Erectile dysfunction post radical cystectomy. The role of early rehabilitation with pharmacotherapy in nerve sparing and non-nerve sparing group: A randomized, clinical trial

  • Mohamad Moussa Head of Urology department ,Zahraa Hospital, University Medical Center,Beirut ,Lebanon, Lebanon.
  • Athanasios Papatsoris 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece., Greece.
  • Mohamad Abou Chakra | mohamedabouchakra@hotmail.com Urology department, Lebanese Univeristy, Lebanon.
  • Athanasios Dellis Department of Urology/General Surgery, Areteion Hospital, Athens, Greece, Greece.

Abstract

Objectives: No clinical studies testing erectile function (EF) post radical cystectomy (RC) were done. Our objective was to assess the effect of early pharmacologic therapy after RC using intracorporeal injection (ICI), phosphodiesterase inhibitor (PDE5i) and PDE5i+ICI.
Materials and Methods: In our randomized, double-blinded study, we prospectively enrolled 160 potent male patients with invasive bladder cancer. Patients were operated by RC using the nerve-sparing (NS) or non-nerve sparing (NNS) technique. They were treated since 1 month postoperatively by different regimens (PDE5i vs. ICI vs. ICI+PDE5i). Patients were evaluated using the international index of erectile function questionnaire and were followed up regularly at 1, 3, 6, and 12 months using the same parameters.
Results: One month after therapy, the mean of EF domain improved in both NS and NNS group. In the NNS group, in patients treated with ICI alone and ICI+PDE5i, the EF domain at 12 months moved to the moderate and to the mild category respectively. In patients treated by the NS approach, the mean value remained in the mild category with or without therapy.
Conclusions: Early pharmacotherapy since one-month post RC using ICI and a combination of ICI+PDE5i can improve the erectile function of patients operated with a NNS approach.

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Published
2021-03-18
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Issue
Section
Original Papers - Oncology
Keywords:
Erectile dysfunction, Early rehabilitation, Radical cystectomy, Nerve-sparing; Non nerve-sparing
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How to Cite
Moussa, M., Papatsoris, A., Abou Chakra, M., & Dellis, A. (2021). Erectile dysfunction post radical cystectomy. The role of early rehabilitation with pharmacotherapy in nerve sparing and non-nerve sparing group: A randomized, clinical trial. Archivio Italiano Di Urologia E Andrologia, 93(1), 58-64. https://doi.org/10.4081/aiua.2021.1.58