radical retropubic prostatectomy]

The aim of the study was evaluation of erectile function (EF) recovery and effects of PDE-5 inhibitor tadalafil in the treatment of erectile impairment one year after conduction of nerve-preserving retropubic radical prostatectomy (RRP). Thirty patients with intact EF before surgery who had RRP were divided into two groups. In 18 patients of group I vasculonervous fascicles (VNF) were preserved on both sides. A unilateral nerve-preserving technique was used in 12 patients of group 2. Tadalafil administration was started 3 months after operation in the dose 20 mg. In group I partial erection was observed in 11 patients, was absent in 33% (6 patients), a complete erection was in one (6%) patient. Thus, 67% (12 patients) could maintain erection sufficient for coitus. Out of 12 patients of group 2, a complete erection was achieved in none patients, partial erection was observed in 5 (42%) patients, erection did not occur in 7 (58%) patients. Thus, EF is better in patients with bilateral preservation of VNF than in unilateral one. Pharmacotherapy of erectile dysfunction after nerve-preserving RRP is most effective. It is desirable to adhere to early postoperative policy in the treatment of EF. PDE-5 inhibitors are rather effective if the patient has a partial erection. They fail in the absence of spontaneous erections. Early therapy prevents subsequent progression of erectile dysfunction.