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Penile rehabilitation for postprostatectomy erectile dysfunction.

Yiannis A Philippou1, Jae Hung Jung, Martin J Steggall

  • 1Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headington, Oxford, UK, OX39DU.

The Cochrane Database of Systematic Reviews
|October 24, 2018
PubMed
Summary
This summary is machine-generated.

Penile rehabilitation using scheduled phosphodiesterase type 5 inhibitors (PDE5I) after prostatectomy may not improve erectile function compared to on-demand use. Evidence quality is low, indicating uncertainty in these findings for erectile dysfunction recovery.

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Area of Science:

  • Urology
  • Oncology
  • Sexual Medicine

Background:

  • Erectile dysfunction is a common complication following radical prostatectomy, despite nerve-sparing surgical techniques.
  • Postoperative penile rehabilitation aims to restore erectile function, but existing evidence is conflicting.

Purpose of the Study:

  • To evaluate the efficacy of various penile rehabilitation strategies in restoring erectile function after radical prostatectomy for prostate cancer.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases and clinical trial registries.
  • Included were randomized or quasi-randomized trials with parallel or cross-over designs.
  • Primary outcomes included self-reported potency, validated erectile function questionnaires, and serious adverse events.

Main Results:

  • Scheduled phosphodiesterase type 5 inhibitors (PDE5I) showed little to no significant effect on short-term or long-term self-reported potency or erectile function compared to placebo or on-demand use.
  • Evidence quality for most outcomes was very low, leading to significant uncertainty in the findings.
  • Scheduled PDE5I may result in fewer serious adverse events than placebo, but this finding is uncertain and potentially coincidental.

Conclusions:

  • Penile rehabilitation strategies using scheduled PDE5I following radical prostatectomy may not offer significant advantages over on-demand use for improving erectile function.
  • The current evidence, primarily of very low quality, suggests limited benefit from scheduled PDE5I in this context.